Cocoa
Cocoa flavanols are studied for blood pressure, cognition, and vascular function. Effects depend on flavanol dose.
Overview
What is cocoa?
Cocoa powder, made from the roasted and processed seeds of the cacao tree, is rich in polyphenols, especially flavonoids, which provide antioxidant and anti-inflammatory effects. These compounds in cocoa can help lower blood pressure, reduce inflammation, improve heart health, and enhance brain function. While cocoa contains higher flavonoid levels than red wine or tea, its processing can reduce these benefits, so higher cocoa content generally means more health-promoting polyphenols.
Dosage
Typical intake is from dietary cocoa and dark chocolate; no single supplemental dose is standard. In trials, effective amounts range from about 19–54 g cocoa daily, 46–100 g dark chocolate daily, or flavanol intakes of roughly 25–1080 mg daily depending on the outcome. Higher cocoa content generally means more health-promoting polyphenols.
Effect graph
Effect heatmap
SupplementDEX Database
14 conditions for , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most cocoa research is concentrated in a handful of conditions.
- Cardiovascular disease accounts for 21 of 78 studies (27%).
- High blood pressure accounts for 19 of 78 studies (24%).
- Cognitive performance accounts for 9 of 78 studies (12%).
- Sparse coverage remains for Peripheral arterial disease (PAD), Stretch marks, Athletic performance.
Safety
Cocoa is likely safe when used in the typical amounts consumed during cooking or those found in foods.
Unsweetened cocoa powder may contain high amounts of caffeine and heavy metals. Cocoa and dark chocolate products can contain lead and cadmium.
Frequently Asked Questions
Takeaway
Cocoa and dark chocolate, especially high-flavanol products, may support cardiovascular health and modest blood pressure reduction; evidence is mixed for other outcomes. Cocoa does not appear to lower cholesterol in people with high cholesterol, improve weight loss, or prevent stretch marks when applied topically during pregnancy. Choose unsweetened or high-cocoa products and be aware that cocoa can contain caffeine and heavy metals such as lead and cadmium.
References
Sources72 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
SupplementDEX Database · Cardiovascular disease
21 references1.SupplementDEX Database: Cardiovascular disease — The role of cocoa flavanols in modulating peripheral and cerebral microvascular function in healthy individuals and populations at-risk of cardiovascular disease: a systematic review2025
A 2025 systematic review of 19 trials found acute cocoa flavanol intake improved microvascular vasodilation in about 86% of studies, while chronic effects were less consistent.
2.SupplementDEX Database: Cardiovascular disease — Effects of Cocoa Consumption on Cardiometabolic Risk Markers: Meta-Analysis of Randomized Controlled Trials2024
A meta-analysis of 31 RCTs (1,986 adults) found cocoa consumption lowered total and LDL cholesterol, fasting glucose, and blood pressure over at least 4 weeks.
3.SupplementDEX Database: Cardiovascular disease — Relationship between chocolate consumption and overall and cause-specific mortality, systematic review and updated meta-analysis2022
In 27,111 men followed up to 30 years, higher chocolate consumption was associated with lower cardiovascular and all-cause mortality, with benefits plateauing above about 3 servings per week.
4.SupplementDEX Database: Cardiovascular disease — Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial2022
In 21,442 older adults over 3.6 years, 500 mg/day cocoa flavanols did not significantly reduce total cardiovascular events but lowered cardiovascular death by 27%.
5.SupplementDEX Database: Cardiovascular disease — Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies2017
A meta-analysis of 14 prospective studies found higher chocolate intake associated with 10–18% lower risks of coronary heart disease, stroke, and diabetes, with optimal intake around 2–6 servings per week.
6.SupplementDEX Database: Cardiovascular disease — Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study2015
In 100 healthy adults aged 35–60 over 1 month, 450 mg/day cocoa flavanols improved flow-mediated dilation, lowered blood pressure and LDL, and improved Framingham risk scores.
