Cocoa & Science: Your Health’s Future Steven Warren MD DPA Presented by:

ANTIOXIDANT/OXIDATIVE STRESS Free-Radical Damage = Medical Conditions Healthy Chocolate = Free Radical-Fighting Cocoa is High in Antioxidants Cocoa’s ORAC = 10x that of Spinach Presented by:

SCIENTIFIC SUPPORT “Theobroma cacao L. is known to have potential cardiovascular and cancer chemopreventive activities because of its high content of phenolic phytochemicals and their antioxidant capacities.” J Agric Food Chem. 2009 Nov 2. Protective Activity of Theobroma cacao L. Phenolic Extract on AML12 and MLP29 Liver Cells by Preventing Apoptosis and inducing Autophagy. “Cocoa flavonoids have shown a powerful antioxidant activity providing protection against oxidation and helping prevent oxidative stress-related diseases.” J Nutr Biochem. 2009 Feb 4. Cocoa flavonoids up-regulate antioxidant enzyme activity via the ERK1/2 pathway to protect against oxidative stress-induced apoptosis in HepG2 cells. Presented by:

Cocoa Enhances Immune Cells Function IMMUNE FUNCTION Key Benefits: Cocoa Enhances Immune Cells Function Cocoa Has Antimicrobial Properties Presented by:

SCIENTIFIC SUPPORT “Studies in this line suggest that high-dose cocoa intake in young rats favours the T helper 1 (Th1) response and increases intestinal gammadelta T lymphocyte count.” Br J Nutr. 2009 Apr;101(7):931-40. Cocoa: antioxidant and immunomodulator. Presented by:

CARDIOVASCULAR HEALTH Cocoa protects Heart and Vascular systems Neutralizes Free Radicals Relieves Inflammation Stimulates production of Nitric Oxide Improves platelet function Decreases blood clotting Controls blood sugar levels Presented by:

SCIENTIFIC SUPPORT “The acute ingestion of both solid dark chocolate and liquid cocoa improved endothelial function and lowered blood pressure in overweight adults.” Am J Clin Nutr. 2008 Jul;88(1):58-63. Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial. “Diets rich in flavanols reverse vascular dysfunction in diabetes, Highlighting therapeutic potentials in cardiovascular disease.” J Am Coll Cardiol. 2008 Jun 3;51(22):2141-9. Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients in a double-masked, randomized, controlled trial. “Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption.” Circulation. 2007 Nov 20;116(21):2376-82. Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Presented by:

SPORTS/ATHLETIC PERFORMANCE Cocoa Aids Muscle Recovery Enhances Energy Metabolism Improves Cardio and Lung Function Presented by:

SCIENTIFIC SUPPORT “The results of this study suggest that chocolate milk is an effective recovery aid between two exhausting exercise bouts.” Int J Sport Nutr Exerc Metab. 2006 Feb;16(1):78-91. Chocolate milk as a post-exercise recovery aid. Presented by:

Improves Blood Flow to Brain Improves Mental Awareness Improves Mood Decreases Depression Presented by:

SCIENTIFIC SUPPORT “In this socioeconomically homogenous male cohort, chocolate preference in old age was associated with better health, optimism and better psychological well-being.” Eur J Clin Nutr. 2008 Feb;62(2):247-53. Chocolate, well-being and health among elderly men. Presented by:

Positive Effect on Blood-Sugar Levels DIABETES Positive Effect on Blood-Sugar Levels Protects Blood Vessels from Scarring Minimizes Symptoms of Neuropathy Protects Against Cardiovascular Issues Presented by:

SCIENTIFIC SUPPORT “Dietary supplementation with [cocoa] can dose-dependently prevent the development of hyperglycemia…The dietary intake of food or drinks produced from cacao beans might be beneficial in preventing the onset of type 2 diabetes mellitus.” Nutrition. 2007 Apr;23(4):351-5. Dietary supplementation with cacao liquor proanthocyanidins prevents elevation of blood glucose levels in diabetic obese mice. Presented by:

Cocoa Combats Cholesterol Minimizes Cholesterol Absorption Presented by:

SCIENTIFIC SUPPORT “Results indicate that regular consumption of chocolate as part Of a low-fat diet may support cardiovascular health by lowering Cholesterol and improving blood pressure.” J Nutr. 2008 Apr;138(4):725-31. Daily consumption of a dark chocolate Containing flavanols and added sterol esters affects cardiovascular risk Factors in a normotensive population with elevated cholesterol. Presented by:

Cocoa Inhibits Inflammation Presented by:

SCIENTIFIC SUPPORT “Epicatechin or other flavonoids [in cocoa] were found to suppress lipid peroxidation in LDL induced by [the pro-inflammatory enzyme] myeloperoxidase.” Am J Clin Nutr. 2005 Jan;81(1 Suppl):304S-312S. Cocoa polyphenols and inflammatory mediators. “In a combination of in vivo and in vitro studies, we and others have observed that cocoa can be an anti-inflammatory modulator.” J Med Food. 2009 Feb;12(1):1-7. Cocoa flavanols and procyanidins can modulate the lipopolysaccharide activation of polymorphonuclear cells in vitro. “Our findings suggest that regular consumption of small doses of dark chocolate may reduce inflammation.” J Nutr. 2008 Oct;138(10):1939-45. Regular consumption of dark chocolate is associated with low serum concentrations of C-reactive protein in a healthy Italian population. Presented by:

CANCER/CELL PROTECTION Cocoa Protects Cells Stimulates Detoxification Enzymes Decreases Inflammation Presented by:

