What is chocolate?
Chocolate is made using beans harvested from the cocoa tree, Theobroma cacao. The beans are removed from their pod, fermented, dried, roasted and then ground to produce a cocoa mass or cocoa liquor. This is then pressed to yield cocoa butter and cocoa cake which is ground up into cocoa powder.

What is dark chocolate?
Dark chocolate is also known as "bittersweet" or "semisweet" chocolate. It contains a high percentage (=70%) of cocoa solids, and little or no added sugar. Dark chocolate has a rich, intense flavor, and is found in candies and some of the chocolate morsels (chips) used in baking.

What qualities should you look for in dark chocolate?
70% cocoa or more
Made from cocoa butter instead of fats such as palm and coconut oils. Although cocoa butter does contain significant amounts of saturated fat, it has been shown to have a neutral (or even a beneficial) effect on cholesterol unlike the saturated fat in both palm and coconut oils.
Made without the use of 'hydrogenated' or 'partially hydrogenated' oils which are known to negatively impact cholesterol.
Darker is better: plant chemicals like flavonoids contribute to pigment. So, more flavonoids means darker chocolate and potentially greater health benefits.

Why choose dark chocolate?

• Contains flavonoids called procyanidins & epicatechins; flavonoids are part of a group of antioxidants known as polyphenols and are found in a variety of foods including tea, red wine, and various fruits and vegetables
• Decreases LDL (bad) cholesterol oxidation
• Reduces the risk of blood clots
• Increases blood flow in arteries
• May lower high blood pressure
• Cocoa may have a beneficial effect on cholesterol levels because it consists mainly of stearic acid and oleic acid. Stearic acid is a saturated fat but unlike most saturated fatty acids, it does not raise blood cholesterol levels. Oleic acid, a monounsaturated fat, does not raise cholesterol and may even reduce it.
• May improve mood and pleasure by boosting serotonin and endorphin levels in the brain
• Contains a number of minerals, including calcium, magnesium, and potassium
  

Nutrition Information for 1 oz (28.35g) Dark Chocolate
Calories …….. 136
Protein ……1.19 g
Total Fat ………. 8.51 g
Calcium………9 mg
Magnesium ……..33 mg
Phosphorus ……..37 mg
Potassium ………103 mg
Caffeine ……18 mg

Special Considerations: Milk vs. Dark Chocolate:
Because milk binds to antioxidants in chocolate making them unavailable, milk chocolate is not an antioxidant source and is higher in fat
To get the benefits of antioxidants, avoid drinking milk with dark chocolate

What are the health concerns of chocolate?
Caffeine - Contained in chocolate
An addictive stimulant that may negatively impact health by contributing to headaches, anxiety, insomnia, heart palpitations, high blood pressure, digestive and urinary tract disorders
Has a diuretic effect, causing the body to lose water
Increases stomach acid. Avoiding it may be beneficial to people with digestive concerns.
Even modest amounts of caffeine may increase symptoms of hypoglycemia. Therefore, people with blood sugar concerns may consider avoiding caffeine
Avoidance of caffeine reduces symptoms of fibrocystic breasts in some women

Kidney Stones
Chocolate contains oxalates which can lead to an increase in urinary oxalate excretion. Increased urinary oxalate increases the risk of kidney stone formation. As a result, those individuals prone to developing kidney stones should reduce their intake of oxalate from food - including chocolate - as a way to reduce urinary oxalate.

Migraine Headaches
Dark chocolate which contains a natural chemical, tyramine, is thought to trigger migraines although the data is inconclusive. Not all individuals who suffer from migraines are sensitive to tyramine. Other foods containing tryamine include fermented and aged cheeses, certain red wines, and citrus and overripe fruits. Rather than eliminating all tyramine foods at once, experiment to see if certain foods are more problematic than others.

Nutrition Tips
H igh-quality chocolate contains a high percentage of cocoa solids. It is brown or dark brown in color, and is glossy. Avoid purchasing chocolate that has a grayish tone, white spots on the surface, or small holes.
While a little dark chocolate is food, a lot is not better. Chocolate is loaded with calories so consume sparingly.
Freeze small servings of chocolate to decrease temptation and help with portion control.
Treat yourself to high quality dark chocolate that has >70% cocoa. It is so rich and delicious that a small portion is usually satisfying.
To avoid overindulging in chocolate, eat it when after you have enjoyed a nice lunch or dinner.
Have a piece of fruit prior to the chocolate to help satisfy your sweet craving.

About this document:
Published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.