7.SupplementDEX Database: Cardiovascular disease — Effects of dark chocolate and cocoa consumption on endothelial function and arterial stiffness in overweight adults2013
In overweight adults, 22 g/day high-flavanol cocoa for 4 weeks improved endothelial function and reduced arterial stiffness in women without changing blood pressure or insulin resistance.
8.SupplementDEX Database: Cardiovascular disease — Characterisation of hypertensive patients with improved endothelial function after dark chocolate consumption2013
In 21 treated hypertensive adults, 75 g/day dark chocolate for 1 week improved endothelial function mainly in younger patients with higher baseline cardiovascular risk.
9.SupplementDEX Database: Cardiovascular disease — Blood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trial2013
In 44 pregnant women over 12 weeks, flavanol-rich versus low-flavanol chocolate did not significantly change blood pressure or flow-mediated dilation.
10.SupplementDEX Database: Cardiovascular disease — Effects of chocolate, cocoa, and flavan-3-ols on cardiovascular health: a systematic review and meta-analysis of randomized trials2012
A meta-analysis of 42 RCTs found cocoa or flavan-3-ols improved flow-mediated dilation and insulin resistance and modestly lowered blood pressure and LDL cholesterol.
11.SupplementDEX Database: Cardiovascular disease — Flavonoid-rich cocoa consumption affects multiple cardiovascular risk factors in a meta-analysis of short-term studies2011
A meta-analysis of 24 flavanol-rich cocoa trials found significant reductions in systolic and diastolic blood pressure, LDL cholesterol, and improvements in flow-mediated dilation and insulin resistance.
12.SupplementDEX Database: Cardiovascular disease — Dose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adults2011
In 23 healthy older adults, acute cocoa doses of 5–26 g increased flow-mediated dilation in a dose-dependent manner 1–2 hours after ingestion.
13.SupplementDEX Database: Cardiovascular disease — Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis2011
A meta-analysis of seven observational studies linked higher chocolate intake to 37% lower cardiovascular disease and 29% lower stroke risk, though no RCTs were included.
14.SupplementDEX Database: Cardiovascular disease — The effect of polyphenol-rich dark chocolate on fasting capillary whole blood glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjects2009
In overweight adults, 2 weeks of polyphenol-rich dark chocolate at 500 or 1,000 mg polyphenols reduced fasting glucose and blood pressure similarly versus baseline.
15.SupplementDEX Database: Cardiovascular disease — Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials2008
A flavonoid meta-analysis found chocolate improved flow-mediated dilation and lowered systolic and diastolic blood pressure, while effects of other flavonoid sources were mixed.
16.SupplementDEX Database: Cardiovascular disease — Cocoa consumption for 2 wk enhances insulin-mediated vasodilatation without improving blood pressure or insulin resistance in essential hypertension2008
In 20 hypertensive adults over 2 weeks, flavanol-rich cocoa improved insulin-mediated brachial artery dilation but did not reduce blood pressure or insulin resistance.
17.SupplementDEX Database: Cardiovascular disease — A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults2008
In 101 healthy older adults over 6 weeks, daily dark chocolate and cocoa did not significantly change neuropsychological performance or cardiovascular measures versus placebo.
18.SupplementDEX Database: Cardiovascular disease — Acute effect of oral flavonoid-rich dark chocolate intake on coronary circulation, as compared with non-flavonoid white chocolate, by transthoracic Doppler echocardiography in healthy adults2007
In 39 healthy men over 2 weeks, flavanol-rich dark chocolate 45 g/day improved coronary flow velocity reserve versus white chocolate control.
19.SupplementDEX Database: Cardiovascular disease — Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study2006
In 470 elderly men, higher habitual cocoa intake was associated with lower blood pressure and about 50% lower cardiovascular and all-cause mortality over 15 years.
20.SupplementDEX Database: Cardiovascular disease — Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons2005
In 15 healthy adults over 15 days, 100 g/day dark chocolate improved insulin sensitivity and lowered systolic and diastolic blood pressure versus white chocolate.
21.SupplementDEX Database: Cardiovascular disease — Flavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations in healthy adults2004
In 21 healthy adults over 2 weeks, high-flavanol dark chocolate improved flow-mediated dilation and raised plasma epicatechin without changing blood pressure or lipids.
