Invited Review ArticleCocoa, Chocolate, and Cardiovascular DiseaseGalleano, Monica PhD*; Oteiza, Patricia I PhD†‡; Fraga, Cesar G PhD*†Author Information From the *Physical Chemistry-Program of Free Radicals in Biochemistry (PRALIB), School of Pharmacy and Biochemistry, University of Buenos Aires-National Council of Scientific and Technological Research (CONICET), Argentina; †Department of Nutrition, University of California, Davis, CA; and ‡Department of Environmental Toxicology, University of California, Davis, CA. Received for publication May 30, 2009; accepted June 23, 2009. Supported by National Institute of Health AT2966, Center for Health and Nutrition Research-State of California Vitamin Price Fixing Consumer Settlement Fund, and Universidad de Buenos Aires-Ciencia y Técnica B801-B802, Argentina. The authors report no conflicts of interest. Reprints: Cesar G. Fraga, PhD, Department of Nutrition, University of California, Davis, One Shields Avenue, Davis, CA 95616 (e-mail: [email protected]). Journal of Cardiovascular Pharmacology: December 2009 - Volume 54 - Issue 6 - p 483-490 doi: 10.1097/FJC.0b013e3181b76787 Buy Metrics Abstract A significant body of evidence demonstrates that diets rich in fruits and vegetables promote health and attenuate, or delay, the onset of various diseases, including cardiovascular disease, diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in past years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant and chocolate as food contain a series of chemicals that can interact with cell and tissue components, providing protection against the development and amelioration of pathological conditions. The most relevant effects of cocoa and chocolate have been related to cardiovascular disease. The mechanisms behind these effects are still under investigation. However, the maintenance or restoration of vascular NO production and bioavailability and the antioxidant effects are the mechanisms most consistently supported by experimental data. This review will summarize the most recent research on the cardiovascular effects of cocoa flavanols and related compounds. © 2009 Lippincott Williams & Wilkins, Inc.