Insights & Discussion
Regular chocolate or cocoa consumption, rich in flavan-3-ols, has been associated with improved insulin resistance and blood vessel function, suggesting potential cardiovascular benefits.
The study systematically reviewed 42 randomized controlled trials involving 1297 participants to investigate the impact of chocolate, cocoa, and flavan-3-ols on major cardiovascular disease risk factors. Utilizing a comprehensive search across multiple databases, the researchers conducted meta-analyses, assessing acute and short-term chronic interventions. Results revealed consistent improvements, including reduced insulin resistance (HOMA-IR), enhanced flow-mediated dilatation (FMD), and favorable effects on blood pressure and cholesterol levels.
The findings indicate promising cardiovascular benefits associated with chocolate or cocoa consumption. Notably, the study highlights improvements in insulin sensitivity, blood vessel function, and blood pressure, emphasizing the potential positive impact of flavan-3-ols found in these products.
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Cocoa extract supplementation in older adults reduced cardiovascular disease related death rates, but did not significantly lessen total cardiovascular events.
2022 The American Journal of Clinical Nutrition Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial Sesso HD, Manson JAE, Aragaki AK, Rist PM, Johnson LG, Friedenberg G, et al.
Randomised Controlled Trial Cardiovascular Disease Cocoa
A randomized, double-blind, placebo-controlled trial was conducted on 21,442 US adults aged 60 or over, all of who were free of major cardiovascular disease and recently diagnosed cancer. The participants were assigned to either a cocoa extract supplement, which included 500 mg flavanols per day, or a placebo. The intervention phase ran from June 2015 to December 2020. The primary outcome was focused on the number of total cardiovascular events, including myocardial infarction, stroke, and cardiovascular death among others.
The results showed that during a median follow-up of 3.6 years, there were 410 participants taking cocoa extract and 456 under placebo who had confirmed total cardiovascular events. Secondary endpoints showed reduced death due to cardiovascular disease for the cocoa extract supplement users. However, there was no significant impact on the incidence of total cardiovascular events. Conversely, a lower risk of total cardiovascular events was supported when analyses were censored at nonadherence. Overall, no safety concerns were raised during the trial.
The consumption of cocoa or dark chocolate can reduce low-density lipoprotein cholesterol and fasting blood sugar levels in diabetic patients.
2021 Phytotherapy Research The effect of cocoa/dark chocolate consumption on lipid profile, glycemia, and blood pressure in diabetic patients: A meta‐analysis of observational studies Darand M, Hajizadeh Oghaz M, Hadi A, Atefi M, Amani R
Systematic Review Blood Sugar Cocoa Dark Chocolate
A systematic search of databases identified eight randomized controlled trials (RCTs) with 433 participants for meta-analysis. The results demonstrated a substantial reduction in LDL-c levels (WMD: −15.49 mg/dl) and FBS concentrations (WMD: −6.88 mg/dl) following cocoa/dark chocolate consumption. The study emphasizes the potential positive effects of cocoa/dark chocolate on the metabolic profile of diabetic individuals.
The meta-analysis included RCTs focusing on cocoa/dark chocolate interventions in diabetic patients, with a significant pooled analysis showing reduced LDL-c and FBS levels. The findings suggest that incorporating cocoa/dark chocolate in the diet of diabetic individuals could be beneficial for managing lipid profile and glycemia. Further research is necessary to solidify these insights and understand the complete impact on metabolic health.
Chocolate and cocoa product consumption significantly improved lipid profiles, but had no significant effect on other heath aspects such as cognitive function and blood pressure.
2021 Nutrients The Health Effects of Chocolate and Cocoa: A Systematic Review Tan TYC, Lim XY, Yeo JHH, Lee SWH, Lai NM
Systematic Review Chocolate Cocoa
A systematic search was performed on academic databases such as MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The researchers utilized a precise search strategy and keywords to gather the most relevant studies and evidence. The studies focused on a variety of health effects related to the consumption of chocolate and cocoa products, like their effects on skin, cardiovascular health, anthropometry, cognitive function, blood glucose levels, and overall quality of life.
The research revealed considerable improvements in lipid profiles (particularly in triglycerides) among those who consumed chocolate or cocoa products, compared to controls. However, there were no significant differences observed in other outcome parameters related to skin health, blood pressure, cognitive function, anthropometry, blood glucose levels, and quality of life between the chocolate/cocoa consumption group and the control group. The subjects generally accepted chocolate well, with gastrointestinal disturbances and unpalatability reported as their main concerns.
Cocoa-rich products consumption can improve mood and affect in the short term.
2021 Critical Reviews in Food Science and Nutrition The effect of cocoa-rich products on depression, anxiety, and mood: A systematic review and meta-analysis Fusar-Poli L, Gabbiadini A, Ciancio A, Vozza L, Signorelli MS, Aguglia E
Systematic Review Anxiety Cocoa
The study carried out a systematic review and meta-analysis in line with PRISMA guidelines to ascertain the effects of cocoa-derived food on depressive and anxiety symptoms, as well as positive and negative affect. Potential sources were found on Web of Knowledge and PsycINFO until April 3, 2020. Out of 761 documents screened, nine studies were picked. Two trials were involved in examining the long-term impact (>1 week) of cocoa consumption, two reviewed the short-term effects (3 days), and five studies were conducted in acute conditions (single administration).
The results indicate that cocoa-rich products had a significant overall effect on reducing depressive and anxiety symptoms. There was also significant improvement in both positive and negative affect. The effect size in all meta-analyses was medium, while the heterogeneity was low. Despite these promising outcomes, the conclusions must be cautiously interpreted due to the short duration of the trials and the limited number of participants and studies included in the meta-analyses.
Our findings showing that chocolate and flavonoid intake significantly improves the flow-mediated dilatation, provide mechanistic evidence to support a causal link between chocolate and flavonoid intake and lowered CVD risk.
2020 Clinical Nutrition ESPEN Effect of dark chocolate on flow-mediated dilatation: Systematic review, meta-analysis, and dose–response analysis of randomized controlled trials Ebaditabar M, Djafarian K, Saeidifard N, Shab-Bidar S
Systematic Review Cardiovascular Disease Dark Chocolate Flow-Mediated Dilatation
This meta-analysis identified 23 studies that randomly assigned participants to dark chocolate, cocoa, or flavonoid in comparison with control groups in acute or short-term chronic interventions. At the end of our meta-analysis, we found a protective effect of acute and chronic consumption of dark chocolate and flavonoids on FMD. Greater improvement was seen in higher doses (>20 day) of chronic consumption of dark chocolate with more than about one month. A non-linear effect of acute consumption of dark chocolate and flavonoids on FMD was also found.
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