Dark chocolate: a real but small effect on cholesterol and blood pressure

Dark chocolate has been tested in many randomized trials. A meta-analysis pooled 31 randomized trials with 1986 adults eating cocoa or dark chocolate of 70 percent cocoa or more for at least 4 weeks. LDL cholesterol fell by 9.47 mg/dL (95% CI 5.20 to 13.75) and systolic pressure by 2.52 mmHg (95% CI 0.88 to 4.17). That analysis pooled cocoa extract with chocolate, so part of the effect comes from a product you cannot buy as a bar. A second meta-analysis of 17 trials with 615 people found regular dark chocolate raised flow-mediated dilation, a measure of how well arteries widen, by 0.69 percentage points. The weight worry is also tested. Across 35 randomized trials, cocoa or dark chocolate did not change body weight, a pooled difference of 0.24 lb (0.108 kg) that did not reach significance. The biggest trial did not use chocolate at all. In COSMOS, 21,442 older US adults took cocoa extract capsules with 500 mg flavanols a day, and total cardiovascular events over 3.6 years did not fall significantly (HR 0.90, 95% CI 0.78 to 1.02).

The numbers, per 3.5 oz (100 g)

How much is actually in it

• Across USDA dark chocolate records from 45% to 85% cacao, copper ranges from 1.03 to 1.77 mg and fat from 31.3 to 42.6 g per 3.5 oz (100 g). — 3 SR Legacy records by cacao band (n = 3 records) Evidence E source
  Copper 1.028-1.766 mg; saturated fat 18.519-24.489 g; fat 31.28-42.63 g per 3.5 oz (100 g); 60-69% record: copper 1.248 mg (139% DV)

What a real portion looks like

• US survey portions put one piece of dark chocolate at 8 g, a snack size at 15 g and a regular bar at 45 g. — FNDDS portion weights (n = -) Evidence E source
  Piece 8 g, bite size 10 g, snack size 15 g, regular 45 g, king size 90 g

What your body absorbs

• In a crossover trial in 6 people, epicatechin absorption was similar across dark chocolate recipes, while cocoa drinks gave higher peaks of 42 to 43 nM. — Six subjects, single servings of chocolate confections and cocoa beverages, serum sampled over 6 h (n = 6) Evidence B source
  AUC similar among chocolate matrices; Cmax beverages 42-43 nM vs 32 nM dark chocolate
• In a crossover trial in 20 men aged 40 to 80, 2.5 oz (70 g) of dark chocolate improved flow-mediated dilation by 0.96% after 2 hours, with epicatechin absorbed as well as from pure capsules. — Healthy men aged 40-80, single dose of 70 g dark chocolate (150 mg epicatechin) (n = 20) Evidence B source
  FMD +0.96% (p = 0.04); AIx -4.6% (p = 0.02); epicatechin bioavailability not different (p = 0.14)

What cooking and storage change

• No study in the corpus measures how cocoa processing such as alkalization or roasting changes flavanols in dark chocolate eaten by people, and US 21 CFR holds no claim for dark chocolate. — PubMed corpus and USDA R6 (n = 0) Evidence E source
  No studies found

What it does to your health

• In a meta-analysis of 31 randomized trials with 1986 adults, cocoa or 70% plus dark chocolate for at least 4 weeks lowered LDL cholesterol by 9.47 mg/dL and systolic pressure by 2.52 mmHg. — Adults with and without comorbidities, cocoa extract or dark chocolate of 70% cocoa or more, 4 weeks or longer (n = 1986) Evidence A source
  LDL-c -9.47 mg/dL (95% CI -13.75 to -5.20); SBP -2.52 mmHg (95% CI -4.17 to -0.88); no effect on body weight or HbA1c
• In a meta-analysis of 17 randomized trials with 615 people, regular dark chocolate raised flow-mediated dilation by 0.69 percentage points. — Participants of randomized trials of chronic dark chocolate intake (n = 615) Evidence A source
  FMD +0.69 (95% CI 0.22-1.16); I2 64.2% for pooled analysis
• A meta-analysis of 64 controlled feeding trials found that dark chocolate added to the diet lowered IL-6, while most sugar sources had no effect on inflammation. — Mostly healthy adults, 64 controlled feeding trials of fructose-containing sugar sources, median 6 weeks (n = 4094) Evidence A source
  Dark chocolate in addition trials decreased IL-6; certainty moderate to low
• In a crossover trial in 30 adults, small-letter contrast sensitivity was 0.15 logCS higher 1.75 hours after a dark chocolate bar than after milk chocolate. — Adults without eye disease, mean age 26, one bar per session (n = 30) Evidence B source
  +0.15 logCS (95% CI 0.08-0.22); visual acuity +0.04 logMAR
• A 2019 dose-response meta-analysis of 35 RCTs found cocoa or dark chocolate did not change body weight (-0.24 lb / -0.11 kg), BMI or waist circumference. — participants in randomized clinical trials of cocoa or dark chocolate reporting weight, BMI or waist circumference, to December 2017 (n = 35 RCTs) Evidence A source
  Body weight -0.24 lb (95% CI -0.58 to 0.1; P = 0.168; metric: -0.108 kg, -0.262 to 0.046); BMI -0.014 kg/m2 (NS); waist +0.01 in (0.025 cm) (NS)
• A 2024 meta-analysis of 31 RCTs with 1986 adults eating cocoa extract or dark chocolate of at least 70% for 4 weeks or more found no effect on weight, BMI or waist. — adults with and without comorbidities in RCTs of cocoa extract or >=70% cocoa dark chocolate for >=4 weeks (n = 31 studies, 1986 participants) Evidence A source
  No effect on body weight, BMI or waist circumference; total cholesterol -8.35 mg/dL, LDL -9.47 mg/dL, SBP -2.52 mmHg
• In the full text of that meta-analysis, cocoa did not change total body mass in 11 studies (612 people), even in subgroup analysis. — adults in RCTs of cocoa reporting total body mass (11 studies) or BMI (15 studies) (n = 11 studies, 612 participants (body mass); 15 studies, 755 (BMI)) Evidence A source
  Body mass and BMI unchanged, also in subgroup analyses; abdominal circumference -1.5 in (-3.93 cm) in 3 studies (n = 174)
• In a 2026 cross-sectional study of 1960 Spanish adults, both dark and milk chocolate eaters had lower BMI, and dark chocolate went with higher LDL. — adults from the SALMANTICOR population-based cohort, chocolate type and frequency of intake (n = 1960) Evidence C source
  Dark and milk chocolate consumption associated with lower BMI; dark chocolate associated with higher LDL cholesterol

Safety, limits and interactions

• In calcium kidney stone formers, 3 days of dark chocolate with 94 mg oxalate raised urinary oxalate by about 20%, unlike milk chocolate with more calcium. — Calcium stone-forming patients randomized to milk (n=28) or dark (n=30) chocolate for 3 days (n = 58) Evidence B source
  Urinary oxalate 30 to 36 mg/24 h with dark chocolate; no rise with milk chocolate
• In young healthy women, a single dose of 85% dark chocolate raised resting systolic pressure by 5.1% after 2 hours compared with milk chocolate. — Young healthy women, 1 g chocolate per kg body weight, measured 2 h later (n = not stated in abstract) Evidence B source
  Systolic BP +5.1% vs -2.4% after milk chocolate (p < 0.04)
• A case report confirms that true IgE-mediated cocoa allergy exists but is rare, with anaphylaxis to a dark chocolate bar in a 2-year-old. — One 2-year-old girl with tree nut anaphylaxis history (n = 1) Evidence D source
  Positive oral challenge with dark chocolate, multisystem reaction
• Laboratory testing after a severe reaction found undeclared milk protein in dark chocolate at levels that could trigger reactions in up to 68% of milk-allergic adults. — Complaint sample plus dark chocolate products of other batches and brands (n = -) Evidence D source
  Up to 68% of adult milk-allergic consumers could react
• Laboratory testing of 72 US dark chocolate and cocoa products found 43% exceeded California Prop 65 lead limits per serving, though 70 of 72 were under FDA lead reference levels. — 72 consumer cocoa products bought in 2014, 2016, 2019 and 2022 (n = 72) Evidence D source
  43% over Prop 65 for lead, 35% for cadmium, 0% for arsenic; organic products higher in Cd and Pb
• In calcium kidney stone formers, 3 days of dark chocolate raised urinary oxalate from 30 to 36 mg a day, which milk chocolate did not. — calcium stone-forming patients randomized to milk (n = 28) or dark (n = 30) chocolate for 3 days (n = 58) Evidence B source
  Urinary oxalate 36 +/- 14 vs 30 +/- 10 mg/24 h with dark chocolate; no rise with milk chocolate
• Testing of 72 US dark chocolate and cocoa products found 43% exceeded California Prop 65 lead limits per serving, while 70 of 72 were under FDA lead reference levels. — 72 consumer dark chocolate and cocoa products bought over 2014-2022 (n = 72 products) Evidence D source
  43% over Prop 65 MADL for lead, 35% for cadmium, 0% for arsenic; 97.2% below FDA interim reference level for lead

What people believe that the data does not support

• In a meta-analysis of 35 randomized trials, cocoa or dark chocolate did not change body weight, with a pooled difference of -0.24 lb (-0.108 kg). — Participants of 35 RCTs of cocoa or dark chocolate (n = 35 trials) Evidence A source
  Body weight -0.24 lb (95% CI -0.58 to 0.1; metric: -0.108 kg, -0.262 to 0.046); BMI -0.014 kg/m2
• The EU did not authorize the claim that polyphenols in dark chocolate protect body cells against free radicals. — EU health claims register (n = -) Evidence E source
  Claim non-authorized

Who this works differently for

• In a cluster randomized school trial in 194 children aged 10 to 12, 7 g of dark chocolate a day for 7 weeks did not lower blood pressure. — Children aged 10-12, randomized by class (n = 194) Evidence B source
  Systolic difference 1.7 mm Hg (95% CI -0.6 to 4.1); diastolic -1.2 mm Hg (95% CI -3.6 to 1.3)
• In a randomized trial in 100 adults aged 65 to 75, 1.8 oz (50 g) of high-flavanol dark chocolate a day for 8 weeks did not improve cognition compared with low-flavanol chocolate. — Cognitively healthy older adults, 50 g/day dark chocolate with 410 vs 86 mg flavanols, 8 weeks (n = 100) Evidence B source
  No between-group difference in Trail Making Test A (p = 0.93) or B (p = 0.66); no change in lipids, glucose or weight
• In a 6-month RCT in 132 postmenopausal women, 10 g a day of 99% cocoa chocolate lowered body fat by 1.4 lb (0.63 kg) without changing weight. — postmenopausal women (57.2 years) adding 10 g/day of 99% cocoa chocolate (59 calories, 65.4 mg polyphenols) to their habitual diet vs no intervention (n = 132) Evidence B source
  Body fat mass -1.4 lb (95% CI -2.5 to -0.24; metric: -0.63 kg, -1.15 to -0.11); body fat -0.79%; BMI -0.20 kg/m2 (95% CI -0.44 to 0.03, NS); weight unchanged
• In a 2-week RCT in 19 postmenopausal women, 3.5 oz (100 g) of chocolate a day cut other eating by 150 to 300 calories but did not offset its own 542 calories. — postmenopausal females eating 3.5 oz (100 g) of chocolate in the morning, in the evening/at night, or none for 2 weeks, other food ad libitum (n = 19) Evidence B source
  Ad libitum intake -300 calories/day (morning) and -150 calories/day (evening) vs 542 calories/day from chocolate; body weight did not increase over 14 days
• In a 10-week placebo-controlled trial in endurance athletes, 5 g of flavanol-rich cocoa powder a day lowered body fat percentage. — training endurance athletes receiving 5 g cocoa (425 mg flavanols) daily for 10 weeks vs placebo Evidence B source
  Body fat percentage reduced (p = 0.020), trunk (p = 0.022), visceral area (p = 0.034); no change in performance

What is still unknown

• In the COSMOS trial of 21,442 older adults, a cocoa extract with 500 mg flavanols a day did not significantly cut total cardiovascular events over 3.6 years (HR 0.90). — US women aged 65 or older and men aged 60 or older free of major CVD, median 3.6 years (n = 21442) Evidence B source
  Total CVD HR 0.90 (95% CI 0.78-1.02); CVD death HR 0.73 (95% CI 0.54-0.98)
• In the same meta-analysis, weight and BMI fell only in a subgroup of trials giving at least 1.1 oz (30 g) of chocolate a day for 4 to 8 weeks. — subgroup of RCTs with cocoa or dark chocolate doses of 30 g/day or more and durations of 4 to 8 weeks (n = subgroup of 35 RCTs) Evidence A source
  Significant reduction of weight and BMI in the >=30 g/day, 4-8 week subgroup; size not given in abstract
• In the ARIC cohort of 15,732 US adults, eating chocolate at least weekly went with a BMI gain 0.39 higher over six years than eating it less than monthly. — Atherosclerosis Risk in Communities cohort participants reporting usual frequency of a 1-oz (~28 g) chocolate serving (n = 15,732 at the first visit, 12,830 at the second) Evidence C source
  BMI +0.26 (95% CI 0.08 to 0.44) at 1-4 times/month and +0.39 (0.23 to 0.55) at weekly or more vs less than monthly, over 6 years