SupplementDEX Database · High blood pressure
17 references22.SupplementDEX Database: High blood pressure — Consumption of cocoa-containing foods and risk of hypertension in French women2020
In 45,653 French women, moderate cocoa intake from plain chocolate was inversely associated with hypertension risk, while sweet cocoa sources showed no benefit.
23.SupplementDEX Database: High blood pressure — Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial2020
In 140 postmenopausal women over 6 months, 10 g/day 99% cocoa reduced pulse pressure by 2 mmHg versus control but did not change systolic blood pressure or arterial stiffness.
24.SupplementDEX Database: High blood pressure — Cocoa Consumption and Blood Pressure in Middle-Aged and Elderly Subjects: a Meta-Analysis2020
A meta-analysis of 13 trials (758 adults) found cocoa consumption reduced systolic blood pressure by 2.8 mmHg and diastolic by 1.5 mmHg, mainly in hypertensive subgroups.
25.SupplementDEX Database: High blood pressure — Effect of cocoa on blood pressure2017
An updated Cochrane meta-analysis of 40 comparisons found flavanol-rich cocoa lowered systolic blood pressure by 1.8 mmHg and diastolic by 1.8 mmHg over 2–18 weeks.
26.SupplementDEX Database: High blood pressure — Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial2015
In healthy adults, up to 2,000 mg/day cocoa flavanols for 12 weeks was well tolerated and did not significantly change blood pressure, platelet function, or metabolic markers.
27.SupplementDEX Database: High blood pressure — Consumption of high-polyphenol dark chocolate improves endothelial function in individuals with stage 1 hypertension and excess body weight2012
In 20 adults with stage 1 hypertension and excess weight over 4 weeks, 50 g/day 70% dark chocolate improved endothelial function without changing lipids or blood pressure.
28.SupplementDEX Database: High blood pressure — Effect of cocoa on blood pressure2012
A 2012 Cochrane meta-analysis of 20 trials found flavanol-rich cocoa lowered systolic blood pressure by 2.8 mmHg and diastolic by 2.2 mmHg over 2–18 weeks.
29.SupplementDEX Database: High blood pressure — Dark chocolate for children's blood pressure: randomised trial2012
In 70 children aged 10–12 over 7 weeks, daily dark chocolate did not significantly change systolic or diastolic blood pressure versus control.
30.SupplementDEX Database: High blood pressure — Effect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjects2011
In 16 prehypertensive adults over 15 days, dark chocolate 30 g/day raised nitric oxide and lowered systolic blood pressure versus white chocolate control.
31.SupplementDEX Database: High blood pressure — Does chocolate reduce blood pressure? A meta-analysis2010
A meta-analysis of 13 trials found dark chocolate significantly lowered blood pressure in hypertensive and prehypertensive adults but not in normotensive subjects.
32.SupplementDEX Database: High blood pressure — Effect of cocoa products on blood pressure: systematic review and meta-analysis2009
A meta-analysis of 10 trials (297 participants) found flavanol-rich cocoa lowered systolic blood pressure by 4.5 mmHg and diastolic by 2.5 mmHg over 2–18 weeks.
33.SupplementDEX Database: High blood pressure — Dark chocolate or tomato extract for prehypertension: a randomised controlled trial2009
In 36 prehypertensive adults over 12 weeks, 50 g/day dark chocolate or tomato extract did not significantly lower blood pressure versus placebo.
34.SupplementDEX Database: High blood pressure — Blood pressure is reduced and insulin sensitivity increased in glucose-intolerant, hypertensive subjects after 15 days of consuming high-polyphenol dark chocolate2008
In 19 hypertensive adults with impaired glucose tolerance over 15 days, flavanol-rich dark chocolate 100 g/day improved insulin sensitivity, blood pressure, endothelial function, and LDL versus white chocolate.
35.SupplementDEX Database: High blood pressure — Effect of cocoa flavanols and exercise on cardiometabolic risk factors in overweight and obese subjects2008
In 49 overweight adults over 12 weeks, high-flavanol cocoa 902 mg/day improved endothelial function and lowered diastolic blood pressure, while exercise reduced abdominal fat.
