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Theobroma cacao

Theobroma cacao


No documentation

Vernacular Name

Theobroma, cacao, cocoa


Theobroma cacao has an ancient history of use in South and Central America and has been such an important plant that it was known as the “food of the gods”.  It was used for many purposes in tribal cultures and continues to be used today.

The leaves of the T. cacao are unlobed, alternate, entire and an average 10 inches long by 5 inches wide. These leaves produce a poisonous milky substance.  The flowers grow in clusters on the trunk and solid, older branches.  These flowers are quite small and are pollinated by small midges.  The fruit is produced in a pod and is yellow to yellow-orange when ripe.  Each fruit pod weighs up to 400-500g and contains the seeds which are typically referred to as ‘beans’.

Origin / Habitat

T. cacao is native to the Amazon region.  It is now found throughout Central and South America.  It requires a tropical habitat with high humidity and good soil in order to thrive. It also needs some shade which it receives by growing under other taller trees.  The leaves of this tree are poisonous.

Chemical Constituents

T. cacao bean is composed of 31% fat, 14% carbohydrates, and 9% protein. Phytochemicals include: polyphenols, including procyanidins and flavan-3-ols ((-)-epicatechin, catechin); minerals including magnesium, calcium, iron, zinc, copper, manganese; vitamins including vitamin A, B1, B2, B3, C, E and pantothenic acid; theobromine; phenethylamine (PEA); caffeine. The average chocolate bar (1.65 oz) contains approximately 10mg of caffeine and 92mg of theobromine. Chocolate has been found to contain up to 2.2% phenylethylamine (PEA). T. cacao butter contains mainly palmitic and stearic fatty acids.[2],[3],[4],[5],[6]

Plant Part Used

Seed (bean)

Medicinal Uses


Food source
Cardiovascular health
Mood enhancer

Most Frequently Reported Uses

Food source
Cardiovascular health


Dosage Range

Chocolate, 70-85% T. cacao: 20-25g every 2-3 days

Most Common Dosage

Standardized powdered extract: 900mg 2 times daily

The consuming milk chocolate or white chocolate, or drinking fat-containing milk with dark chocolate, can negate the health benefits of T. cacao. The antioxidant qualities of processed T. cacao powder (or Dutch chocolate, processed with alkali) are greatly reduced when compared to "raw" T. cacao powder or standardized extracts. Unfermented, nonroasted, and blanch-treated T. cacao powder contains the highest levels of flavanols (epicatechin and procyanidin).[1]

Standardization Dosage

Standardized to 15% polyphenols, 10% theobromine



T. cacao and its phytochemical constituents including flavan-3-ols have been reported to have several health benefits, including antioxidant, anticarcinogen, cardiopreventive, antimicrobial, and neuro-protective agents.[7] Flavanols are antioxidants and modify the production of pro-inflammatory cytokines, the synthesis of eicosanoids, C-reactive protein (CRP) levels, the activation of platelets, and nitric oxidemediated mechanisms of inflammation, potentially leading to decreased risk of chronic diseases like Alzheimer’s disease, type 2 diabetes, heart disease and cancer.[8],[9],[10]

T. cacao has been found to contain much higher levels of antioxidants, including total phenolics (611 mg of gallic acid equivalents, GAE) and flavonoids (564mg of epicatechin equivalents, ECE) per serving than black tea (124mg of GAE and 34 mg of ECE, respectively), green tea (165 mg of GAE and 47 mg of ECE), and red wine (340 mg of GAE and 163 mg of ECE).[11]

T. cacao is reported to have antioxidant activity by lowering F2-isoprostanes,  decreasing lipid peroxidation and decreasing reactive oxygen species (ROS).[12] In a laboratory animal study, T. cacao decreased liver lipid peroxide, liver glutathione levels and plasma ALT and AST, supporting the strong antioxidant activity of T. cacao in the liver.[13]

