It’s a long story. Cocoa (Theobroma cacao) comes from the seeds of the fruit of a tropical tree grown around the world. There are about 20 species of the genus Theobroma, with only one of commercial value, divided into three groups. The trees make a good crop, are easy to grow, and yield about 20 to 30 pods a year, each containing 30 to 40 beans. The seeds are removed from their shells, dried, fermented, lightly roasted and ground to produce chocolate liquor—the basic ingredient for all chocolate products. Cocoa butter is the hard fat obtained from the crushed seeds.

Cacao has a recorded history of about 4000 years. The origin of the word “cacao” comes from the Maya of the Yucatan Peninsula. The Aztecs believed cacao was food of the gods (that’s what “Theobroma” means) and they used it as currency. I know people who would probably work for chocolate; I certainly have patients who pay me in chocolate. The Maya were the first to create chocolate by drying, fermenting, roasting and grinding the beans.

Christopher Columbus was the first European to bring the beans back to Europe around 1502. Chocolate wasn’t quite a hit among Europeans at first, because the Aztecs mixed their chocolate drink with chilies and dyed it red with annatto to look like blood (yes, they had a reputation for being “bloodthirsty”). Europeans quickly learned to mix their chocolate drinks with sugar, vanilla, cinnamon and even beer and wine. It was even served at Mass (I bet attendance increased!). When the French started drinking it, they were soon exalting its aphrodisiacal properties, placed heavy taxes on it and thus perpetuated its mythical reputation as a drink for the rich and romantic.

Chocolate houses in 17th and 18th century England supposedly became more popular than pubs. The first chocolate factory in England began in 1728. The first chocolate bar was produced at that same business in 1876 when they mixed chocolate powder with sugar and cocoa butter. The first milk chocolate bar was created in 1876 by Nestlé and Peters. American Milton Hershey became the first to mass-produce chocolate in 1894. His first Hershey Bar was sold for five cents. Today, of course, there are no limits to the chocolate creations you can make or purchase, from home, local stores, the internet and so on.

Chocolate liquor, the basic ingredient for chocolate products, has a high content of cocoa butter (over 50 percent). Unsweetened chocolate is chocolate liquor made into bars. Semisweet chocolate has more than 35 percent chocolate liquor; sweet dark chocolate has around 15 percent; milk chocolate has around 10 percent; and white chocolate has no cocoa solids but has around 20 percent cocoa butter (technically it’s not chocolate, but who’s counting).

Almost 400 compounds have been measured in cocoa. Some of the more well-known are: theobromine; methylxanthines; caffeine; fats (oleic acid, stearic acid, palmitic acid); starch; sugars; proteins; tannins; oxalates.

Here are some of the many positive effects of chocolate:

• Flavonoids (flavonols in dark chocolate) reduce risk of cardiovascular disease

• Lowers blood pressure by helping produce nitric oxide (Viagra, Levitra and Cialis all enhance the effects of nitric oxide). A tribe in Panama that drinks five cups of cocoa a day rarely develops high blood pressure, but when they leave their home island, some of them develop high blood pressure (is it the chocolate or exposure to modern society?)

• Antioxidant properties, preventing fat-like substances in the blood from oxidizing and clogging arteries, thus improving circulation

• Inhibits platelets from sticking together and forming clots

• Stimulants in chocolate like theobromine, caffeine, tyramine and phenylethylamine all contribute to increased alertness and mental activity (example: there are about 30 mg of caffeine in a chocolate bar, 95 mg in a cup of coffee)

• Tryptophan in chocolate produces serotonin which is antidepressant

• Anandamide is thought to be an endogenous ligand for the cannabinoid receptor, the receptor in the brain that binds THC (tetrahydrocannabinol), the chemical that causes the narcotic effects of marijuana (it is estimated that you may need to eat about 25 pounds of chocolate to mimic a marijuana high)

• Other compounds found in chocolate that may contribute to the chocolate high and addiction include: histamine, serotonin, theobromine, tryptophan, phenylethylamine, tyramine and salsolinol 

• Triggers the release of the body’s natural opiates (pain killers)

• Methylxanthines act like a diuretic, bronchyolytic, vasodilator, improve cardiac muscle performance, and muscle relaxant

• Treats diarrhea, causes constipation

• Does not increase serum cholesterol or LDL cholesterol

• Cocoa butter is used by the pharmaceutical and cosmetic industries as an inactive ingredient in dermatological preparations

Precautions and adverse effects: chocolate is stimulating and addicting for some people. It can cause migraine headaches, allergic reactions and constipation. Animals such as dogs and cats should not eat chocolate as they react to the theobromine and caffeine. Acne and tooth decay really cannot be blamed on chocolate, but rather on the sugars and fats that are added to its preparations. The benefits of chocolate do not apply to milk chocolate. Enjoy it—the darker, the better—in moderation.

William H. Stager, DO, MS, MPH, FAAFP, FAMA, FAAO, FACOFP AOBNMM Board Certified: Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine. AOBFP Board Certified: Family Medicine. Medical Acupuncture. Clinical Professor, Department of Family Medicine, NSUCOM. Clinical Associate Professor, Department of Family Medicine, LECOM. Medical Director, Flagler Institute for Rehabilitation, Inc., 311 Golf Rd., Ste. 1100, West Palm Beach. To contact the author, call 561-832-1894.