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One of the largest, most rigorous randomized controlled trials in nutrition was published last month. Called COSMOS, it evaluated whether a supplement containing 500 milligrams of cocoa flavanols reduced cardiovascular events and/or death. It did. With more than 20,000 participants and a full 15% reduction in cardiovascular events and 39% reduction in cardiovascular deaths, this is one of the most successful nutrition intervention studies of all time. Mechanisms of cocoa flavanols include reduced blood pressure, increased blood vessel elasticity, and reduced inflammation. To match the doses given in the trial, about half a pound of dark chocolate would be required—or a handful of cacao nibs, or a supplement (as used in the study). Milk chocolate not recommended because of the large quantities required and likely bad health effects due to excess calories and refined sugar. Sorry.

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