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  Substance Info: (and synonyms)
Cacao / Cocoa

Background Info:

Seed of tropical cacao tree, Theobroma Cacao, which means "food of the Gods". Cacao was cultivated by the Aztecs and Mayans over 2,000 years ago. All cocoa and chocolate products are made from the seed, which is split open and left to ferment for about a week. This removes the raw taste and develops the oils. The beans are then dried, roasted and ground to make chocolate powder.

The cocoa is liquefied (cocoa liquor) and processed in one of three ways. It can be poured into moulds (baking chocolate), pressed to separate most of the butter from the cocoa (cocoa powder), or sweetened and processed into chocolate.

Cocoa butter is used in manufacturing confections. Cocoa butter substitutes can be produced from soy, maize/corn, palm kernel oil, and cottonseed, and are used in chocolate-flavored products.

Cocoa butter is used in chocolate manufacture. If not adequatly purified, may contain cocoa allergens.

 

Adverse Reactions:

IMMUNE REACTIONS


[ 1 / 1 ]

Specific IgE antibodies have been found in patients with symptoms such as bronchial asthma and allergic rhinitis after different food intake, of which chocolate was one. (Galant 1973 ref.26419 7)

Reference:
Galant SP, Bullock J, Frick OL. An immunological approach to the diagnosis of food sensitivity. Clin Allergy 1973 Dec;3(4):363-72.




Non-Immune reactions


[ 1 ]

Cocoa powder aspiration. (Lopatka 2004 ref.26404 5)

Reference:
Lopatka J, Goto M, Ravindranath T. Cocoa powder aspiration. Clin Pediatr (Phila) 2004 Jan-Feb;43(1):111-4.



[ 2 ]

A 23-month-old girl with an 8-month history of multiple hospitalizations for recurrent acute severe cutaneous and mucous membrane vasculitis with large joints involvement. She had a slightly elevated serum total IgE level, but negative skin tests to foods, including chocolate that was suspected by the mother. Avoidance of chocolate resulted in remission, except following accidental ingestion of cocoa-containing products. (Businco 2002 ref.5817 7)

Reference:
Businco L, Falconieri P, Bellioni-Businco B, Bahna SL. Severe food-induced vasculitis in two children. Pediatr Allergy Immunol 2002;13(1):68-71



[ 3 ]

Cocoa consumption suppressed ADP- or epinephrine-stimulated platelet activation and platelet microparticle formation. Cocoa consumption had an aspirin-like effect on primary hemostasis. (Rein 2000 ref.7166 5)

Reference:
Rein D, Paglieroni TG, Wun T, Pearson DA, Schmitz HH, Gosselin R, Keen CL. Cocoa inhibits platelet activation and function. Am J Clin Nutr 2000;72(1):30-5



[ 4 ]

Migraine. In this study, cacao, banana, egg and hazelnuts were found to be responsible for migraine headaches in children and young adults. On an oligoantigenic diet, 6/12 presented a completed remission of headache, 5/12 had a significant improvement of the migrainous pattern (Guariso 1993 ref.2092 7)

Reference:
Guariso G, Bertoli S, Cernetti R, Battistella PA, Setari M, Zacchello F. Migraine and food intolerance: a controlled study in pediatric patients [Italian] Pediatr Med Chir 1993;15(1):57-61



[ 5 ]

A hypothesis that multiple sclerosis may be caused by an allergic or other adverse reactions to certain foods, mostly cocoa products, cola, and coffee. (Maas 1987 ref.2024 3)

Reference:
Maas AG, Hogenhuis LA. Multiple sclerosis and possible relationship to cocoa: a hypothesis. Ann Allergy 1987;59(1):76-79



[ 6 ]

Histamine can be released without IgE involvement. (Moneret-Vautrin 1979 ref.74 875) Chocolate contains many other substances which may result in hypersensitivity and allergy-like reactions.

Reference:
Moneret Vautrin DA Food pseudo-allergy. Pitman Med Publ Co Ltd London 1979




Occupational reactions


[ 1 ]

Respiratory function and immunological status were studied in 40 cocoa and 53 flour processing workers employed as packers in a confectionery industry and in 65 unexposed control workers in the same industry. A high prevalence of chronic respiratory symptoms was recorded in exposed workers, varying from 5.0% to 30.0% in cocoa workers and from 5.7% to 28.3% in flour workers. Occupational asthma was diagnosed in 2 (5%) of the cocoa workers and in 3 (5.7%) of the flour workers. None of the control workers suffered from occupational asthma. The prevalence of positive skin tests for cocoa (60.2%) was significantly higher than the prevalence of positive skin tests for flour (25.8%) among the 93 exposed workers. Bronchoprovocation testing demonstrated significant decreases in lung function following inhalation of cocoa dust extract and flour dust in workers with respiratory symptoms and large across-shift reductions in lung function. (Zuskin 1998 ref.2022 2)

Reference:
Zuskin E, Kanceljak B, Schachter EN, Godnic-Cvar J, Mustajbegovic J, Budak A. Respiratory function and immunological status in cocoa and flour processing workers. Am J Ind Med 1998;33(1):24-32



[ 2 ]

Occupational asthma. A case study on a confectionery worker complaining of symptoms in the nose and respiratory system reported the presence of specific IgE antibodies to cacao allergens. (Perfetti 1997 ref.2091 5)

Reference:
Perfetti L, Lehrer SB, McCants M, Malo JL Occupational asthma caused by cacao. Allergy 1997;52(7):778-780



[ 3 ]

This study assessed immunologic and clinical findings of workers in a confectionary plant: a group of 71 confectionary workers were evaluated. The most frequent positive skin reaction occurred with extracts of cacao (31%), followed by reactions to chocolate (9%), cocoa (6%), hazelnut (6%), and sugar (2%). Increased serum IgE levels were found in 13.0% and increased IgM serum levels in 52.1% of these confectionary workers. The prevalence of asthma (26.1%) and dyspnea (26.1%) in workers with positive skin tests was significantly higher than in workers with negative skin tests. There was a high prevalence of acute respiratory symptoms during the work shift, but no significant association with immunologic tests was found. (Zuskin 1994 ref.1949 7)

Reference:
Zuskin E, Kanceljak B, et al. Immunologic findings in confectionary workers. Ann Allergy 1994;73(6):521-526



[ 4 ]

Immunological and respiratory findings were studied in a group of 90 confectioners. Intradermal skin tests with different food allergens demonstrated the largest positive skin reaction to cocoa (63%), followed by chocolate (9%), cacao, nut and almond (6%) and sugar (2%). Increased IgE serum levels were found in 13.8% of the confectioners, and elevated IgM concentrations in 43.3%. The prevalence of occupational asthma and dyspnea (26.1%) in workers with positive skin tests was significantly higher than in those with negative skin tests (0%; 4.1%). There was a high prevalence of acute symptoms during the work shift. Most of these complaints were more frequent in workers with positive than in those with negative skin tests. Lung function studies demonstrated significant mean acute across-shift reductions of ventilatory capacity. (Zuskin 1994 ref.2023 7)

Reference:
Zuskin E, Kanceljak B, Mustajbegovic J. Epidemiologic study of immunologic status of confectionary workers [Serbo-Croatian]. Lijec Vjesn 1994;116(9-10):240-244




Information supplied from an abridged section of:
Allergy Advisor - Zing Solutions
http://allergyadvisor.com/index.html

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Allergy Advisor  - Food Additive and Preservative Allergy and Intolerance Database


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