Kuna Cocoa: The Optimal Way to Decrease Blood Pressure, and, to Reduce Risk of Heart Disease and Cancer?

The main drawback to optimal health if you eat store-bought chocolate is that cacao beans are roasted, thereby increasing the concentration of the carcinogen, acrylamide (https://michaellustgarten.com/2014/07/27/acrylamide-is-in-chocolate-another-reason-why-cooking-food-at-high-temperature-is-not-good-for-you/). Besides eating homemade chocolate made from raw cacao beans (https://michaellustgarten.com/2014/09/21/homemade-chocolate-in-2-minutes/), are there any health benefits to drinking raw cacao?

The answer is yes, and it comes from the Kuna Indians, who live on a group of islands near Panama. The Kuna have been shown to have a low average blood pressure (BP, 110/70 mm Hg), and, do not experience the age-related increase in blood pressure that is common in Western society (Hollenberg et al. 1997). More importantly, death rates from cardiovascular disease and cancer, the #1 and #2 causes of death in the US were almost completely eliminated in the Kuna. Between 2000 to 2004, on the mainland of Panama, Bayard et al. (2007) reported that for every 100,000 residents, 83 died from cardiovascular disease (CVD), and 68 died from cancer. In contrast, per 100,000 Kuna, these death rates were reduced to 9 for CVD (a 9-fold reduction!) and 4 (a 15-fold reduction!) for cancer, respectively. In other words, cardiovascular disease and cancer are almost non-existent as a cause of death among the Kuna!

One could make the argument that the Kuna have decreased rates of CVD and cancer if it can be shown that their population is younger than on mainland Panama. The incidence of CVD and cancer increase with age, so if the Kuna population was younger than on the mainland, this could possibly explain their reduced death rates. However, the opposite was found to be true: approximately 94% of the residents of Panama are younger than 55 years of age, whereas ~87% of the Kuna are younger than 55. In addition, ~6% of Kuna’s population were found between the age of 55-64; ~4.4% were 65-74, and, ~2.4% were older than 75. In contrast, only 3% of mainland Panamanians were 55-64, ~1.9% were 65-74, and ~1.1% were older than 75 (Bayard et al. 2007). In other words, the percentage of Kuna older than 55 years was more than doubled, relative to mainland Panama! Not only do the Kuna have less CVD and cancer, they live longer than their mainland counterparts.

Before discussing how this is possible, it’s important to mention that the Kuna’s salt intake has been reported to be higher than both mainland Panama and, when compared with a Western diet. The Kuna eat, on average, 5500 mg of salt per day (Hollenberg et. al 1997). In comparison, Kuna who migrate to mainland Panama consume ~3300 mg/day (McCullough et. al 2006), subjects on a Western diet consume ~3700 mg, and, vegans consume ~1400 mg salt/day (Fontana et. al 2007). In other words, the Kuna eat more salt, but yet have lower BP, the absence of an age-related rise in BP, and have reduced risk of disease and mortality, relative to their Westernized-diet counterparts on the mainland of Panama.

Do the Kuna have genes that protect them from elevated blood pressure? If the Kuna were genetically protected, one would anticipate that they could move to an urban environment and maintain low blood pressure. However, Kuna that migrated to mainland Panama approximately 20 years earlier were found to have an increased incidence of both hypertension, and an age-related rise in BP (Hollenberg et. al 1997). This indicates that the Kuna were not protected by genes, and the factor that was keeping their blood pressure down was environmental.

So, how is this possible? There may be clues in the Kuna diet, which is almost exclusively plant and fish based, with almost no dairy, meat or nuts. The Kuna eat more fruit, 5 servings/day, vs. 1 serving/day on the mainland. The Kuna eat approximately 6 oz. fish/day, compared with, 1.5 oz/ day on the mainland (McCullough et. al 2006). Both increased fruit and fish intake may be responsible for the improved health that the Kuna experience, relative to their mainland counterparts.

But, there is another factor which is dramatically different in the Kuna diet when compared to the mainland-the Kuna consume more than 4 cups, or 30-40 ounces of a cocoa drink on a daily basis.  Mainland Panamanians ingest little cocoa, and what they take is commercially available and flavanol-poor (McCullough et. al 2006). In contrast, unlike almost all commercially available chocolate, the cocoa consumed by the Kuna is not roasted. To make their cocoa drink, the Kuna grind raw cacao beans, which is then boiled with banana. After boiling this mixture, it is poured through a strainer, leaving behind the cocoa and banana solids. Because it’s not roasted, Kuna cocoa contains all of the health benefits of the cacao bean, with none of the acrylamide!

