Introduction and objective:
Chocolate is one of the most popular food products worldwide. Sometimes the smell or consistency alone evokes a feeling of happiness among consumers. Although dark chocolate appears to be a wellknown product, there is a lot of misinformation about it, based on incomplete or outdated data which should be updated due to its growing popularity. The aim of this study was to summarize the available scientific reports and on their basis to formulate clear conclusions.

Review methods:
Scientific research was reviewed using electronic databases, such as PubMed and Google Scholar.

Brief description of the state of knowledge:
Bitter chocolate is a product that combines attractive organoleptic features and a valuable composition. Many reports indicate the beneficial effect of the cocoa product. Promising research results suggest that it has antioxidant, anti-inflammatory, cardiovascular, neuroprotective, metabolic and antidepressant effects. However, despite many potentially beneficial biological effects it has on the human body, the risk of undesirable effects should not be overlooked. Taking into account the content of individual ingredients or their specific action, in some cases it is recommended to limit or permanently stop the consumption of dark chocolate.

Currently, more data show benefits than negative consequences of consuming dark chocolate. Overall, dark chocolate appears to be a nutritional component when consumed in reasonable amounts as part of a healthy, balanced diet.

Dyrektywa 2000/36/WE Parlamentu Europejskiego i Rady z dnia 23 czerwca 2000 r. odnosząca się do wyrobów kakaowych i czekoladowych przeznaczonych do spożycia przez ludzi (DzUrz WE L 197 z 03.08.2000, str. 19; DzUrz UE Polskie wydanie specjalne, rozdz. 13, t. 25, str. 431).
Caligiani A, Marseglia A, Palla G. Cocoa: Production, Chemistry, and Use. Encycl Food Health. 2016:185–190.
Krotki M, Stoparczyk B. Właściwości przeciwutleniające kakao w zapobieganiu chorobom układu krążenia. Postępy Fitoterapii. 2009; 1: 45–49.
Montagna MT, Diella G, Triggiano F, et al. Chocolate, “Food of the Gods”: History, Science, and Human Health. Int J Environ Res Public Health. 2019; 16(24): 4960.
Cinquanta L, Di Cesare C, Manoni R, et al. Mineral Essential Elements for Nutrition in Different Chocolate Products. Int J Food Sci Nutr. 2016; 67(7): 773–778.
Nowaczewska M, Wiciński M, Kaźmierczak W, et al. To Eat or Not to Eat: A Review of the Relationship between Chocolate and Migraines. Nutrients. 2020; 12(3): 608.
Cova I, Leta V, Mariani C, et al. Exploring Cocoa Properties: Is Theobromine a Cognitive Modulator? Psychopharmacology (Berl). 2019; 236(2): 561–572.
Barišić V, Kopjar M, Jozinović A, et al. The Chemistry behind Chocolate Production. Molecules. 2019; 24(17): 3163.
Murphy KJ, Chronopoulos AK, Singh I, et al. Dietary flavanols and procyanidin oligomers from cocoa (Theobroma cacao) inhibit platelet function. Am J Clin Nutr. 2003; 77(6): 1466–1473.
Głodo P, Matejko B. Ciemna czekolada jako bogactwo flawonoidów – sprzymierzeńców w prewencji i leczeniu wielu schorzeń. Probl Hig Epidemiol. 2019; 100(2): 82–88.
Skrajda M, Dąbrowski G. Chocolate as a Source of Bioactive Compounds Acting on the Organism. J Educat Health Sport. 2015; 5(9): 429–442.
Andres-Lacueva C, Monagas M, Khan N, et al. Flavanol and Flavonol Contents of Cocoa Powder Products: Influence of the Manufacturing Process. J Agric Food Chem. 2008; 56(9): 3111–3117.
Caprioli G, Fiorini D, Maggi F, et al. Nutritional composition, bioactive compounds and volatile profile of cocoa beans from different regions of Cameroon. Int J Food Sci Nutr. 2016; 67(4): 422–430.
Kobus-Cisowska J, Flaczyk E, Hęś M, et al. Ocena aktywności przeciwutleniającej prób kakao dostępnego na rynku. Probl Hig Epidemiol. 2014; 95(1): 138–142.
Gammone MA, Efthymakis K, Pluchinotta FR. Impact of chocolate on the cardiovascular health. Frontiers in bioscience (Landmark edition). 2018; 23(5): 852–864.
Katz DL, Doughty K, Ali A. Cocoa and chocolate in human health and disease. Antioxid Redox Signal. 2011; 15(10): 2779–2811.
Zdrojewicz Z, Grześkowiak K, Łukasiewicz M. Wpływ spożycia czekolady na organizm człowieka. Med Rodzinna. 2017; 20(3): 237–243.
Seem SA, Yuan YV, Tou JC. Chocolate and chocolate constituents influence bone health and osteoporosis risk. Nutrition. 2019; 65: 74–84.
