Hot cocoa and the heart-healthy Kuna: a Harvard case study.

Azure water. White sand. Mint green palm trees. Travel with me. To the Caribbean. A tiny island off of Panama. A unique and indigenous community of Kuna Indians. They’ve been living here in relative isolation for more than 500 years, enjoying their own private paradise — extraordinarily low rates of cardio vascular disease and remarkably long life expectancy.

Ecotourism brings visitors, but their exceptional health has long attracted health researchers from all over the globe, including a team led by Norman K. Hollenberg, MD, PhD, of Harvard Medical School and Brigham and Women’s Hospital. Dr. Hollenberg initially suspected that genetics were behind the Kuna’s low disease rates. But his group’s research showed that Kuna Indians who had moved from the island to Panama City decades earlier now have similar levels of hypertension and disease risk as the mainlanders. And a 1,280 percent higher risk of cardiovascular death versus those remaining on the island!

Genes were not the answer. What was?

Inside palm thatched dwellings, it’s time for breakfast. But it’s not coffee the Kuna are sipping. It’s hot cocoa, the first of at least five cups they’ll drink today. Dr. Hollenberg learned that the water on the island needs to be boiled for consumption, and the Kuna like to then add cocoa — a local, lightly processed recipe very high in cocoa flavanols.

Meticulously assessing lifestyle and environmental factors, Hollenberg’s team concluded that the Kuna’s exceptional health is likely influenced by dietary factors related to this local cocoa, the most common drink on the islands. (It turns out mainland Panamanians drink little cocoa, and it’s generally the commercially available, highly processed, low in flavanols kind.)

Hollenberg spent years continuing and confirming his research through controlled clinical trials. With a little help from the Kuna Indians, he profoundly advanced our understanding of cocoa flavanols and their compelling health benefits.

Back to New England. My messy desk. Right in the middle, a steaming, guilt-free mug of FlavaMix cocoa. (Thanks Dr. Hollenberg!)