Chocolate and cocoa may interfere with platelet activation and aggregation. Some of the beneficial effects of chocolate may be related to its effect on platelet aggregation.


Underlying cause: polyphenols



(1) suppression of ADP-stimulated platelet activation

(2) suppression of epinephrine-stimulated platelet activation

(3) suppression of platelet microparticle formation


Factors associated with a greater effect upon platelets:

(1) chocolate or cocoa with higher levels of polyphenols (such as dark chocolate)

(2) greater amount of chocolate or cocoa

(3) concurrent use of aspirin or other antiplatelet medications

(4) concurrent intake of other foods high in polyphenols


A patient with a moderate to severe coagulopathy (von Willebrand disease, hemophilia, other) may be advised to avoid chocolate to reduce the risk of serious bleeding.


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