Ioannone F, Di Mattia CD, De Gregorio M, et al. Flavanols, proanthocyanidins and antioxidant activity changes during cocoa (Theobroma cacao L.) roasting as affected by temperature and time of processing. Food Chem. 2015; 174: 256–262.
Olechnowicz J, Staniek H. Ocena zawartości wybranych pierwiastków w różnych rodzajach czekolad. Żywność Nauka Technologia Jakosc. 2017; 24(1): 70 77.
Jarosza M, Rychlik E, Stoś K, et al. Normy żywienia dla populacji Polski i ich zastosowanie. Warszawa: NIZP-PZH; 2020.
Kühn J, Schröter A, Hartmann BM, et al. Cocoa and chocolate are sources of vitamin D2. Food Chem. 2018; 269: 318–20.
Tabelle di composizione degli alimenti. Clitt. Roma, 2013.
De Deurwaerdere P, Di Giovanni G. Serotonin in Health and Disease. Int J Mol Sci. 2020; 21(10): 3500.
Guillén-Casla V, Rosales-Conrado N, León-González ME, et al. Determination of serotonin and its precursors in chocolate samples by capillary liquid chromatography with mass spectrometry detection. J Chromatogr A. 2012; 1232: 158–65.
WHO (access: 2022.04.24).
Asgary S, Rastqar A, Keshvari M. Functional Food and Cardiovascular Disease Prevention and Treatment: A Review. J Am Coll Nutr. 2018; 37(5): 429–455.
Ludovici V, Barthelmes J, Nägele MP, et al. Cocoa, Blood Pressure, and Vascular Function. Front Nutr. 2017; 4: 36.
Nishiwaki M, Nakano Y, Matsumoto N. Effects of regular high-cocoa chocolate intake on arterial stiffness and metabolic characteristics during exercise. Nutrition. 2019;60:53–8.
Sun Y, Zimmermann D, De Castro CA, et al. Dose-response relationship between cocoa flavanols and human endothelial function: a systematic review and meta-analysis of randomized trials. Food Funct. 2019; 10(10): 6322–30.
Baba S, Osakabe N, Kato Y, et al. Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. Am J Clin Nutr. 2007; 85(3): 709–17.
Basu A, Betts NM, Leyva MJ, et al. Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast. J Nutr. 2015; 145(10): 2325–32.
Sarriá B, Martínez-López S, Sierra-Cinos JL, et al. Regular consumption of a cocoa product improves the cardiometabolic profile in healthy and moderately hypercholesterolaemic adults. Br J Nutr. 2014; 111(1): 122–34.
Kwok CS, Boekholdt SM, Lentjes MAH, et al. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart. 2015; 101(16): 1279–87.
Ren Y, Liu Y, Sun XZ, et al. Chocolate consumption and risk of cardiovascular diseases: a meta-analysis of prospective studies. Heart. 2019; 105(1): 49–55.
Yuan S, Li X, Jin Y, et al. Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies. Nutrients. 2017; 9(7): 688.
Larsson SC, Akesson A, Gigante B, et al. Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis. Heart. 2016; 102(13): 1017–22.
Gong F, Yao S, Wan J. Chocolate Consumption and Risk of Heart Failure: A Meta-Analysis of Prospective Studies. Nutrients. 2017; 9(4): 402.
Endres K, Schäfer KH. Influence of Commensal Microbiota on the Enteric Nervous System and Its Role in Neurodegenerative Diseases. J Innate Immun. 2018;10:172–180.
Scheiblich H, Trombly M, Ramirez A, et al. Neuroimmune Connections in Aging and Neurodegenerative Diseases. Trends Immunol. 2020; 41(4): 300–312.
Magrone T, Russo M. A, Jirillo E. Cocoa and Dark Chocolate Polyphenols: From Biology to Clinical Applications. Front Immunol. 2017; 8: 677.
Mastroiacovo D, Kwik-Uribe C, Grassi D, et al. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study--a randomized controlled trial. Am J Clin Nutr. 2015; 101(3): 538–48.
Spencer JPE. Flavonoids and brain health: multiple effects underpinned by common mechanisms. Genes Nutr. 2009; 4(4): 243–50.
Madhavadas S, Kapgal VK, Kutty BM, et al. The Neuroprotective Effect of Dark Chocolate in Monosodium Glutamate-Induced Nontransgenic Alzheimer Disease Model Rats: Biochemical, Behavioral, and Histological Studies. J Diet Suppl. 2016; 13(4): 449–60.
Dubner L, Wang J, Ho L, et al. Recommendations for Development of New Standardized Forms of Cocoa Breeds and Cocoa Extract Processing for the Prevention of Alzheimer’s Disease: Role of Cocoa in Promotion of Cognitive Resilience and Healthy Brain Aging. J Alzheimers Dis. 2015;48(4):879–89.
