Cocoa and chocolate, their clinical benefits: Insights in study design

Randomized controlled trials and meta-analyses have demonstrated the potential protective effect of cocoa and chocolate consumption with respect to cardiovascular disease (CVD) risk markers. Findings from experimental studies are in concordance with observational data, which include reduction in clinical disease (especially stroke) being associated with chocolate consumption. However, the effect size of any benefit, and the exact mechanism of action due to variability in reporting of dose and type potential bioactive compounds remains unclear. Thus, the present review aimed to analyse the published work where cocoa and chocolate have been assessed for their potential to protect against CVD and highlight the role of study design and type of product used in the variances of outcomes and how that might be used in formulating health advice.