Despite discrepancy among results in the literature, flavanol‐rich chocolate consumption during pregnancy could have beneficial effects on the risk of preeclampsia (PE) through improvement of blood pressure and endothelial function. Theobromine, a major constituent of dark chocolate, also possesses vasodilatation properties. However, to our knowledge, no study has investigated the effect of high‐flavanol and high‐theobromine chocolate consumption on lipid profile in pregnant women at risk of PE.ObjectiveTo assess the impact of high‐flavanol and high‐theobromine chocolate consumption on lipid profile in pregnant women at risk of PE.MethodsA single‐center randomized controlled trial was conducted in women with singleton pregnancy between 11 and 14 weeks gestation. Uterine artery Doppler was performed and women with bilateral diastolic notches and either a uterine artery pulsatility index (PI) >95th percentile on one side and/or bilateral PI>50th percentile were considered as potentially eligible for randomization. A total of 131 pregnant women were randomly assigned to either high‐flavanol, high theobromine (HFHT) or low‐flavanol, low‐theobromine (LFLT) chocolate groups. Women had to consume a total of 30 g of chocolate on a daily basis for 12 weeks. Fasting blood samples and anthropometric variables were measured at baseline and at 12 weeks.ResultsA significant group by time interaction was observed for triglyceride concentrations (p=0.006), with a more pronounced increase in the LFLT group (increases of 0.6 mmol/L in HFHT versus 0.8 mmol/L in LFLT). Significant time effects were observed in total‐C, LDL‐C, HDL‐C and total‐C on HDL‐C ratio (p< 0.0001), with similar increases in both HFHT and LFLT chocolate groups. A significant group by time interaction was noted for body weight (p=0.03), with a greater weight gain in the HFHT group.ConclusionOur results suggest that consumption of HFHT chocolate could have beneficial effects on triglyceride concentrations in pregnant women at risk of PE.Support or Funding InformationThis research project was supported by Canadian Institute of Health Research by the Jeanne and Jean‐Louis Lévesque Perinatal Research Chair at Laval University.