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Chocolate may be a factor for heartburn in some people because one of its constituents, theobromine, may affect the esophageal sphincter muscle in a way that permits stomach acids to enter the esophagus.[76] Theobromine poisoning is an overdosage reaction to the bitter alkaloid, which happens more frequently in domestic animals than humans. However, daily intake of 50–100 g cocoa (0.8–1.5 g theobromine) by humans has been associated with sweating, trembling and severe headache.[77] Chocolate contains alkaloids such as theobromine and phenethylamine, which have physiological effects in humans, but the presence of theobromine renders it toxic to some animals, such as dogs and cats.[78]
Chocolate and cocoa contain moderate to high amounts of oxalate,[79][80] which may increase someone's risk for kidney stones.[81] During cultivation and production, chocolate may absorb the heavy metal lead from the environment,[82] but the total amounts typically eaten are less than the tolerable daily limit for lead consumption, according to a World Health Organization report from 2010.[83] However, reports from 2014 indicate that "chocolate might be a significant source" of lead ingestion for children if consumption is high,[84][85] and "one 10 g cube of dark chocolate may contain as much as 20% of the daily lead oral limit."[84]
A few studies have documented allergic reactions from chocolate in children.[76] Other research has shown that dark chocolate can aggravate acne in men who are prone to it.[86] Research has also shown that consuming dark chocolate does not substantially affect blood pressure.[36] Chocolate and cocoa are under preliminary research to determine if consumption affects the risk of certain cardiovascular diseases[87] or cognitive abilities.[88]
A one-tablespoon (5 grams) serving of dry unsweetened cocoa powder has 12.1 mg of caffeine[89] and a 25-g single serving of dark chocolate has 22.4 mg of caffeine.[90] Although a single 7 oz. serving of coffee may contain 80–175 mg,[91] studies have shown psychoactive effects in caffeine doses as low as 9 mg, and a dose as low as 12.5 mg was shown to have effects on cognitive performance.