The bottom line

What you get per bar depends on the cacao percentage. Across three USDA records from 45 to 85 percent cacao, fat runs from 31.3 to 42.6 g and copper from 1.03 to 1.77 mg per 3.5 oz (100 g). US survey portions put one piece at 8 g, a snack size at 15 g and a regular bar at 45 g. Absorption looks similar across ordinary products. In a crossover trial in only 6 people, epicatechin absorption was similar across chocolate recipes, and cocoa drinks reached higher peaks, 42 to 43 nM against 32 nM. In 20 healthy men aged 40 to 80, a single 70 g dose improved flow-mediated dilation by 0.96 percent after 2 hours, with epicatechin absorbed as well as from pure capsules. We found no study of how alkalization or roasting changes the flavanols in chocolate people actually eat. Some hopes did not hold up. In 100 healthy adults aged 65 to 75, 50 g a day of high-flavanol dark chocolate for 8 weeks did not improve cognition compared with low-flavanol dark chocolate. In a school trial in 194 children aged 10 to 12, 7 g a day for 7 weeks did not lower blood pressure. The EU did not authorize the claim that the polyphenols in dark chocolate protect body cells against free radicals. A 64-trial meta-analysis of sugar sources found dark chocolate added to the diet lowered the inflammation marker IL-6, with moderate to low certainty and no effect size given in the abstract. In a crossover trial in 30 adults without eye disease, small-letter contrast sensitivity was 0.15 logCS higher after a dark bar than after milk chocolate, an acute lab result. Several groups should be careful. In a randomized trial in 58 calcium kidney stone formers, 3 days of dark chocolate raised urinary oxalate from 30 to 36 mg a day, while milk chocolate caused no rise. That was a short load test, and stones themselves were not measured. People allergic to milk should know that laboratory testing after one severe reaction found undeclared milk protein in European dark chocolate at levels that could trigger up to 68 percent of milk-allergic adults. True allergy to cocoa itself is rare, and one case report describes anaphylaxis to a dark chocolate bar in a 2-year-old with a tree nut allergy history. In young healthy women, a single 85 percent bar at 1 g per kg raised resting systolic pressure by 5.1 percent after 2 hours against milk chocolate, a short acute effect in a trial whose abstract does not give its size. Heavy metals are the other caution. Laboratory testing of 72 US dark chocolate and cocoa products found 43 percent exceeded California Prop 65 lead limits per serving and 35 percent exceeded them for cadmium, while 70 of 72 stayed under FDA lead reference levels. Prop 65 limits are much stricter than the FDA reference levels, which is why the two counts differ so widely. Organic products came out higher in both metals.