SCIENTIFIC SUPPORT “Due to their high concentration of catechins and procyanidins, Cocoa and chocolate products may have beneficial health effects against oxidative stress and chronic inflammation, risk factors for cancer. Nutr Cancer. 2009;61(5):573-9. Cancer protective properties of cocoa: a review of the epidemiological evidence. “A significant reduction in the incidence of prostate tumors was also observed… In conclusion, [cocoa] protected from prostate carcinogenesis.” Eur J Cancer Prev. 2008 Feb;17(1):54-61. Protective effect of Acticoa powder, a cocoa polyphenolic extract, on prostate carcinogenesis in Wistar Unilever rats. Presented by:

Slows Gum-Tissue Damage Slows Tooth Decay ORAL HEALTH Slows Gum-Tissue Damage Slows Tooth Decay Presented by:

SCIENTIFIC SUPPORT “Consuming a cocoa-enriched diet could diminish periodontist-induced oxidative stress, which, in turn, might suppress the progression of periodontitis.” J Periodontol. 2009 Nov;80(11):1799-808. Preventive effects of a cocoa- enriched diet on gingival oxidative stress in experimental periodontitis. “CBHE is highly effective in reducing mutans streptococci counts and plaque deposition when used as a mouth rinse by children.” J Indian Soc Pedod Prev Dent. 2008 Jun;26(2):67-70. Chocolate Mouth rinse: Effect on plaque accumulation and mutans streptococci Counts when used by children. Presented by:

Cocoa’s antioxidant properties VISUAL/EYE HEALTH Cocoa’s antioxidant properties protect the eye’s sensitive tissue and nerves. Presented by:

SCIENTIFIC SUPPORT “Our findings suggest that [cocoa procyanidins] inhibits diabetes-induced cataract formation possibly by virtue of its antioxidative activity.” Exp Biol Med (Maywood). 2004 Jan;229(1):33-9. Ingestion of proanthocyanidins derived from cacao inhibits diabetes-induced cataract formation in rats. Presented by:

Cocoa Regulates Weight-Control Genes Suppresses Appetite Reduces Cravings Stabilizes Blood-Sugar Levels Presented by:

SCIENTIFIC SUPPORT “Ingested cocoa can prevent high-fat diet-induced obesity by modulating lipid metabolism, especially by decreasing fatty acid synthesis and transport systems, and enhancement of part of the thermogenesis mechanism in liver and white adipose tissue.” Nutrition. 2005 May;21(5):594-601. Ingested cocoa can prevent high-fat diet- induced obesity by regulating the expression of genes for fatty acid metabolism. “Satiety and fullness were significantly increased after [ingesting] chocolate milk.” Br J Nutr. 2007 Mar;97(3):579-83. Increased satiety after intake of a chocolate Milk drink compared with a carbonated beverage, but no difference in Subsequent ad libitum lunch intake. Presented by:

Protects Skin from UV Radiation Minimizes Inflammation in Skin Tissue Presented by:

SCIENTIFIC SUPPORT “Our study demonstrated that regular consumption of a chocolate rich in flavanols confers significant photoprotection and can thus be effective at protecting human skin from harmful UV effects.” J Cosmet Dermatol. 2009 Sep;8(3):169-73. Eating chocolate can significantly protect the skin from UV light. Presented by:

Minimizes certain causes of stroke/dementia Improves blood flow to the brain Improves cognitive performance Presented by:

SCIENTIFIC SUPPORT “The prospect of increasing cerebral perfusion [blood flow] With cocoa flavanols is extremely promising.” J Cardiovasc Pharmacol. 2006;47 Suppl 2:S210-4. Cocoa flavanols and brain perfusion. Presented by:

BRAIN/STROKE “Our data suggests a promising role for regular cocoa flavanol’s consumption in the treatment of cerebrovascular ischemic syndromes, including dementias and stroke.” Neuropsychiatr Dis Treat. 2008 Apr;4(2):433-40. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. “Our results show that cocoa extract and epicatechin may exert a [brain and nerve] protective action by reducing [free radical] production.” Eur J Nutr. 2009 Feb;48(1):54-61. Neuroprotective effect of cocoa flavonoids on in vitro oxidative stress. Presented by:

COCOA’S BENEFITS AT A GLANCE Mood Brain/Mental Function Eye/Visual Health Skin Health Oral Health Cardiovascular Health Weight Control Presented by:

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NUMBER OF STUDIES CONDUCTED Approx. 30 Studies 60+ Studies 12+ Studies 70+ Studies Approx. 40 Studies 30+ Studies Antioxidant Properties = Cardiovascular Health = Diabetes = Brain Health = Mood = Cancer/Cell Protective Properties = Inflammation = Skin Health = Presented by:

WHAT KIND OF CHOCOLATE IS BEST? Cocoa that is cold-pressed contains far more polyphenols (epicatechins and flavanols) than cocoa that has been roasted and heated. How chocolate is sweetened is another important point. Obviously, avoid products high in refined sugars. Presented by:

WHAT KIND OF CHOCOLATE IS BEST? Processing temperature for cacao beans should not exceed 110°F. Choose dried, not roasted, cacao beans that have been washed and thoroughly cleaned. Avoid chocolates that have undergone any alkalization or “dutching” processes. Presented by:

HOW MUCH CHOCOLATE SHOULD YOU EAT? 600-900 mg of Flavonoids Daily High Flavonoid Chocolate 3x per day for Maximum Health Benefits Presented by: