Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans. Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults. Effects of dark chocolate and cocoa consumption on endothelial function and arterial stiffness in overweight adults. Realistic intake of a flavanol-rich soluble cocoa product increases HDL-cholesterol without inducing anthropometric changes in healthy and moderately hypercholesterolemic subjects. Regular dark chocolate consumption's reduction of oxidative stress and increase of free-fatty-acid mobilization in response to prolonged cycling. Dark Chocolate Improves Coronary Vasomotion and Reduces Platelet Reactivity Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. Dose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adults. Dark chocolate supplementation reduces the oxygen cost of moderate intensity cycling High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension Effect of dark chocolate on arterial function in healthy individuals. Beneficial effects of dark chocolate on exercise capacity in sedentary subjects: underlying mechanisms. A double blind, randomized, placebo controlled trial. Central Arterial Hemodynamic Effects of Dark Chocolate Ingestion in Young Healthy People: A Randomized and Controlled Trial Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. Cocoa consumption dose-dependently improves flow-mediated dilation and arterial stiffness decreasing blood pressure in healthy individuals Acute and chronic effects of flavanol-rich cocoa on vascular function in subjects with coronary artery disease: a randomized double-blind placebo-controlled study.
BACKGROUND Flavonoids are polyphenolic compounds of plant origin with antioxidant effects . Flavonoids inhibit LDL oxidation and reduce thrombotic tendency in vitro . Little is known about how cocoa powder and dark chocolate , rich sources of polyphenols , affect these cardiovascular disease risk factors . OBJECTIVE We evaluated the effects of a diet high in cocoa powder and dark chocolate ( CP-DC diet ) on LDL oxidative susceptibility , serum total antioxidant capacity , and urinary prostagl and in concentrations . DESIGN We conducted a r and omized , 2-period , crossover study in 23 healthy subjects fed 2 diets : an average American diet ( AAD ) controlled for fiber , caffeine , and theobromine and an AAD supplemented with 22 g cocoa powder and 16 g dark chocolate ( CP-DC diet ) , providing approximately 466 mg procyanidins/d . RESULTS LDL oxidation lag time was approximately 8 % greater ( P = 0.01 ) after the CP-DC diet than after the AAD .  Serum total antioxidant capacity measured by oxygen radical absorbance capacity was approximately 4 % greater ( P = 0.04 ) after the CP-DC diet than after the AAD and was positively correlated with LDL oxidation lag time ( r = 0.32 , P = 0.03 ) . HDL cholesterol was 4 % greater after the CP-DC diet ( P = 0.02 ) than after the AAD ; however , LDL-HDL ratios were not significantly different . Twenty-four-hour urinary excretion of thromboxane B(2 ) and 6-keto-prostagl and in F(1)(alpha ) and the ratio of the 2 compounds were not significantly different between the 2 diets . CONCLUSION Cocoa powder and dark chocolate may favorably affect cardiovascular disease risk status by modestly reducing LDL oxidation susceptibility , increasing serum total antioxidant capacity and HDL-cholesterol concentrations , and not adversely affecting prostagl and ins Consumption of flavanol-rich dark chocolate ( DC ) has been shown to decrease blood pressure ( BP ) and insulin resistance in healthy subjects , suggesting similar benefits in patients with essential hypertension ( EH ) . Therefore , we tested the effect of DC on 24-hour ambulatory BP , flow-mediated dilation ( FMD ) , and oral glucose tolerance tests ( OGTTs ) in patients with EH . After a 7-day chocolate-free run-in phase , 20 never-treated , grade I patients with EH ( 10 males ; 43.7±7.8 years ) were r and omized to receive either 100 g per day DC ( containing 88 mg flavanols ) or 90 g per day flavanol-free white chocolate ( WC ) in an isocaloric manner for 15 days . After a second 7-day chocolate-free period , patients