In an animal model of atherosclerosis, T. cacao powder at a human dose equivalent of two dark chocolate bars per day significantly inhibited atherosclerosis, lowered cholesterol, low-density lipoprotein, and triglycerides, raised high-density lipoprotein, and protected the lower density lipoproteins from oxidation.[14] Human studies have also reported that intake of Cacao powder can improve cholesterol levels, actually decreasing LDL oxidized cholesterol levels while improving HDL levels.[15],[16],[17]

Cacao polyphenols are potent antioxidants that can support nitric oxide production to help improve blood vessel dilation and improve blood flow. A laboratory animal study found that Cacao powder high in polyphenols can lower blood pressure with similar effects to the antihypertiensive drug captopril (Capoten).[18] Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption. These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration.[19]

Consuming high flavanol containing chocolate and T. cacao can have a positive effect on brain health. Touted as a mood enhancer, chocolate has traditionally been eaten to elevate mood and help with depression. Laboratory animal studies support these effects and report that polyphenols found in T. cacao have antidepressant-like activity. T. cacao contains phenylethylamine (PEA), a neurochemical that helps with an increased sense of well-being and contentment and in sleep.[20]  PEA seems to release b-endorphin, an opioid peptide that is the driving force behind Cacao’s pleasurable effects.

T. cacao is reported to exert a neuroprotective action by reducing oxidative stress through reducing reactive oxygen species (ROS) production and modulating mitogen-activated protein kinase (MAPK) activation.[21] A pilot study evaluated the relationship between cerebral blood flow and a single acute dose (450 mg flavanols) of flavanol-rich T. cacao.[22]

The laboratory studies have found that T. cacao exerts anti-inflammatory and inmmune modulating activity, partially through T helper 1 (Th1) response and increases intestinal T lymphocyte count.[23] T. cacao exerts regulatory activity on the secretion of inflammatory mediators from macrophages and other leucocytes in vitro.[24]

The ingesting of T. cacao may protect against cancer. The laboratory studies have reported that T. cacao extracts high in polyphenols have an antiproliferative effect on colon and prostate cancer cell growth.[25],[26] The positive benefits of decreasing oxidative stress, inflammation and in pleasure seem to be sufficient enough to warrant further testing of T. cacao for cancer treatment.


Human studies have reported a modest reduction in blood pressure levels after consuming high flavanol dark chocolate daily.[27],[28] Five randomized controlled studies of T. cacao administration involving a total of 173 subjects with a median duration of 2 weeks looked at blood pressure after consuming T. cacao in the diet.[29]  The authors concluded that consumption of foods rich in T. cacao may reduce blood pressure. A cohort study in 470 elderly men also found that consumption of T. cacao was inversely associated with blood pressure  and mortality.[30]  One randomized, placebo-controlled, double-blind, crossover trial looked at the use of a flavanol-rich T. cacao drink (150mL twice a day, approximately 900 mg flavanols/day) in 20 individuals with essential hypertension. Antihypertensive medications were discontinued before study enrollment. T. cacao treatment for 2 weeks increased insulin-stimulated changes in brachial artery diameter when compared with placebo; however, T. cacao treatment did not significantly reduce blood pressure or improve insulin resistance and had no significant effects on skeletal muscle capillary recruitment, circulating plasma concentrations of adipocytokines, or endothelial adhesion molecules.[31]

The flavanols found in T. cacao (similar to tea) have been reported to have positive effects on cardiovascular health.[32],[33] The results of human trials suggests that the regular consumption of T. cacao products containing high levels of flavanols may reduce risk of cardiovascular disease (CVD).[34],[35],[36]

A small human study found that regular consumption of high flavanol chocolate offers significant photoprotection and can be useful at protecting human skin from harmful UV effects.[37] Sweetened and processed chocolate (including milk chocolate, low in flavanols) has no such effect.

