Background: Cocoa’s healthy benefits may be attributed to the potent antioxidant
activity of cocoa polyphenols, mainly flavanols, which have been characterised as existing in a high
concentration in cocoa. However, the phenolic composition of cocoa and cocoa-derived products
is highly variable, and manufacturing processes might significantly reduce their phenolic content.
For that reason, the full characterisation of cocoa and cocoa-derived products before evaluating their
bioactivity is crucial. The aim of this review is to analyse the available evidence on the effect of
flavanol-fortified cocoa-derived products on human health. (2) Methods: Forty-eight clinical trials
focused on the health effect of consuming flavanol-fortified drinks, bars and chocolate have been
reviewed, with a total of 1523 subjects. (3) Results: Although studies differ widely in methodology,
dosage, duration, and target population, beneficial effects of flavanol-rich cocoa consumption have
been observed at doses ranging from 45.3 mg/d to 1078 mg/d, especially on cardiovascular health
and cognitive function. (4) Conclusions: Considering the high consumption and acceptability of cocoa
and cocoa-derived products, the fortification of cocoa products as well as other highly consumed
foods with cocoa flavanols could be an effective strategy for health promotion.