It’s important to note that the cocoa ingested by the Kuna is naturally very rich in a specific subclass of flavonoids known as flavanols, including epicatechin, catechin, and flavanol-based oligomers known as procyanidins (Chevaux et. al 2001, Fisher and Hollenberg 2005). Kuna cocoa beans provide 3000 mg/100g flavanols. Kuna cocoa powder provides less (flavanols are lost during the fermentation process), at ~2000 mg/100g cocoa. In contrast, 6 commercially available cocoa powders /cocoa drinks didn’t exceed 150 mg flavanols/100g cocoa (Fisher and Hollenberg 2005). High levels of flavanol have been shown to reduce risk of death from coronary artery disease by as much as 58% (Mukamal et al. 2002).

Since I don’t live with the Kuna off the mainland of Panama, I don’t have access to unfermented cacao beans. However, raw, organic, fermented, non-roasted cacao beans are indeed available online. To make the cocoa drink, I use 1 oz. of cacao beans, 1 medium-large banana and ~35 oz. of water, boiled for 10-15 minutes. Then, I pass this solution through a strainer, and drink it once it cools down. It’s delicious!

If you’re interested in watching an ABC news video on the Kuna and the preparation of this cocoa drink, here is the link:http://abcnews.go.com/Health/video/cocoa-kuna-indians-panama-native-americans-chocolate-production-13402637.


If you’re interested, please have a look at my book!


Acrylamide data via: http://www.fda.gov/Food/FoodborneIllnessContaminants/ChemicalContaminants/ucm053549.htm

Bayard V, Chamorro F, Motta J, Hollenberg NK. Does flavanol intake influence mortality from nitric oxide-dependent processes? Ischemic heart disease, stroke, diabetes mellitus, and cancer in Panama. Int J Med Sci. 2007 Jan 27;4(1):53-8.

Chevaux KA, Jackson L, Villar ME, et al. Proximate mineral and procyandin content of certain foods and beverages consumed by Kuna Amerinds of Panama. J Food Composit Anal. 2001;14: 553–563.

Fisher NDL, Hollenberg NKH. Flavanols for cardiovascular health: the science behind the sweetness. J Hypertension. 2005;23: 1453–1459.

Fontana L, Meyer TE, Klein S, Holloszy JO. Long-term low-calorie low-protein vegan diet and endurance exercise are associated with low cardiometabolic risk. Rejuvenation Res. 2007 Jun;10(2):225-34.

Hollenberg NK, Martinez G, McCullough M, et al. Aging, acculturation, salt intake, and hypertension. Hypertension. 1997; 29:171–176.

McCullough ML, Chevaux K, Jackson L, Preston M, Martinez G, Schmitz HH, Coletti C, Campos H, Hollenberg NK. Hypertension, the Kuna, and the epidemiology of flavanols. J Cardiovasc Pharmacol. 2006;47 Suppl 2:S103-9; discussion 119-21.

Mukamal KJ, Maclure M, Muller JE, Sherwood JB, Mittleman MA. Tea consumption and mortality after acute myocardial infarction. Circulation 2002; 105:2476–2481.


Michael Lustgarten

Ph.D, Physiology, University of Texas Health Science Center at San Antonio, 2009 B.S., Biochemistry, Queens College, 2003 B.A, English Textual Studies, 1994, Syracuse University

31 thoughts on “Kuna Cocoa: The Optimal Way to Decrease Blood Pressure, and, to Reduce Risk of Heart Disease and Cancer?

  1. First of all thanks for the great post!!

    Just something I noticed when reading your post and then watching the video. The video seems to say that the Kuna prepare their cocoa beans by fermenting and roasting them. But in your post you say they use unfermented and non roasted cocoa beans. Because I am thinking of trying to make the drink could you please clarify?

    Thanks in advance.

      1. Right. But exactly where? I did some looking and was unsure if some of the products meet all these specifications, “raw, organic, fermented, and non-roasted”. Which website and/or brand do you prefer?

      1. hi have you tried the drink from the beans yet? I am interested to try it but what is the exact process?