The results found that flavanol-rich T. cacao can increase the cerebral blood flow to gray matter, suggesting the potential of Cacao flavanols for treatment of vascular impairment, including dementia and strokes, and thus for maintaining cardiovascular health. Other studies have found that short-term ingestion of flavanol-rich T. cacao leads to significant peripheral vasodilation, including blood brain flow, in healthy people by improving endothelial function mediated by nitric oxide, thereby potentially offering protection from conditions such as cerebrovascular ischemic syndromes, including dementia and stroke.[38],[39]

One study in humans has reported that ingesting T. cacao does improve insulin sensitivity.[40] ,A study followed 1169 non-diabetic patients who had their first heart attack and who consumed chocolate regularly.[41] Chocolate consumption was associated with lower cardiac mortality in a dose dependent manner in patients free of diabetes surviving their first heart attack. Although more research is necessary, results of consuming chocolate and the reduced risks of heart disease is promising.

Interaction and Depletions

Interaction with other Herbs

No documentation

Interaction with Drugs

Based on pharmacology, use with caution in individuals with bleeding disorders or those taking blood-thinning medications such as aspirin or warfarin (Coumadin).

Based on pharmacology, use with caution in individuals taking medications which may interact with caffeine, including heart medications and stimulants.

Other interactions

Based on clinical reports, chocolate should not be consumed within 12 hours of having Tc-99m radioimaging scan, including red blood cell labeling. Chocolate intake inhibited the labeling rate, compared with the control condition, and significantly increased the free Tc-99m fraction.[45]

Precautions and Contraindications

Side effects

Chocolate (T. cacao) consumption may result in migraine headaches in sensitive individuals.[43] If you have a history of migraine headaches or other vascular headaches, avoid chocolate. Discontinue if allergy occurs.

T. cacao does contain caffeine, so avoid T. cacao if there is sensitivity to caffeine.

T. cacao has been reported safe in recommended doses. Do not use T. cacao or chocolate if you are at an increased risk for testicular cancer. Various studies in animals reported that T. cacao and theobromine, the main stimulant of T. cacao, exert toxic effects on the testis, inducing testicular atrophy and impaired sperm quality.[42]


No documentation

Age limitation

No documentation

Adverse reaction

Consumption of standardized T. cacao may lead to inhibition of platelet aggregation, so if a bleeding disorder is present or if you are taking anticoagulants, only use T. cacao supplements or consume high flavanol chocolate regularly under the supervision of a doctor.[44]


