Chocolate and cocoa health effects in healthy people
What it found
In 15 randomised trials in healthy people, chocolate or cocoa made no clear difference to skin, blood pressure, cholesterol, weight, blood sugar, thinking skills or quality of life.
The one exception was triglycerides, which fell slightly more with chocolate than with control.
What they found
Studies in people
Triglycerides improved
Chocolate consumption significantly reduced triglyceride levels compared with control. This was the only outcome that showed a significant difference.
Blood pressure unchanged
Chocolate was not significantly better than control at reducing systolic or diastolic blood pressure. The certainty of evidence was moderate.
Cholesterol mostly unchanged
Chocolate made no significant difference to total cholesterol, LDL or HDL. The certainty of evidence was moderate for total cholesterol and LDL, and low for HDL.
Weight and body measures
Chocolate was not significantly different from control for body weight, BMI, waist circumference or body fat percentage. The certainty of evidence ranged from very low for weight to moderate for the others.
Blood sugar unchanged
Chocolate was not significantly different from control in affecting fasting plasma glucose. The certainty of evidence was moderate.
Skin, thinking, quality of life
No significant differences were found for skin hydration, wrinkles, sebum, corneocyte damage or elasticity, for cognitive function measures, or for quality of life. The certainty of evidence was low for cognitive outcomes.
Tolerability
Chocolate was generally well accepted. The most reported concerns were gastrointestinal disturbances and unpalatability. One severe adverse event of atrial arrhythmia occurred in the treatment group but was thought not related to the treatment.
What the authors conclude
“Low-to-moderate evidence showed no clear differences between the effects of chocolate and control groups on parameters related to skin, blood pressure, lipid profile, cognitive function, anthropometry, blood glucose, cognitive function, and quality of life regardless of form, dose, and duration among healthy individuals.”
Also in their conclusions
- They conclude that low-to-moderate evidence showed no clear differences between the effects of chocolate and control groups on parameters related to skin, blood pressure, lipid profile, cognitive function, anthropometry, blood glucose, cognitive function, and quality of life regardless of form, dose, and duration among healthy individuals.
- They note that chocolate is generally well accepted by study subjects, with gastrointestinal disturbances and unpalatability being the most reported concerns.
- They advise that high-quality evidence on the influence of chocolate on skin-related adverse effects, especially acne, cognitive functions, and quality of life, are still limited, and that no RCTs were identified for anticancer and immune-enhancing effects of chocolate among healthy volunteers.
How it was done
Chocolate and cocoa are eaten worldwide and are increasingly seen as functional foods, so the authors wanted to critically appraise the clinical evidence on their health effects. Previous reviews had focused on people with existing heart or metabolic conditions, not the general healthy population.
They searched medical databases for randomised controlled trials of chocolate or cocoa products taken for at least four weeks in healthy people, compared with placebo, no intervention or other non-cocoa interventions. They found 15 studies with 1025 participants, conducted in eight countries, lasting four to twenty-four weeks. Most studies lasted four to six weeks.
What it can’t tell you
- The studies were mostly short-term, lasting four to six weeks, so they cannot show what happens over longer periods.
- The evidence is low to moderate quality, so the results may change with more research.
- The review could not assess the contribution of specific bioactive compounds in chocolate because of limited data.
Who paid
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- Institute for Medical Research, Malaysia; Hospital Sultanah Bahiyah, Malaysia; Monash University Malaysia, Malaysia
The paper
- Title
- The Health Effects of Chocolate and Cocoa: A Systematic Review
- Type
- Systematic review
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Tan TYC, Lim XY, Yeo JHH, Lee SWH, Lai NM (2021). The Health Effects of Chocolate and Cocoa: A Systematic Review. Nutrients. doi:10.3390/nu13092909Free full textPubMed 34578786DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error