were crossed over to the other  treatment . Noninvasive 24-hour ambulatory BP , FMD , OGTT , serum cholesterol , and markers of vascular inflammation were evaluated at the end of each treatment . The homeostasis model assessment of insulin resistance ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , and insulin sensitivity index ( ISI ) were calculated from OGTT values . Ambulatory BP decreased  after DC ( 24-hour systolic BP −11.9±7.7 mm Hg , P<0.0001 ; 24-hour diastolic BP −8.5±5.0 mm Hg , P<0.0001 ) but not WC . DC but not WC decreased HOMA-IR ( P<0.0001 ) , but it improved QUICKI , ISI , and FMD . DC also decreased serum LDL cholesterol ( from 3.4±0.5 to 3.0±0.6 mmol/L ; P<0.05 ) . In  summary , DC  decreased BP and serum LDL cholesterol , improved FMD , and ameliorated insulin sensitivity in hypertensives . These results suggest that , while balancing total calorie intake , flavanols from cocoa products may provide some cardiovascular benefit if included as part of a healthy diet for patients with EH BACKGROUND In recent years , there has been increased interest in the potential health-related benefits of antioxidant- and phytochemical-rich dark chocolate and cocoa . OBJECTIVE The objective of the study was to examine the short-term ( 6 wk ) effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health in healthy older adults . DESIGN A double-blind , placebo-controlled , fixed-dose , parallel-group clinical trial was used . Participants ( n = 101 ) were r and omly assigned to receive a 37-g dark chocolate bar and 8 ounces ( 237 mL ) of an artificially sweetened cocoa beverage or similar placebo products each day for 6 wk . RESULTS No significant group ( dark chocolate and cocoa or placebo)-by-trial ( baseline , midpoint , and end-of-treatment assessment s ) interactions were found for the neuropsychological , hematological , or blood pressure variables examined . In contrast , the midpoint and end-of-treatment mean pulse rate assessment s in the dark chocolate and cocoa group were significantly higher than those at baseline and significantly higher than the midpoint and end-of-treatment rates in the control group . Results of a follow-up question naire item on the treatment products that participants believed they had consumed during the trial showed that more than half of the participants in both groups correctly identified the products that they had ingested during the experiment . CONCLUSIONS This investigation failed to support the predicted beneficial effects of short-term dark chocolate and cocoa consumption on any of the neuropsychological or cardiovascular health-related variables included in this research . Consumption of dark chocolate and cocoa was , however , associated with significantly higher pulse rates at 3- and 6-wk treatment assessment The consumption of cocoa and dark chocolate is associated with a lower risk of CVD , and improvements in endothelial function may mediate this relationship . Less is known about the effects of cocoa/chocolate on the augmentation index ( AI ) , a measure of vascular stiffness and vascular tone in the peripheral arterioles . We enrolled thirty middle-aged , overweight adults in a r and omised , placebo-controlled , 4-week , cross-over study . During the active treatment ( cocoa ) period , the participants consumed 37 g/d of dark chocolate and a sugar-free cocoa beverage ( total cocoa = 22 g/d , total flavanols ( TF ) = 814 mg/d ) . Colour-matched controls included a low-flavanol chocolate bar and a cocoa-free beverage with no added sugar ( TF = 3 mg/d ) . Treatments were matched for total fat , saturated fat , carbohydrates and protein . The cocoa treatment significantly increased the basal diameter and peak diameter of the brachial artery by 6 % ( + 2 mm ) and basal blood flow volume by 22 % . Substantial decreases in the AI , a measure of arterial stiffness , were observed in only women . Flow-mediated dilation and the reactive hyperaemia index remained unchanged . The consumption of cocoa had no effect on fasting blood measures , while the control treatment increased fasting insulin concentration and insulin resistance ( P= 0·01 ) . Fasting blood pressure ( BP ) remained unchanged , although the acute consumption of cocoa  increased resting BP by 4 mmHg . In summary , the high-flavanol cocoa and dark chocolate treatment was associated with enhanced vasodilation in both conduit and resistance arteries and was accompanied by significant reductions in arterial stiffness in women To assess whether antioxidant , anti-inflammatory and other cardio-protective effects attributed to cocoa are achieved when regularly consuming moderate amounts of a flavanol-rich soluble cocoa product , a non-r and omized , controlled , crossover , free-living study was carried out in healthy ( n = 24 ; 25.9 ± 5.6 years ) and moderately hypercholesterolemic ( 200 - 240 mg dL(-1 ) ; n = 20 ; 30.0 ± 10.3 years ) volunteers . Participants consumed two servings per day ( 7.5 g per serving ) of a soluble cocoa product ( providing 45.3 mg flavanols per day ) in milk , which was compared with consuming only milk during a 4 week period . The effects on systolic and diastolic blood pressure and heart rate were determined , as well as on serum lipid and lipoprotein profiles , interleukins (IL)-1β , IL-6 , IL-8 , IL-10 , tumor necrosis factor-α ( TNF-α ) , monocyte chemoattractant protein-1 ( MCP-1 ) , vascular ( VCAM-1 ) and intercellular cell adhesion molecules ( ICAM-1 ) , serum malondialdehyde ( MDA ) , carbonyl groups ( CG ) , ferric reducing/antioxidant power ( FRAP ) , oxygen radical absorbance capacity ( ORAC ) , and free radical scavenging capacity ( ABTS ) . During the study , the volunteers ' diets and physical activity were also evaluated , as well as any changes in weight , skin folds , circumferences and related anthropometric parameters . Cocoa and certain polyphenol-rich fruits and vegetables and their derivatives were restricted . After consuming the cocoa product positive effects were observed such as an increase in serum HDL-C ( p < 0.001 ) and dietary fiber intake ( p = 0.050 ) , whereas IL-10 decreased ( p = 0.022 ) . Other cardiovascular-related biomarkers and anthropometric parameters were unaffected . We have therefore concluded that regular consumption of this cocoa product in a Spanish-Mediterranean diet may protect against cardiovascular disease in healthy and hypercholesterolemic subjects without producing any weight gain or other anthropometric changes This study investigated the effects of regular consumption of dark chocolate ( DC ) , rich in cocoa polyphenols , on plasma metabolites , hormones , and markers of oxidative stress after prolonged exhaustive exercise . Twenty active men cycled at 60 % maximal oxygen uptake ( VO2max ) for 1.5 hr , with the intensity increased to 90 % VO2max for a 30-s period every 10 min , followed by a ride to exhaustion at 90 % VO2max . In the 2 wk before exercise participants consumed 40 g of DC or an isocarbohydrate-fat control cocoa liquor-free chocolate ( CON ) twice daily and once 2 hr before exercise in a r and omized , counterbalanced , crossover design . Venous blood sample s were taken immediately before exercise , postexercise ( fixed duration ) , postexhaustion , and after 1 hr of recovery . F2-isoprostanes were significantly lower ( post hoc tests : p < .001 ) at exhaustion and after 1 hr of recovery with DC . Oxidized low-density lipoproteins were significantly lower with DC ( p < .001 ) both before and after exercise and at exhaustion . DC was also associated with ~21 % greater rises in free fatty acids during exercise ( main effect : p < .05 ) . Changes in circulating glucose , insulin , glucagon , cortisol , and interleukin (IL)-6 , IL-10 , and IL-1ra were unaffected by treatment . Time to exhaustion at 90 % VO2max was not significantly different between trials ( 398 ± 204 and 374 ± 194 s for DC and CON , respectively ) . These results suggest that regular DC intake is associated with reduced oxidative-stress markers and increased mobilization of free fatty acids after exercise but has no observed effect on exercise performance Background — Dark chocolate has potent antioxidant properties . Coronary atherosclerosis is promoted by impaired endothelial function and