Jackson SE, Smith L, Firth J, et al. Is there a relationship between chocolate consumption and symptoms of depression? A cross-sectional survey of 13,626 US adults. Depress Anxiety. 2019;36(10):987–95.
Zugravu C, Otelea MR. Dark Chocolate: To Eat or Not to Eat? A Review. J AOAC Int. 2019;102(5):1388–96.
Araujo QRD, Gattward JN, Almoosawi S, et al. Cocoa and Human Health: From Head to Foot- A Review. Crit Rev Food Sci Nutr. 2016; 56(1):1–12.
Lamport DJ, Christodoulou E, Achilleos C. Beneficial Effects of Dark Chocolate for Episodic Memory in Healthy Young Adults: A Parallel-Groups Acute Intervention with a White Chocolate Control. Nutrients. 2020; 12 (2): 483.
Socci V, Tempesta D, Desideri G, et al. Enhancing Human Cognition with Cocoa Flavonoids. Front Nutr. 2017; 4: 19.
Karabay A, Saija JD, Field DT, et al. The acute effects of cocoa flavanols on temporal and spatial attention. Psychopharmacology (Berl). 2018; 235(5): 1497–511.
Neshatdoust S, Saunders C, Castle SM, et al. High-flavonoid intake induces cognitive improvements linked to changes in serum brain-derived neurotrophic factor: Two randomised, controlled trials. Nutr Healthy Aging. 2016; 4(1): 81–93.
Barrera-Reyes PK, de Lara JCF, González-Soto M, et al. Effects of Cocoa-Derived Polyphenols on Cognitive Function in Humans. Systematic Review and Analysis of Methodological Aspects. Plant Foods Hum Nutr. 2020;75(1):1–11.
Krakowiak O, Nowak R. Mikroflora przewodu pokarmowego człowieka – znaczenie, rozwój, modyfikacje. Postępy Fitoterapii. 2015;3:193–200.
Martin MÁ, Ramos S. Impact of cocoa flavanols on human health. Food Chem Toxicol. 2021;151:112121.
Sorrenti V, Ali S, Mancin L, et al. Cocoa Polyphenols and Gut Microbiota Interplay: Bioavailability, Prebiotic Effect, and Impact on Human Health. Nutrients. 2020; 12 (7): 1908.
Wiese M, Bashmakov Y, Chalyk N, et al. Prebiotic Effect of Lycopene and Dark Chocolate on Gut Microbiome with Systemic Changes in Liver Metabolism, Skeletal Muscles and Skin in Moderately Obese Persons. Biomed Res Int. 2019;2:4625279.
Shin JH, Kim CS, Cha L, et al. Consumption of 85% cocoa dark chocolate improves mood in association with gut microbial changes in healthy adults: a randomized controlled trial. J Nutr Biochem. 2021; 99: 108854.
Ezra-Nevo G, Henriques SF, Ribeiro C. The diet-microbiome tango: how nutrients lead the gut brain axis. Curr Opin Neurobiol. 2020;62: 122–32.
Kord-Varkaneh H, Ghaedi E, Nazary-Vanani A, et al. Does cocoa/dark chocolate supplementation have favorable effect on body weight, body mass index and waist circumference? A systematic review, meta-analysis and dose-response of randomized clinical trials. Crit Rev Food Sci Nutr. 2019;59(15):2349–2362.
Bruinsma K, Taren DL. Chocolate: food or drug? J Am Diet Assoc. 1999; 99(10): 1249–1256.
Arzani M, Jahromi SR, Ghorbani Z, et al. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain. 2020;21(1):15.
Nowaczewska M, Wiciński M, Kaźmierczak W, et al. To Eat or Not to Eat: A Review of the Relationship between Chocolate and Migraines. Nutrients. 2020;12(3):608.
Jabłońska-Ryś E, Zalewska-Korona M, Michalak-Majewska M. Czekolada jako źródło szczawianów rozpuszczalnych w diecie. Bromat Chem Toksykol. 2013;2:206–210.
Lopes JP, Kattan J, Doppelt A, et al. Not so sweet: True chocolate and cocoa allergy. J Allergy Clin Immunol Pract. 2019;7(8):2868–2871.
Rodríguez-Lagunas MJ, Vicente F, Pereira P, et al. Relationship between Cocoa Intake and Healthy Status: A Pilot Study in University Students. Molecules. 2019;24(4):812.
Pérez-Cano FJ, Massot-Cladera M, Franch A, et al. The effects of cocoa on the immune system. Front Pharmacol. 2013;4:71.
Gandhi GR, Neta MTSL, Sathiyabama RG, et al. Flavonoids as Th1/Th2 cytokines immunomodulators: A systematic review of studies on animal models. Phytomedicine. 2018;44:74–84.