Sources

1. dkc-r8-17 · dataset
   USDA FDC SR Legacy Chocolate, dark, 60-69% cacao solids (FDC 170272): copper 1.248 mg, saturated fat 22.031 g, fat 38.31 g per 100 g; range over 3 records (45-59%, 60-69%, 70-85%): copper 1.028-1.766 mg, saturated fat 18.519-24.489 g, fat 31.28-42.63 g
   USDA FoodData Central, SR Legacy (2018), dark chocolate 45-59%, 60-69%, 70-85% cacao · checked 2026-09-29
2. dkc-r8-18 · dataset
   FNDDS 91705300 Dark chocolate candy: 1 piece 8 g; 1 miniature/bite size 10 g; 1 fun/snack size 15 g; 1 pouch/regular size 45 g; 1 large/king size 90 g; Quantity not specified 45 g
   USDA FNDDS 2021-2023, food code 91705300 (fdc_id 2710336) · checked 2026-09-29
3. dkc-r8-06 · RCT (crossover)
   These data suggest that bioavailability of cocoa flavan-3-ols is likely similar from typical commercial cocoa based foods and beverages, but that the physical form and sucrose content may influence T(MAX) and C(MAX).
   J Agric Food Chem, 2009 · checked 2026-09-29
4. dkc-r8-07 · RCT (crossover)
   Dark chocolate significantly improved FMD (+0.96%; p = 0.04) and AIx (-4.6%; p = 0.02).
   Mol Nutr Food Res, 2016 · checked 2026-09-29
5. dkc-r8-19 · search result
   corpus_search.py (cocoa OR chocolate) AND (alkalization OR alkalized OR Dutch OR roasting OR fermentation) AND flavanol*: found 1 (29299877, exercise review); retention_search.py dark chocolate: no method; claims_search.py dark chocolate: nothing in 21 CFR 101
   Bioma corpus search log, PubMed snapshot 469217, 2026-09-29 · checked 2026-09-29
6. dkc-r8-01 · meta-analysis of RCTs
   Yet, there was a reduction in total cholesterol (-8.35 mg/dL, 95% CI -14.01; -2.69 mg/dL), LDL-c (-9.47 mg/dL, 95% CI -13.75; -5.20 mg/dL), fasting blood glucose (-4.91 mg/dL, 95% CI -8.29; -1.52 mg/dL), SBP (-2.52 mmHg, 95% CI -4.17; -0.88 mmHg), and DBP (-1.58 mmHg, 95% CI -2.54; -0.62 mmHg).
   Nutrients, 2024 · checked 2026-09-29
7. dkc-r8-02 · meta-analysis of RCTs
   Chronic consumption of dark chocolate and flavan-3-ols both increased FMD (0.69, 95% CI 0.22-1.16, p < 0.001, 1.16, 95% CI 0.52-1.80 p = 0.001, respectively).
   Clin Nutr ESPEN, 2020 · checked 2026-09-29
8. dkc-r8-04 · meta-analysis of controlled trials
   and addition trials (fruit decreased CRP and TNF-α; sweets and desserts (dark chocolate) decreased IL-6)
   Nutrients, 2022 · checked 2026-09-29
9. dkc-r8-12 · RCT (crossover)
   small-letter contrast sensitivity was significantly higher after consumption of dark chocolate (mean [SE], 1.45 [0.04] logCS) vs milk chocolate (mean [SE], 1.30 [0.05] logCS; mean improvement, 0.15 logCS [95% CI, 0.08-0.22 logCS]; P < .001)
   JAMA Ophthalmol, 2018 · checked 2026-09-29
10. ev-dcwl-01 · meta-analysis of RCTs
    Meta-analysis did not suggest any significant effect of cocoa/DC supplementation on body weight (-0.108 kg, 95% CI -0.262, 0.046 P = 0.168), BMI (-0.014 kg/m2 95% CI -0.105, 0.077, P: 0.759,) and WC (0.025 cm 95% CI -0.083, 0.129, P = 0.640).
    Crit Rev Food Sci Nutr, 2019 · checked 2026-10-07
11. ev-dcwl-03 · meta-analysis of RCTs
    Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c.
    Nutrients, 2024 · checked 2026-10-07
12. ev-dcwl-04 · meta-analysis of RCTs
    The effect of cocoa consumption on total body mass was evaluated in 11 studies (n = 612) and was found to be ineffective (Figure 2A), even in the subgroup analysis (Figure S1, Supplementary Material File S2; Figure S11, Supplementary Material File S3).
    Nutrients, 2024 · checked 2026-10-07
13. ev-dcwl-09 · cross-sectional
    In multivariable models without interaction terms, both dark and milk chocolate consumption were associated with lower BMI, whereas dark chocolate consumption was associated with higher LDL cholesterol.
    Nutrients, 2026 · checked 2026-10-07
14. dkc-r8-08 · RCT
    The consumption of dark chocolate induced a significant increase in mean urinary Ox (36 +/- 14 versus 30 +/- 10 mg/24 hr) not observed in the milk chocolate group.
    J Ren Nutr, 2003 · checked 2026-09-29
15. dkc-r8-11 · RCT
    Two hours after ingestion at rest, dark chocolate administration resulted in a significant increase in relative values of systolic BP and DP by 5.1% ± 1.4% and 13.7% ± 3.2%, respectively, compared to the responses in the milk chocolate group (-2.4% ± 1.6% and 0.6% ± 3.4%, respectively, p < 0.04 for both comparisons) without changes in diastolic BP, HR, and MAP.