increased platelet activation . Traditional risk factors , high oxidative stress , and reduced antioxidant defenses play a crucial role in the pathogenesis of atherosclerosis , particularly in transplanted hearts . Thus , flavonoid-rich dark chocolate holds the potential to have a beneficial impact on graft atherosclerosis . Methods and Results — We assessed the effect of flavonoid-rich dark chocolate compared with cocoa-free control chocolate on coronary vascular and platelet function in 22 heart transplant recipients in a double-blind , r and omized study . Coronary vasomotion was assessed with quantitative coronary angiography and cold pressor testing before and 2 hours after ingestion of 40 g of dark ( 70 % cocoa ) chocolate or control chocolate , respectively . Two hours after ingestion of flavonoid-rich dark chocolate  , coronary artery diameter was increased significantly ( from 2.36±0.51 to 2.51±0.59 mm , P<0.01 ) , whereas it remained unchanged after control  chocolate . Endothelium-dependent coronary vasomotion improved significantly after dark chocolate ( 4.5±11.4 % versus −4.3±11.7 % in the placebo group , P=0.01 ) . Platelet adhesion decreased from 4.9±1.1 % to 3.8±0.8 % ( P=0.04 ) in the dark chocolate group but remained unchanged in the control group . Conclusions — Dark chocolate  induces coronary vasodilation , improves coronary vascular function , and decreases platelet adhesion 2 hours after consumption . These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration CONTEXT Regular intake of cocoa-containing foods is linked to lower cardiovascular mortality in observational studies . Short-term interventions of at most 2 weeks indicate that high doses of cocoa can improve endothelial function and reduce blood pressure ( BP ) due to the action of the cocoa polyphenols , but the clinical effect of low habitual cocoa intake on BP and the underlying BP-lowering mechanisms are unclear . OBJECTIVE To determine effects of low doses of polyphenol-rich dark chocolate on BP . DESIGN , SETTING , AND PARTICIPANTS R and omized , controlled , investigator-blinded , parallel-group trial involving 44 adults aged 56 through 73 years ( 24 women , 20 men ) with untreated upper-range prehypertension or stage 1 hypertension without concomitant risk factors . The trial was conducted at a primary care clinic in Germany between January 2005 and December 2006 . INTERVENTION Participants were r and omly assigned to receive for 18 weeks either 6.3 g ( 30 kcal ) per day of dark chocolate containing 30 mg of polyphenols or matching polyphenol-free white chocolate . MAIN OUTCOME MEASURES Primary outcome measure was the change in BP after 18 weeks . Secondary outcome measures were changes in plasma markers of vasodilative nitric oxide ( S-nitrosoglutathione ) and oxidative stress ( 8-isoprostane ) , and bioavailability of cocoa polyphenols . RESULTS From baseline to 18 weeks , dark chocolate intake reduced mean ( SD ) systolic BP by -2.9 ( 1.6 ) mm Hg ( P < .001 ) and diastolic BP by -1.9 ( 1.0 ) mm Hg ( P < .001 ) without changes in body weight , plasma levels of lipids , glucose , and 8-isoprostane . Hypertension prevalence declined from 86 % to 68 % . The BP decrease was accompanied by a sustained increase of S-nitrosoglutathione by 0.23 ( 0.12 ) nmol/L ( P < .001 ) , and a dark chocolate dose result ed in the appearance of cocoa phenols in plasma . White chocolate intake caused no changes in BP or plasma biomarkers . CONCLUSIONS Data in this relatively small sample of otherwise healthy individuals with above-optimal BP indicate that inclusion of small amounts of polyphenol-rich dark chocolate as part of a usual diet efficiently reduced BP and improved formation of vasodilative nitric oxide . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00421499 An inverse relation exists between intake of flavonoid-rich foods , such as cocoa , and cardiovascular-related mortality . Favorable effects of flavonoids on the endothelium may underlie these associations . We performed a r and omized , double-blind , placebo-controlled study to test the hypothesis that acute cocoa ingestion dose dependently increases endothelium-dependent vasodilation , as measured by an increase in brachial artery flow-mediated dilation ( FMD ) , in healthy older adults . Measurements were obtained before ( preingestion ) and after ( 1- and 2-h postingestion ) ingestion of 0 ( placebo ) , 2 , 5 , 13 , and 26 g of cocoa in 23 adults ( 63 ± 2 yr old , mean ± SE ) . Changes in brachial artery FMD 1- and 2-h postingestion compared with preingestion were used to determine the effects of cocoa . FMD was unchanged 1 ( Δ-0.3 ± 0.2%)- and 2-h ( Δ0.1 ± 0.1 % ) after placebo ( 0 g cocoa ) . In contrast , FMD increased both 1-h postingestion ( 2 g cocoa Δ0.0 ± 0.2 % , 5 g cocoa Δ0.8 ± 0.3 % , 13 g cocoa Δ1.0 ± 0.3 % , and 26 g cocoa Δ1.6 ± 0.3 % : P < 0.05 compared with placebo for 5 , 13 , and 26 g cocoa ) and 2-h postingestion ( 2 g cocoa Δ0.5 ± 0.3 % , 5 g cocoa Δ1.0 ± 0.3 % , 13 g cocoa Δ1.4 ± 0.2 % , and 26 g cocoa Δ2.5 ± 0.4 % : P < 0.05 compared with placebo for 5 , 13 , and 26 g cocoa ) on the other study days . A serum marker of cocoa ingestion ( total epicatechin ) correlated with increased FMD 1- and 2-h postingestion ( r = 0.44 - 0.48 ; both P < 0.05 ) . Collectively , these results indicate that acute cocoa ingestion dose dependently increases brachial artery FMD in healthy older humans . These responses may help to explain associations between flavonoid intake and cardiovascular-related mortality in humans Background Dark chocolate ( DC ) is abundant in flavanols which have been reported to increase the bioavailability and bioactivity of nitric oxide ( NO ) . Increasing NO bioavailability has often demonstrated reduced oxygen cost and performance enhancement during submaximal exercise . Methods Nine moderately-trained male participants volunteered to undertake baseline ( BL ) measurements that comprised a cycle V.O2max$$ \overset{.}{V}{O}_{2 max } $ $ test followed by cycling at 80 % of their established gas exchange threshold ( GET ) for 20-min and then immediately followed by a two-minute time-trial ( TT ) . Using a r and omised crossover design participants performed two further trials , two weeks apart , with either 40 g of DC or white chocolate ( WC ) being consumed daily . Oxygen consumption , RER , heart rate and blood lactate ( BLa ) were measured during each trial . Results  DC consumption increased GET and TT performance compared to both BL and WC ( P < 0.05 ) .  DC consumption increased V.O2max$$ \overset{.}{V}{O}_{2 max } $ $ by 6 % compared to BL ( P < 0.05 ) , but did not reach statistical significance compared to WC . There were no differences in the moderate-intensity cycling for V.O2$$ \overset{.}{V}{O}_2 $ $ , RER , BLa and heart rate between conditions , although , V.O2$$ \overset{.}{V}{O}_2 $ $ and RER exhibited consistently lower trends following DC consumption compared to BL and WC , these did not reach statistical significance . Conclusion Chronic supplementation with DC result ed in a higher GET and enhanced TT performance . Consequently , ingestion of DC reduced the oxygen cost of moderate intensity exercise and may be an effective ergogenic aid for short- duration moderate intensity exercise BACKGROUND The aim was to examine the effects of high-cocoa polyphenol-rich chocolate on lipid profiles , weight , blood pressure , glycemic control , and inflammation in individuals with Type 2 diabetes and hypertension . METHODS Sixty individuals [ 32 in dark chocolate group ( DCG ) and 28 in white chocolate group ( WCG ) ] with Type 2 diabetes on stable medication were enrolled in a r and omized , placebo-controlled double-blind study . Subjects were r and omized to consume 25 g DCG or WCG for 8 weeks . Changes in weight , blood pressure , glycemic control , lipid profile , and high sensitive C-reactive protein ( hsCRP ) were measured at the beginning and end of the intervention . This clinical trial was registered at the Iranian registry of clinical trials . RESULTS In DCC group , compared with baseline , serum levels of Apo A-1 ( P = 0.045 ) was increased and fasting blood sugar ( FBS ) ( P = 0.027 ) , hemoglobin A1c ( HbA1c ) ( P = 0.025 ) , Apo B ( P = 0.012 ) and Log of hsCRP ( P = 