Fact Check: Can dark chocolate prevent heart attack?

Claim: An Instagram reel claims that eating dark chocolate can prevent heart attacks. The user claims that eating a small amount of dark chocolate with high cocoa content is good for the heart. According to the user, dark chocolates are rich in flavonoids, which improve blood flow, lower blood pressure, and reduce the risk of blood clots. The video can be seen here. 

Fact Check: This claim is Misleading. 

Understanding Heart Attack

Heart attacks, medically called myocardial infarctions, are a leading cause of death globally. According to the National Heart, Lung, and Blood Institute (NHLBI), myocardial infarction, also known as a heart attack, occurs when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can’t get oxygen. If blood flow isn’t restored quickly, the section of the heart muscle begins to die. (1)

Incidence of Heart Attack 

According to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the leading cause of death globally, with more than 17.9 million deaths each year. Of these, heart attacks and strokes account for a significant majority. (8) This is due to lifestyle factors such as increased consumption of unhealthy diets, higher rates of smoking, and sedentary lifestyles.

Risk Factors Associated with Heart Attacks

Dr Manav Aggarwal, Interventional Cardiologist, Sanjeevan Hospital, New Delhi, explained, "Understanding the risks of heart attacks is crucial for prevention. Lifestyle choices play a significant role; an unhealthy diet, lack of exercise, and smoking are major red flags. Medical conditions like high cholesterol, hypertension, diabetes, and obesity further escalate the risk, and when these conditions cluster, it's termed metabolic syndrome, which notably raises heart attack risks. But there are also factors beyond our control, such as age and family history, that influence risk. We must manage what we can through lifestyle adjustments and regular check-ups to mitigate these risks."

Benefits of eating Dark Chocolate

Dark chocolate has gained popularity over several decades for its significant health benefits. It contains numerous bioactive components, such as polyphenols, flavonoids and minerals like Iron, Magnesium, Copper, and Manganese, which positively influence the human immune system. Dark Chocolate offers protection against cardiovascular diseases, certain cancers, and neurological disorders like Alzheimer's and Parkinson's disease. Additionally, dark chocolate possesses anti-diabetic, anti-inflammatory, and antimicrobial properties. It is also known for its role in promoting a healthy lipid profile. (2) According to the American Heart Association (AHA), Dark chocolate is high in flavonoids, particularly a subtype called flavanols that is associated with a lower risk of heart disease. (3)

Can dark chocolate prevent heart attack?

Dark chocolate contains compounds such as flavonols, catechins, procyanidins, and theobromine that may offer cardiovascular benefits, but it is incorrect to claim that eating dark chocolate can prevent heart attacks. 

Research published in Frontiers in Nutrition by Ludovici et al. found that consuming flavanol-rich cocoa or chocolate can lower blood pressure and improve cardiovascular health. The study stated that cardiovascular disease (CVD) is a leading cause of death worldwide, and polyphenol-rich foods like cocoa may reduce CVD risk by improving blood pressure, vascular function, and other cardiovascular factors. (6) 

Moreover, a meta-analysis of prospective studies involving 508,705 participants found that eating chocolate three times per week lowered the risk of cardiovascular disease by 9%. However, eating chocolate more frequently showed little additional benefit. This suggests that moderate consumption of chocolate may be optimal for heart health. (7)

Research published in the European Journal of Preventive Cardiology indicates that eating chocolate at least once a week is associated with a reduced risk of heart disease, based on an analysis of studies examining chocolate consumption and coronary artery disease (4). Furthermore, a study in Vascular Pharmacology by Asimina Kerimi et al. found that dark chocolate contains bioactive components such as catechins, procyanidins, and theobromine, which positively affect the cardiovascular system by improving blood pressure and endothelial function (5).

In conclusion, while there is evidence that dark chocolate has beneficial properties like lowering blood pressure and improving cardiovascular health, there is no scientific evidence that it can prevent heart attacks.

What do experts say?

The Medical Dialogues Fact Check Team spoke with Dr Prem Aggarwal, Cardiologist and Chairman of Sanjeevan Hospital, New Delhi; he said, "Dark chocolate is richer in flavanols compared to other types of chocolate, which has sparked interest in its potential heart health benefits. Flavanols are known for their association with a lower risk of heart disease, and some studies have linked chocolate consumption with reduced insulin resistance and may improve endothelial function. However, while these findings are promising, the evidence that dark chocolate contains enough flavanols to significantly impact heart health is still not robust. More research is needed to fully understand its effects. Meanwhile, dark chocolate can be a part of a healthy diet when consumed in moderation, keeping in mind its caloric content." 

Medical Dialogues Final Take

While dark chocolate has cardiovascular benefits and may support heart health, there is no conclusive evidence or medical consensus that eating it will prevent heart attacks. Moderation is essential, and dark chocolate should be enjoyed as part of a balanced diet rather than being relied upon as a specific preventive measure.

Hence, this claim is Misleading. 

References

1. https://www.nhlbi.nih.gov/health/heart-attack

2. Samanta S, Sarkar T, Chakraborty R, Rebezov M, Shariati MA, Thiruvengadam M, Rengasamy KRR. Dark chocolate: An overview of its biological activity, processing, and fortification approaches. Curr Res Food Sci. 2022 Oct 15;5:1916-1943. doi: 10.1016/j.crfs.2022.10.017. PMID: 36300165; PMCID: PMC9589144.

3. https://www.heart.org/en/news/2019/02/12/are-there-health-benefits-from-chocolate

4. Krittanawong C, Narasimhan B, Wang Z, et al. Association between chocolate consumption and risk of coronary artery disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2020. doi:10.1177/2047487320936787.

5. Kerimi A, Williamson G. The cardiovascular benefits of dark chocolate. Vascul Pharmacol. 2015 Aug;71:11-5. doi: 10.1016/j.vph.2015.05.011. Epub 2015 May 27. PMID: 26026398.

6. Ludovici, V., Barthelmes, J., Nägele, M. P., Enseleit, F., Ferri, C., Flammer, A. J., Ruschitzka, F., & Sudano, I. (2017). Cocoa, Blood Pressure, and Vascular Function. Frontiers in nutrition, 4, 36. https://doi.org/10.3389/fnut.2017.00036

7. Yuan, S., Li, X., Jin, Y., & Lu, J. (2017). Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies. Nutrients, 9(7), 688. https://doi.org/10.3390/nu9070688

8. https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1