    J Am Coll Nutr, 2020 · checked 2026-09-29
16. dkc-r8-13 · case report
    True immunoglobulin E (IgE)-mediated cocoa allergy is rare, with only a few confirmed cases published to date.
    Front Pediatr, 2026 · checked 2026-09-29
17. dkc-r8-14 · case report with probabilistic risk assessment
    The results show that milk protein concentrations in unlabelled products reach levels that may elicit allergic reactions in up to 68% of the adult allergic consumers.
    Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 2010 · checked 2026-09-29
18. dkc-r8-15 · food contaminant survey
    Our analysis reports that 43, 35, and 0% of the products tested exceed Prop 65 MADLs for heavy metal concentrations, respectively, of Pb, Cd, and As, while 97.2% (70 of 72) fall below US FDA IRL limits established for Pb.
    Front Nutr 2024 · checked 2026-09-29
19. ev-dcwl-10 · RCT
    The consumption of dark chocolate induced a significant increase in mean urinary Ox (36 +/- 14 versus 30 +/- 10 mg/24 hr) not observed in the milk chocolate group.
    J Ren Nutr, 2003 · checked 2026-10-07
20. ev-dcwl-11 · food contaminant survey
    Our analysis reports that 43, 35, and 0% of the products tested exceed Prop 65 MADLs for heavy metal concentrations, respectively, of Pb, Cd, and As, while 97.2% (70 of 72) fall below US FDA IRL limits established for Pb.
    Frontiers in Nutrition, 2024 (heavy metals in 72 dark chocolate and cocoa products) · checked 2026-10-07
21. dkc-r8-03 · meta-analysis of RCTs
    Meta-analysis did not suggest any significant effect of cocoa/DC supplementation on body weight (-0.108 kg, 95% CI -0.262, 0.046 P = 0.168), BMI (-0.014 kg/m2 95% CI -0.105, 0.077, P: 0.759,) and WC (0.025 cm 95% CI -0.083, 0.129, P = 0.640).
    Crit Rev Food Sci Nutr, 2019 · checked 2026-09-29
22. dkc-r8-16 · regulatory register
    POL-HC-7781 Polyphenols Polyphenols are antioxidants, which naturally occure in cocoa and therfore in dark chocolate. They help to protect our body cells against free radicals. Non-authorised
    EU Register on nutrition and health claims, claim POL-HC-7781, snapshot 2026-09-21 · checked 2026-09-29
23. dkc-r8-09 · RCT
    Intervention and control students had similar systolic (mean difference 1.7 mm Hg, 95% CI -0.6 to 4.1) and diastolic (-1.2 mm Hg, 95% CI -3.6 to 1.3) blood pressure, anthropometry and well-being at outcome.
    Arch Dis Child, 2012 · checked 2026-09-29
24. dkc-r8-10 · RCT
    The healthy older adults showed no effect from the eight-week intake of dark chocolate flavanols on cognition.
    Exp Gerontol, 2020 · checked 2026-09-29
25. ev-dcwl-05 · RCT
    Daily addition of 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women reduces their body fat mass and body fat percentage without modifying their weight.
    Br J Nutr, 2021 · checked 2026-10-07
26. ev-dcwl-06 · RCT
    Chocolate consumption decreased hunger and desire for sweets (P < .005), and reduced ad libitum energy intake by ~300 kcal/day during MC and ~150 kcal/day during EC (P = .01), but did not fully compensate for the extra energy contribution of chocolate (542 kcal/day).
    FASEB J, 2021 · checked 2026-10-07
27. ev-dcwl-07 · RCT
    Cocoa intake significantly reduced body fat percentage (p = 0.020), specifically in the trunk (p = 0.022), visceral area (p = 0.034) and lower limbs (p = 0.004).
    Food Funct, 2020 · checked 2026-10-07
28. dkc-r8-05 · RCT
    During a median follow-up of 3.6 y, 410 participants taking cocoa extract and 456 taking placebo had confirmed total cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11).
    Am J Clin Nutr, 2022 · checked 2026-09-29
29. ev-dcwl-02 · meta-analysis of RCTs
    Subgroup analysis revealed that that weight and BMI were reduced with cocoa/DC supplementation ≥ 30 g chocolate per day in trials between 4-8 weeks.
    Crit Rev Food Sci Nutr, 2019 · checked 2026-10-07
30. ev-dcwl-08 · prospective cohort
    For instance, compared to participants who ate a chocolate serving less often than monthly, those who ate it 1-4 times a month and at least weekly experienced an increase in Body Mass Index (kg/m2) of 0.26 (95% CI 0.08, 0.44) and 0.39 (0.23, 0.55), respectively, during the six-year study period.
    PLoS One, 2013 · checked 2026-10-07