0.043 ) levels were decreased at the end of study . No changes were seen within the WCG in studied parameters . High polyphenol chocolate consumption compared to white chocolate result ed in significant decrease in of systolic ( −5.93 ± 6.25 vs. −1.07 ± 7.97 mmHg , P = 0.004 ) and diastolic blood pressure ( −6.4 ± 6.25 vs. 0.17 ± 7.9 mmHg , P = 0.002 ) , FBS ( −7.84 ± 19.15 vs. 4.00 ± 20.58 mg/dl , P = 0.019 ) over the course of 8 weeks of daily chocolate consumption neither weight nor body mass index and TG levels altered from baseline . CONCLUSION High polyphenol chocolate is effective in improving TG levels in hypertensive patients with diabetes and decreasing blood pressure and FBS without affecting weight , inflammatory markers , insulin resistance or glycemic control BACKGROUND Epidemiologic studies suggest that high flavonoid intake confers a benefit on cardiovascular outcome . Endothelial function , arterial stiffness , and wave reflections are important determinants of cardiovascular performance and are predictors of cardiovascular risk . METHODS The effect of flavonoid-rich dark chocolate ( 100 g ) on endothelial function , aortic stiffness , wave reflections , and oxidant status were studied for 3 h in 17 young healthy volunteers according to a r and omized , single-blind , sham procedure-controlled , cross-over protocol .  Flow-mediated dilation ( FMD ) of the brachial artery , aortic augmentation index ( AIx ) , and carotid-femoral pulse wave velocity ( PWV ) were used as measures of endothelial function , wave reflections , and aortic stiffness , respectively . Plasma oxidant status was evaluated with measurement of plasma malondialdehyde ( MDA ) and total antioxidant capacity ( TAC ) . RESULTS Chocolate led to a significant increase in resting and hyperemic brachial artery diameter throughout the study ( maximum increase by 0.15 mm and 0.18 mm , respectively , P < .001 for both ) . The FMD increased significantly at 60 min ( absolute increase 1.43 % , P < .05 ) . The AIx was significantly decreased with chocolate throughout the study ( maximum absolute decrease 7.8 % , P < .001 ) , indicating a decrease in wave reflections , whereas PWV did not change to a significant extent . Plasma MDA and TAC did not change after chocolate , indicating no alterations in plasma oxidant status . CONCLUSIONS Our study shows for the first time that consumption of dark chocolate acutely decreases wave reflections , that it does not affect aortic stiffness , and that it may exert a beneficial effect on endothelial function in healthy adults .  Chocolate consumption may exert a protective effect on the cardiovascular system ; further studies are warranted to assess any long-term effects In heart failure patients the consumption of (-)-epicatechin ( (-)-Epi)-rich cocoa can restore skeletal muscle ( SkM ) mitochondrial structure and decrease biomarkers of oxidative stress . However , nothing is known about its effects on exercise capacity and underlying mechanisms in normal , sedentary subjects . Twenty normal , sedentary subjects ( ∼50 years old ) were r and omized to placebo or dark chocolate ( DC ) groups and consumed 20 g of the products for 3 months . Subjects underwent before and after treatment , bicycle ergometry to assess VO2 max and work , SkM biopsy to assess changes in mitochondrial density , function and oxidative stress and blood sampling to assess metabolic endpoints . Seventeen subjects completed the trial . In the DC group ( n = 9 ) , VO2 max increased ( 17 % increase , p = 0.056 ) as well as maximum work ( watts ) achieved ( p = 0.026 ) with no changes with placebo ( n = 8) . The DC group evidence d increases in HDL levels ( p = 0.005 ) and decreased triglycerides ( p = 0.07 ) . With DC , SkM evidence d significant increases in protein levels for LKB1 , AMPK and PGC1α and in their active forms ( phosphorylated AMPK and LKB1 ) as well as in citrate synthase activity while no changes were observed in mitochondrial density . With DC , significant increases in SkM reduced glutathione levels and decreases in protein carbonylation were observed . Improvements in maximum work achieved