36.SupplementDEX Database: High blood pressure — Effect of cocoa and tea intake on blood pressure: a meta-analysis2007
A meta-analysis of five cocoa trials (173 participants) found cocoa lowered systolic blood pressure by 4.7 mmHg and diastolic by 2.8 mmHg over about 2 weeks; tea showed no effect.
37.SupplementDEX Database: High blood pressure — Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial2007
In 44 adults with upper-range prehypertension over 18 weeks, 6.3 g/day dark chocolate lowered systolic blood pressure by 2.9 mmHg and diastolic by 1.9 mmHg versus white chocolate.
38.SupplementDEX Database: High blood pressure — Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives2005
In 20 untreated grade I hypertensive patients over 15 days, 100 g/day dark chocolate lowered 24-hour blood pressure, improved endothelial function and insulin sensitivity, and reduced LDL versus white chocolate.
39.SupplementDEX Database: Athletic performance — Regular consumption of a flavanol-rich chocolate can improve oxidant stress in young soccer players2005
In 28 young soccer players over 14 days, flavanol-rich chocolate 105 g/day lowered diastolic and mean blood pressure, LDL cholesterol, and oxidative stress markers versus cocoa-butter control.
SupplementDEX Database · Cirrhosis
1 reference40.SupplementDEX Database: Cirrhosis — Postprandial effects of dark chocolate on portal hypertension in patients with cirrhosis: results of a phase 2, double-blind, randomized controlled trial2012
In 22 cirrhosis patients, dark chocolate 0.55 g/kg blunted the post-meal rise in hepatic venous pressure gradient versus white chocolate.
SupplementDEX Database · Cognitive performance
8 references41.SupplementDEX Database: Cognitive performance — Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial2023
In 2,262 older adults over 3 years, 500 mg/day cocoa flavanols did not improve global cognition, while daily multivitamin-mineral supplementation did.
42.SupplementDEX Database: Cognitive performance — Acute effects of cocoa flavanols on visual working memory: maintenance and updating2022
In 48 young adults, acute cocoa flavanol doses did not improve visual working memory maintenance or updating versus placebo.
43.SupplementDEX Database: Cognitive performance — The effect of acute cocoa flavanol intake on the BOLD response and cognitive function in type 1 diabetes: a randomized, placebo-controlled, double-blinded cross-over pilot study2019
In 11 type 1 diabetes patients, acute 900 mg cocoa flavanols improved flanker task reaction time and brain BOLD responses versus placebo.
44.SupplementDEX Database: Cognitive performance — The acute effects of cocoa flavanols on temporal and spatial attention2018
In 48 students, acute cocoa flavanols improved visual search efficiency but did not enhance temporal attention or integration versus placebo.
45.SupplementDEX Database: Cognitive performance — Acute cocoa flavanols intake improves cerebral hemodynamics while maintaining brain activity and cognitive performance in moderate hypoxia2018
In 20 healthy adults under moderate hypoxia, 530 mg cocoa flavanols improved cerebral hemodynamics during some cognitive tasks but did not improve overall cognitive performance.
46.SupplementDEX Database: Cognitive performance — Cocoa polyphenols enhance positive mood states but not cognitive performance: a randomized, placebo-controlled trial2013
In 72 healthy middle-aged adults over 30 days, 500 mg/day cocoa polyphenols increased calmness and contentedness versus placebo but did not change cognition.
47.SupplementDEX Database: Cognitive performance — Consumption of cocoa flavanols results in acute improvements in mood and cognitive performance during sustained mental effort2010
In 30 healthy adults, acute cocoa flavanol drinks 520–994 mg improved serial subtraction performance and reduced mental fatigue during sustained cognitive demand.
48.SupplementDEX Database: Cognitive performance — The effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young people2006
In 16 healthy young adults after 5 days of 150 mg/day cocoa flavanols, fMRI showed increased BOLD response during a cognitive task without faster reaction times.