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  2. Hani M, El-Saied, Morsi MK, et al. Composition of cocoa shell fat as related to cocoa butter. Zeitschrift fur Ernahrungswissenschaft. 1981;20(2):145-151.
  3. Mehrinfar R, Frishman WH. Flavanol-rich cocoa: a cardioprotective nutraceutical. Cardiol Rev. May-Jun2008;16(3):109-115.
  4. Urpi-Sarda M, Monagas M, Khan N, et al. Epicatechin, procyanidins, and phenolic microbial metabolites after cocoa intake in humans and rats. Anal Bioanal Chem. Jul2009;394(6):1545-1556.
  5. Ziegleder G, Stojacic E, Stumpf B. [Occurrence of beta-phenylethylamine and its derivatives in cocoa and cocoa products] Z Lebensm Unters Forsch. Sep1992;195(3):235-238.
  6. Padilla FC, Liendo R, Quintana A. Characterization of cocoa butter extracted from hybrid cultivars of Theobroma cacao L. Arch Latinoam Nutr. Jun2000;50(2):200-205.
  7. Aron PM, Kennedy JA. Flavan-3-ols: nature, occurrence and biological activity. Mol Nutr Food Res. Jan 2008;52(1):79-104.
  8. Selmi C, Cocchi CA, Lanfredini M, Keen CL, Gershwin ME. Chocolate at heart: the anti-inflammatory impact of cocoa flavanols. Mol Nutr Food Res. Nov2008;52(11):1340-1348.
  9. di Giuseppe R, Di Castelnuovo A, Centritto F, et al. Regular consumption of dark chocolate is associated with low serum concentrations of C-reactive protein in a healthy Italian population. J Nutr. Oct2008;138(10):1939-1945.
  10. Patel AK, Rogers JT, Huang X. Flavanols, mild cognitive impairment, and Alzheimer's dementia. Int J Clin Exp Med. 2008;1(2):181-191.
  11. Lee KW, Kim YJ, Lee HJ, Lee CY. Cocoa has more phenolic phytochemicals and a higher antioxidant capacity than teas and red wine. J Agric Food Chem. 2003;3(51):7292-7295.
  12. Wiswedel I, Hirsch D, Kropf S, Gruening M, Pfister E, Schewe T, Sies H. Flavanol-rich cocoa drink lowers plasma F2-isoprostane concentrations in humans. Free Radic Biol Med. 1Aug2004;37(3):411-421.
  13. Kiliçgün H, Altiner D. The Antioxidant Activity of Cocoa. Pharmacognasy Magazine. 2009;5(20):298-300.
  14. Vinson JA, Proch J, Bose P, Muchler S, Taffera P, Shuta D, Samman N, Agbor GA. Chocolate is a powerful ex vivo and in vivo antioxidant, an antiatherosclerotic agent in an animal model, and a significant contributor to antioxidants in the European and American Diets. J Agric Food Chem. 18Oct2006;54(21):8071-8076.
  15. Baba S, Natsume M, Yasuda A, et al. Plasma LDL and HDL cholesterol and oxidized LDL concentrations are altered in normo- and hypercholesterolemic humans after intake of different levels of cocoa powder. J Nutr. Jun2007;137(6):1436-1441.
  16. Osakabe N, Baba S, Yasuda A, Iwamoto T, Kamiyama M, Takizawa T, Itakura H, Kondo K. Daily cocoa intake reduces the susceptibility of low-density lipoprotein to oxidation as demonstrated in healthy human volunteers. Free Radic Res. Jan2001;34(1):93-99.
  17. Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PM. Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans.Am J Clin Nutr. Nov 2001;74(5):596-602.
  18. Cienfuegos-Jovellanos E, Quiñones Mdel M, Muguerza B, Moulay L, Miguel M, Aleixandre A. Antihypertensive effect of a polyphenol-rich cocoa powder industrially processed to preserve the original flavonoids of the cocoa beans. J Agric Food Chem. 22Jul2009;57(14):6156-6162.
  19. Flammer AJ, Hermann F, Sudano I, et al. Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Circulation. 20Nov2007;116(21):2376-2382.
  20. Messaoudi M, Bisson JF, Nejdi A, Rozan P, Javelot H. Antidepressant-like effects of a cocoa polyphenolic extract in Wistar-Unilever rats. Nutr Neurosci. Dec2008;11(6):269-276.
  21. Ramiro-Puig E, Casadesús G, Lee HG, et al. Neuroprotective effect of cocoa flavonoids on in vitro oxidative stress. Eur J Nutr. Feb2009;48(1):54-61.
  22. Francis ST, Head K, Morris PG, Macdonald IA. The effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young people. J Cardiovasc Pharmacol. 2006;47.
  23. Ramiro-Puig E, Castell M. Cocoa: antioxidant and immunomodulator. Br J Nutr. Apr2009;101(7):931-940.
