High cholesterol doesn't mean giving up this sweet treat, says a cardiologist

Finding out that your cholesterol is high can change the way you look at your favourite foods. Suddenly, snacks you once enjoyed without a second thought may seem off the menu. For anyone with a sweet tooth, knowing what can stay and what should be limited can feel like another thing to worry about.

But not every food needs to be treated the same way. Some contain different types of fat, making the picture more complicated than it first appears.

The sweet treat a cardiologist says you can still enjoy

French cardiologist François Paillard has a reassuring message for chocolate lovers: a small daily portion of dark chocolate can still fit into your diet, even if your cholesterol is high.

In an interview with Journal des Femmes Santé, Paillard recommends around 10 to 20 grams a day, roughly one or two squares, depending on the bar.

His reasoning centres on the type of fat found in cocoa butter. Much of its saturated fat is stearic acid, which generally has a smaller effect on LDL cholesterol than some other saturated fatty acids.

His suggested portion is modest, providing around 100 to 120 calories for 20 grams. The French Cardiology Federation has also previously recommended one or two small squares of dark chocolate a day.

That doesn't mean chocolate lowers cholesterol. It simply means a small portion may fit into an otherwise balanced diet.

The opposing view

The Dutch food agency, Voedingscentrum, takes a more cautious view. Chocolate contains plenty of calories and saturated fat, around 20 grams per 100 grams, according to its guidance.

Saturated fat can raise LDL cholesterol, often called “bad” cholesterol, which is associated with a higher risk of cardiovascular disease. Dark chocolate may contain more cocoa than milk chocolate, but that doesn't automatically make it a low-fat or low-calorie food.

The agency also points out that evidence that chocolate protects the heart is limited. Some studies have found potentially positive effects, but the evidence is not strong enough to recommend eating chocolate to prevent cardiovascular disease.

What about the much-discussed cocoa flavanols?

Cocoa contains plant compounds called flavanols, which may help blood vessels function. But the amount varies considerably between products.

According to Voedingscentrum, research on blood vessel elasticity uses specific amounts of cocoa flavanols. An ordinary square from the supermarket may not contain enough to deliver the same effect.

A large US study, the COSMOS trial, tested a cocoa extract supplement in more than 21,000 adults. It did not find a statistically significant reduction in its primary outcome: total cardiovascular events. Taking a concentrated supplement is also not the same as eating chocolate.

So while cocoa flavanols are interesting to researchers, they are not a reason to treat an ordinary chocolate bar as a heart-health food.

How much chocolate is a sensible portion?

If you enjoy dark chocolate, Paillard's 10-to-20-gram suggestion offers a practical reference, not a universal rule for everyone. Chocolate squares vary in size, so checking the weight and nutrition label can help you keep track of your portion.

Look at the saturated fat, sugar and calorie content, too. A higher cocoa percentage does not automatically mean a product is low in saturated fat.

Most importantly, chocolate is not a treatment for high cholesterol. If your levels are elevated, follow your GP's or cardiologist's advice about diet, medication and other risk factors.

The takeaway: you may not need to give up every favourite treat, but portion size matters. A little dark chocolate can fit into some people's diets; it just shouldn't be mistaken for a way to lower cholesterol.