  2. How many cups a day do you drink and how many calories are in a cup? Considering the health benefits, calories are minor so I’m mainly curious. Can’t wait to try it!

  3. @lee, the recipe is in the post:

    “To make the cocoa drink, I use 1 oz. of cacao beans, 1 medium-large banana and ~35 oz. of water, boiled for 10-15 minutes. Then, I pass this solution through a strainer, and drink it once it cools down”.

  4. Hi there,

    I have been wanting to clarify that the Kuna Indians don’t roast their beans. Although you point out that the video you reference doesn’t mention roasting beans, I wanted to read concrete evidence that the Kuna Indians don’t roast their beans. Particularly as some foods really should be cooked before eating.

    However, I haven’t been able to red any specific studies mentioning the Kuna Indian’s not roasting their beans, and indeed the best I’ve read about the Kuna Indians suggests they do roast the beans before consumption; http://choco-story-brugge.be/ENG/panama2.htm

    I’d like to be proved wrong though as their is no doubting the acrylamide concern in roasted cocoa, but equally I’d love to see empirical evidence of societies consuming regular amounts of raw/unroasted cocoa.

    Thank you,


  5. I cannot buy whole raw cacao beans in my country (and getting it shipped from the US is both impractical and cost-prohibitive), but I can purchase organic raw cacao powder. Is it any good?

    1. It’s better than nothing. Ideally we we’d get the beans straight from the tree. Next best would be grinding the beans, fresh. Who knows how long the powder sits in the store…

      1. Yeah, I guess you’re right. Plus I believe the powder is defatted as it contains only 12% fat.

  6. I eventually managed to purchase some whole cacao beans.
    The label says they are raw and organic, but of course I have no way to tell. The way I make my own hot chocolate is: peel the beans (just in case they are moldy), crush the peeled beans in a word processor, add to a small pot along with the banana, some whole milk and a touch of chili pepper, boil (below boiling point) for ten minutes, and blend using an immersion blender.
    I don’t strain it.

    1. Do you like the taste? I do, but I was wasting a lot of the nutrition by only drinking the water. Now, I eat the beans with dates about once per week.

  7. Dear Michael, I understand from your Kuna-Cocoa article that the Kuna consume raw cocoa beans that have not been roasted or dutched. Do you know if raw means fermented or are the beans the Kuna use for their drink unfermented? Many thanks, Emma

    1. Hi Emma, I’m not sure if the Kuna use unfermented, raw cacao beans. because of proximity, I’d bet that they’re completely raw and fresh, not fermented. However, I’ve yet to come across any cacao bean online that isn’t sold as somewhat fermented.

  8. I’ve been drinking cocoa “tea” for a while now. I get my raw cocoa beans from https://chocolatealchemy.com/. I buy the “testing evaluation” beans for $31.50 for 10 lbs. I grind the raw beans in a blender until it looks like ground coffee. I put 1/3 cup of ground cocoa beans in a clean blender, then add the contents of one bigalow mint tea bag. I then add 1/4 cup of walnuts, two brazil nuts, and some stevia or a date. I then add 3 cups of boiling water to the contents of the blender and let it sit for 10 minutes then blend it on high for 2-3 minutes. I then add some ice and cold almond milk to cool it. I then pour the contents into a nut milk bag to strain it. It tastes great, although a bit bitter which is the way I like it.

    1. Although cocoa tea tastes great, I’ve been eating the whole bean to get all of its nutrition, rather than drinking its tea for a while. But also glad to hear that you enjoy cocoa tea!

  9. https://www.consumerlab.com/ had several commercial brands of dark chocolates, cacao and cocoa powders, nibs, and flavanol-containing supplements analyzed for the amount of cadmium that they contain. Many of their results are behind a paywall, by the way. ConsumerLab also proposed a likely tolerable threshold of daily cadmium consumption. A number of analyzed products contained more than the threshold. The article speculated that cacao from Africa tends to contain less cadmium than cacao from South America. I find it encouraging that the Kuna don’t seem to be harmed by drinking cacao in spite of their large consumption. Do you have any recommendations or thoughts on cadmium in cacao?

    1. I’m not worried about the cadmium in cacao. If it was a big problem, we’d expect to see adverse health outcomes related to cacao consumption, but that’s not the case…

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