Does cocoa/dark Chocolate Supplementation Have Favorable Effect on Body Weight, Body Mass Index and Waist Circumference? A Systematic Review, Meta-Analysis and Dose-Response of Randomized Clinical Trials

Crit Rev Food Sci Nutr. 2019;59(15):2349-2362. doi: 10.1080/10408398.2018.1451820. Epub 2018 Apr 12.


Background: Cocoa and dark chocolate (DC) have been reported to be effective for health promotion; however the exact effect of cocoa/DC on anthropometric measures have not been yet defined. Methods: A comprehensive search to identify randomized clinical trials investigating the impact of cocoa/DC on body weight, body mass index (BMI) and waist circumference (WC) was performed up to December 2017. A meta-analysis of eligible studies was performed using random effects model to estimate pooled effect size. Fractional polynominal modeling was used to explore dose-response relationships. Results: A total of 35 RCTs investigated the effects of cocoa/DC on weight, BMI and WC were included. Meta-analysis did not suggest any significant effect of cocoa/DC supplementation on body weight (-0.108 kg, 95% CI -0.262, 0.046 P = 0.168), BMI (-0.014 kg/m2 95% CI -0.105, 0.077, P: 0.759,) and WC (0.025 cm 95% CI -0.083, 0.129, P = 0.640). Subgroup analysis revealed that that weight and BMI were reduced with cocoa/DC supplementation ≥ 30 g chocolate per day in trials between 4-8 weeks. Cocoa/DC consumption resulted in WC reduction in non-linear fashion (r = 0.042, P-nonlinearity = 0.008).Conclusion: Cocoa/DC supplementation does not reduce anthropometric measures significantly. However subgroup analysis regarding dose (≥ 30 g/day) and duration (between 4 to 8 weeks) revealed significant reduction of body weight and BMI.

Keywords: Body Weight; anthropometry; cacao; chocolate; meta-analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blood Pressure
  • Body Mass Index*
  • Body Weight*
  • Cacao / chemistry*
  • Chocolate / analysis*
  • Databases, Factual
  • Diet
  • Dietary Supplements*
  • Humans
  • Obesity / diet therapy
  • Randomized Controlled Trials as Topic
  • Waist Circumference*