Vive Le Chocolat!

When we have a drink of cocoa, open a Snickers bar, or eat a chocolate truffle, we are consuming a food product originally named theobroma cacao, from the Greek word origin meaning “food of the gods.” This wonderful product was enjoyed by the Olmecs (1000 BC), Mayans, and Aztecs of Mesoamerica and was first discovered by Europeans in 1502 when Christopher Columbus encountered a boat full of Honduran natives transporting cacao “nibs” to another destination for trading. At that time, the stimulant properties of chocolate were recognized by the native populations who used it in ceremonies and gave it to warriors before battles. It was also enjoyed by the upper classes. The stimulants found in the cacao seed are mainly caffeine, theobromine, and serotonin, all of which have a stimulant effect on the body and brain.

In Mesoamerica, chocolate beverages were known as “xocoatl,” which means “bitter water.” In order to make this beverage, the beans must be fermented so that the flavors evolve. After fermentation, they are dried, cleaned, and then roasted, after which the shell is taken off to reveal a cacao “nib,” which is then ground to make the cocoa “mass.” When liquefied, it is chocolate “liquor” and can be separated into solids and cocoa butter. Cocoa butter is used to make white chocolate and is also used in medicines and cosmetic preparations. Most cacao is processed to produce edible chocolate these days, which can be any combination of cocoa solids, cocoa butter, added fats, and sugar. Milk chocolate actually contains dried milk solids as well.

Cocoa has been linked to health benefits over the years. Compounds in cocoa may help prevent weight gain and diabetes. One major study showed that when one particular part of the flavanols in chocolate known as oligomeric proanthocyanidins was fed to rats, it prevented weight gain if they were on a high-fat diet. These “OPC’s” also improved glucose tolerance and antidiabetic bioactivity better than all the flavanols in cocoa.

It did not take long for the cacao beans to be appreciated by all, especially after the original bitter drink (often mixed with chili peppers) was served with honey, milk, or cane sugar by the Europeans who drank it. It was popularized in Spain, then in France, England, and finally the Netherlands, where a process to add alkali was discovered which made it smoother and more palatable. Dutch cocoa became the gold standard for commercial chocolate in Europe. After Henri Nestle invented a way to powder milk, this was added to the Dutch cocoa to make milk chocolate bars. In this country, Milton Hershey followed the mass production techniques of Henry Ford and made affordable chocolate bars available to the public on a wide scale.

This brief history of cocoa shows a food which, when in its raw and original form, is full of antioxidants and nutrients, but when processed to make it more palatable by adding powders, oils, heat extractions, and sugars can end up being a popular food product with only a small health benefit.

All you have to do is read advertisements for chocolate or watch TV to know chocolate is widely touted as a health food. If you remember from past articles about ORAC values (antioxidant capacity) of foods, you know that cocoa powder is rated 26,000, Gogi berries 25,300, and processed dark chocolate is 13,100. Besides flavonoids, cocoa has catechin and epicatechin, both excellent in their antioxidant ability. However, consider that in almost every 2-ounce chocolate bar, there are 6 teaspoons of sugar. In some chocolate bars, there may also be hydrogenated oils and high fructose corn syrup, so it is important to read the list of ingredients of any chocolate-based product if you want to consume it for its health value. 

Cocoa powder, pure chocolate, can be used to make hot chocolate or used in desserts, and the label of ingredients will state 100 percent cocoa. This is pure chocolate in powder form without cocoa butter. Therefore, this less processed cocoa has more nutrient value and is more concentrated, while the more processed product has less nutrient value and can have more unhealthy ingredients. Bars of chocolate 70 percent dark, 80 percent dark, etc. are alkali processed and contain substantial amounts of sugar. The alkali process reduces the nutrient value of cocoa by about one-third. Commercial chocolate fondue mix usually has cocoa, cocoa butter, vanilla, hydrogenated soybean oil, coconut oil, palm oil, and is one-half sugar content. 

A healthier choice might be cocoa and milk with Stevia or Splenda to sweeten. You can dip fruit in this mixture for a nice combination. The healthiest forms of chocolate in descending order are cacao nibs, cocoa powder, baking chocolate, semisweet chips, and dark chocolate. In general, the higher the sugar content, the more addictive and less healthy it will be for you.

Why did chocolate become the “gift” of choice to wives and sweethearts over the centuries continuing through today? To understand this, consider that cocoa was brought to Europe before tea and coffee and is a milder stimulant than both of those. It also contains serotonin which is a “feel good” or euphoric body chemical. When men were frequenting coffee houses in Paris, women were drinking cocoa and enjoying the mild stimulation plus mood elevation that it was giving them. After the process was invented to make powdered milk, an Englishman named Joseph Fry found a way to make chocolate bars and chocolate truffles that you could give in a box, ready to eat, as a gift. Cadbury first promoted this as a gift for Valentine’s Day (love in a box), and then for other holidays and special occasions.

A recent analysis of the worldwide cocoa trade showed that 2,900,000 tons of chocolate are produced each year, but was only one-half as much as the world coffee production and only 2 percent of total sugar production. Like everything else we eat, scrutinize the ingredients in chocolate food items so you can choose the most healthy, the most pleasurable, or a combination of both. Vive le chocolat! 

James H. Carraway, M.D.

Dr. James Carraway is a full-time academic and practicing clinical plastic surgeon.  He is Director of the Cosmetic & Plastic Surgery Center of EVMS, is board certified in surgery and plastic surgery, and is a fellow of the American College of Surgeons.  Dr. Carraway has been teaching and practicing for 30+ years and has been director and chairman of residency training programs and fellowship programs in plastic surgery.
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