SupplementDEX Database · Diabetes
6 references49.SupplementDEX Database: Diabetes — Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial2023
In 18,381 older adults over 3.5 years, 500 mg/day cocoa flavanol extract did not reduce incident type 2 diabetes versus placebo.
50.SupplementDEX Database: Diabetes — Effects of cocoa products intake on cardiometabolic biomarkers of type 2 diabetes patients: a systematic review and meta-analysis based on both long-term and short-term randomised controlled trials2022
A meta-analysis of 12 trials found long-term cocoa product intake in type 2 diabetes lowered LDL, triglycerides, fasting glucose, and C-reactive protein.
51.SupplementDEX Database: Diabetes — The effect of cocoa/dark chocolate consumption on lipid profile, glycemia, and blood pressure in diabetic patients: A meta-analysis of observational studies2021
A meta-analysis of 8 RCTs (433 diabetic patients) found cocoa or dark chocolate reduced LDL cholesterol by 15.5 mg/dL and fasting glucose by 6.9 mg/dL.
52.SupplementDEX Database: Diabetes — Regular Intake of a Usual Serving Size of Flavanol-Rich Cocoa Powder Does Not Affect Cardiometabolic Parameters in Stably Treated Patients with Type 2 Diabetes and Hypertension-A Double-Blinded, Randomized, Placebo-Controlled Trial2018
In 42 stably treated type 2 diabetes patients with hypertension over 12 weeks, 2.5 g/day flavanol-rich cocoa did not change blood pressure, glucose, or lipids versus placebo.
53.SupplementDEX Database: Diabetes — Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast2015
In 18 obese type 2 diabetes patients, acute high-polyphenol cocoa raised postprandial HDL and insulin after a high-fat meal but did not improve overall metabolic responses.
54.SupplementDEX Database: Diabetes — Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial2008
In medicated type 2 diabetes patients over 30 days, flavanol-rich cocoa 321 mg three times daily increased flow-mediated dilation by 30% and sustained acute vascular benefits.
SupplementDEX Database · High cholesterol
7 references55.SupplementDEX Database: High cholesterol — Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis2011
A meta-analysis of 10 trials (320 participants) found dark chocolate or cocoa reduced LDL by 5.9 mg/dL and total cholesterol by 6.2 mg/dL over 2–12 weeks.
56.SupplementDEX Database: High cholesterol — Dark chocolate effect on platelet activity, C-reactive protein and lipid profile: a pilot study2008
In 28 healthy adults over 1 week, dark chocolate providing 700 mg flavonoids/day lowered LDL, raised HDL, reduced platelet activation, and lowered hsCRP in women.
57.SupplementDEX Database: High cholesterol — Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans2007
In 25 adults over 12 weeks, 26 g/day cocoa powder prolonged LDL oxidation lag time by 9% and raised HDL cholesterol by 24% versus sugar control.
58.SupplementDEX Database: High cholesterol — Plasma LDL and HDL cholesterol and oxidized LDL concentrations are altered in normo- and hypercholesterolemic humans after intake of different levels of cocoa powder2007
In 160 adults over 4 weeks, cocoa powder doses of 13–26 g/day lowered LDL, oxidized LDL, and apo B and raised HDL in hypercholesterolemic subgroups.
59.SupplementDEX Database: High cholesterol — Chronic consumption of flavanol-rich cocoa improves endothelial function and decreases vascular cell adhesion molecule in hypercholesterolemic postmenopausal women2006
In 32 hypercholesterolemic postmenopausal women over 6 weeks, high-flavanol cocoa 446 mg/day improved endothelial function and lowered vascular cell adhesion molecule-1 versus low-flavanol cocoa.
61.SupplementDEX Database: High cholesterol — The role of fatty acid saturation on plasma lipids, lipoproteins, and apolipoproteins: I. Effects of whole food diets high in cocoa butter, olive oil, soybean oil, dairy butter, and milk chocolate on the plasma lipids of young men1993
In young men fed controlled diets for 26 days, cocoa butter and milk chocolate diets did not raise total or LDL cholesterol compared with dairy butter.