  24. Kenny TP, Keen CL, Schmitz HH, Gershwin ME. Immune effects of cocoa procyanidin oligomers on peripheral blood mononuclear cells. Exp Biol Med. 2007;232(2):293-300.
  25. Jourdain C, Tenca G, Deguercy A, Troplin P, Poelman D. In-vitro effects of polyphenols from cocoa and beta-sitosterol on the growth of human prostate cancer and normal cells. Eur J Cancer Prev. Aug2006;15(4):353-361.
  26. Carnésecchi S, Schneider Y, Lazarus SA, Coehlo D, Gossé F, Raul F. Flavanols and procyanidins of cocoa and chocolate inhibit growth and polyamine biosynthesis of human colonic cancer cells. Cancer Lett. 25Jan 2002;175(2):147-155.
  27. Fisher ND, Hughes M, Gerhard-Herman M, et al. Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans. J Hypertension. 2003;21(12):2281-2286.
  28. Faridi Z, Njike VY, Dutta S, Ali A, Katz DL. Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial. Am J Clin Nutr. Jul2008;88(1):58-63.
  29. Taubert D, Roesen R, Schomig E. Effect of cocoa and tea intake on blood pressure: a meta-analysis. Arch Intern Med. 2007;167(7):626-634.
  30. Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study. Arch Intern Med. 27Feb2006;166(4):411-417.
  31. Muniyappa R, Hall G, Kolodziej TL, Karne RJ, Crandon SK, Quon MJ. Cocoa consumption for 2 wk enhances insulin-mediated vasodilatation without improving blood pressure or insulin resistance in essential hypertension.Am J Clin Nutr. Dec2008;88(6):1685-1689.
  32. Grassi D, Desideri G, Croce G, Tiberti S, Aggio A, Ferri C. Flavonoids, vascular function and cardiovascular protection. Curr Pharm Des. 2009;15(10):1072-1084.
  33. Corti R, Flammer AJ, Hollenberg NK, Lüscher TF. Cocoa and cardiovascular health. Circulation. 17Mar2009;119(10):1433-1441.
  34. Erdman JW Jr, Carson L, Kwik-Uribe C, Evans EM, Allen RR. Effects of cocoa flavanols on risk factors for cardiovascular disease. Asia Pac J Clin Nutr. 2008;17 Suppl 1:284-287.
  35. Hamed MS, Gambert S, Bliden KP, et al. Dark chocolate effect on platelet activity, C-reactive protein and lipid profile: a pilot study. South Med J. Dec2008;101(12):1203-1208.
  36. Allen RR, Carson L, Kwik-Uribe C, Evans EM, Erdman JW Jr. Daily consumption of a dark chocolate containing flavanols and added sterol esters affects cardiovascular risk factors in a normotensive population with elevated cholesterol. J Nutr. Apr2008;138(4):725-731.
  37. Williams S, Tamburic S, Lally C. Eating chocolate can significantly protect the skin from UV light. J Cosmet Dermatol. Sep2009;8(3):169-173.
  38. Fisher ND, Sorond FA, Hollenberg NK. Cocoa flavanols and brain perfusion. J Cardiovasc Pharmacol. 2006;47 Suppl 2:S210-14.
  39. Sorond FA, Lipsitz LA, Hollenberg NK, Fisher ND. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatr Dis Treat. Apr2008;4(2):433-440.
  40. Grassi D, Desideri G, Necozione S, Lippi C, Casale R, Properzi G, Blumberg JB, Ferri C. Blood pressure is reduced and insulin sensitivity increased in glucose-intolerant, hypertensive subjects after 15 days of consuming high-polyphenol dark chocolate. J Nutr. Sep2008;138(9):1671-1676.
  41. Janszky I, Mukamal KJ, Ljung R, Ahnve S, Ahlbom A, Hallqvist J. Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program. J Intern Med. Sep2009;266(3):248-257.
  42. Giannandrea F. Correlation analysis of cocoa consumption data with worldwide incidence rates of testicular cancer and hypospadias. Int J Environ Res Public Health. Feb2009;6(2):568-578.
  43. Gibb CM, Davies PT, Glover V, et al. Chocolate is a migraine-provoking agent. Cephalalgia. May 1991;11(2):93-95.
  44. Bordeaux B, Yanek LR, Moy TF, White LW, Becker LC, Faraday N, Becker DM. Casual chocolate consumption and inhibition of platelet function. Prev Cardiol. Fall2007;10(4):175-180.
  45. Bustani H, Colavolpe C, Imbert-Joscht I, et al. Chocolate intake associated with failed labeling of (99m)Tc red blood cells. J Nucl Med Technol. Jun2009;37(2):107-110.

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