The content of purine and other substances in cocoa powder is high, and long-term consumption of cocoa powder in large quantities may increase the purine content in the body, which in turn increases the probability of gout. Similarly, the high fat content in cocoa powder may increase the risk of hyperlipidemia if consumed in large quantities over a long period of time.

The alkaloid content in cocoa powder can have an excitatory effect, which may cause nerves to become tense in nervous people.