60.Cardioprotective effects of chocolate and almond consumption in healthy women. See external sourceExternal source
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SupplementDEX Database · Metabolic syndrome
2 references62.SupplementDEX Database: Metabolic syndrome — A reduced-calorie dietary pattern including a daily sweet snack promotes body weight reduction and body composition improvements in premenopausal women who are overweight and obese: a pilot study2011
In 26 overweight premenopausal women over 18 weeks, a reduced-calorie diet with daily dark chocolate or non-chocolate snack produced similar weight and body composition loss.
63.SupplementDEX Database: Metabolic syndrome — Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans2001
In 23 healthy adults, adding 22 g cocoa powder and 16 g dark chocolate daily for 4 weeks prolonged LDL oxidation lag time and raised HDL versus control diet.
SupplementDEX Database · Obesity
2 references64.SupplementDEX Database: Obesity — Daily Consumption of Chocolate Rich in Flavonoids Decreases Cellular Genotoxicity and Improves Biochemical Parameters of Lipid and Glucose Metabolism2018
In 84 young adults over 6 months, 2 g/day 70% dark chocolate reduced DNA damage and improved total cholesterol, triglycerides, LDL, and waist circumference versus milk chocolate.
65.SupplementDEX Database: Obesity — Effects of dark chocolate in a population of normal weight obese women: a pilot study2013
In 15 normal-weight obese women over 7 days, 100 g/day dark chocolate raised HDL and improved atherogenic lipid ratios and IL-1Ra versus baseline.
66.SupplementDEX Database: Peripheral arterial disease (PAD) — Dark chocolate and vascular function in patients with peripheral artery disease: a randomized, controlled cross-over trial2015
A crossover RCT in 21 patients with symptomatic peripheral artery disease found that a single 50 g dose of dark chocolate did not change brachial flow-mediated dilation or microvascular function at 2 hours compared with white chocolate.
67.SupplementDEX Database: Peripheral arterial disease (PAD) — Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease2014
In 20 PAD patients, acute intake of 40 g dark chocolate (>85% cocoa) increased maximal walking distance by 11% and walking time by 15% at 2 hours, while milk chocolate had no effect.
SupplementDEX Database · Stretch marks
2 references69.SupplementDEX Database: Stretch marks — Prevention of striae gravidarum with cocoa butter cream2009
A double-blind RCT in 300 pregnant women followed from 16 weeks to delivery found cocoa butter cream did not prevent striae gravidarum (44% vs 55% with placebo; P=0.09).
68.SupplementDEX Database: Stretch marks — Cocoa butter lotion for prevention of striae gravidarum: a double-blind, randomised and placebo-controlled trial2008
A multicenter RCT in 175 nulliparous women found daily cocoa butter lotion did not reduce striae gravidarum compared with placebo (45.1% vs 48.8%; P=0.730).
70.SupplementDEX Database: Erectile dysfunction — A Combination of Punica granatum Fruit Rind and Theobroma cacao Seed Extracts Enhances Sexual Function in Aging Males in a Randomized, Double-blind, Placebo-controlled Study2025
In 120 aging men aged 40–70 over 84 days, a pomegranate rind and cocoa seed extract combination improved erectile function and libido versus placebo.
SupplementDEX Database · Glaucoma
1 reference71.SupplementDEX Database: Glaucoma — The short-term effect of flavonoid-rich dark chocolate on retinal vessel diameter in glaucoma patients and age-matched controls2014
In glaucoma patients and controls, dark chocolate improved venous vasodilation 2 hours after intake in controls but not in glaucoma patients.
SupplementDEX Database · Mood
1 reference72.SupplementDEX Database: Mood — Effect of Flavanol-Rich Cacao Extract on the Profile of Mood State in Healthy Middle-Aged Japanese Women: A Randomized, Double-Blind, Placebo-Controlled Pilot Study2023
In 60 fatigued middle-aged Japanese women over 8 weeks, flavanol-rich cacao extract 240 mg/day reduced negative mood states versus placebo without changing fatigue scale scores.