and VO2 max may be due to DC activation of upstream control systems and enhancement of SkM mitochondria efficiency . Larger clinical studies are warranted to confirm these observations Introduction . The aim of this study was to assess the vascular benefits of dark chocolate in healthy and young individuals . Methods . A r and omized and controlled trial was carried out involving 60 healthy volunteers , r and omized into two groups :  control group ( CG ; n = 30 ) and  intervention group ( IG ; n = 30 ) . The IG ingested a daily dosage of 10 g of dark chocolate ( > 75 % cocoa ) for a month . Blood pressure ( BP ) , flow-mediated dilation ( FMD ) , arterial stiffness index ( ASI ) , aortic pulse wave velocity ( PWV ) , and pulse wave analysis ( PWA ) were assessed at baseline and one week after the one-month intervention period . Results . Arterial function improved after intervention in the IG , with PWV decreasing from 6.13 ± 0.41 m/s to 5.83 ± 0.53 m/s ( P = 0.02 ) , with no significant differences observed in the CG . A significant decrease in ASI ( 0.16 ± 0.01 to 0.13 ± 0.01 ; P < 0.001 ) and AiX ( −15.88 ± 10.75 to −22.57 ± 11.16 ; P = 0.07 ) was also depicted for the IG . Endothelial function improved in the IG , with the FMD increasing 9.31 % after the 1-month intervention ( P < 0.001 ) , with no significant variation in the CG . Conclusion . The daily ingestion of 10 g dark chocolate ( > 75 % cocoa ) during a month significantly improves vascular function in young and healthy individuals BACKGROUND Cocoa powder is rich in polyphenols such as catechins and procyanidins and has been shown in various models to inhibit LDL oxidation and atherogenesis . OBJECTIVE We examined whether long-term intake of cocoa powder alters plasma lipid profiles in normocholesterolemic and mildly hypercholesterolemic human subjects . DESIGN Twenty-five subjects were r and omly assigned to ingest either 12 g sugar/d ( control group ) or 26 g cocoa powder and 12 g sugar/d ( cocoa group ) for 12 wk . Blood sample s were collected before the study and 12 wk after intake of the test drinks . Plasma lipids , LDL oxidative susceptibility , and urinary oxidative stress markers were measured . RESULTS At 12 wk , we measured a 9 % prolongation from baseline levels in the lag time of LDL oxidation in the cocoa group . This prolongation in the cocoa group was significantly greater than the reduction measured in the control group ( -13 % ) . A significantly greater increase in plasma HDL cholesterol ( 24 % ) was observed in the cocoa group than in the control group ( 5 % ) . A negative correlation was observed between plasma concentrations of HDL cholesterol and oxidized LDL . At 12 wk , there was a 24 % reduction in dityrosine from baseline concentrations in the cocoa group . This reduction in the cocoa group was significantly greater than the reduction in the control group ( -1 % ) . CONCLUSION It is possible that increases in HDL-cholesterol concentrations may contribute to the suppression of LDL oxidation and that polyphenolic substances derived from cocoa powder may contribute to an elevation in HDL cholesterol Background : Cocoa flavonoids exert beneficial vascular effects and reduce the risk of cardiovascular morbidity and mortality . Nevertheless , the involved mechanisms have not been clarified and no study has yet focused on the dose – response effects . Objectives : We aim ed to investigate the effects of different doses of cocoa flavonoids on flow-mediated dilation ( FMD ) , endothelin-1 ( ET-1 ) , pulse wave velocity ( PWV ) , and SBP and DBP . Design : According to a r and omized , double-blind , controlled , cross-over design , 20 healthy volunteers ( 1.5 % improvement in FMD in 20 individuals : 0.99 at alpha = 0.05 ) were assigned to receive either five treatments with daily intake of 10 g cocoa ( 0 , 80 , 200 , 500 and 800 mg cocoa flavonoids/day ) in five periods lasting 1 week each . Results : Cocoa dose-dependently increased FMD from 6.2 % ( control ) to 7.3 , 7.6 , 8.1 and 8.2 % after the different flavonoid doses , respectively ( P < 0.0001 ) . Compared with the control , even 80 mg cocoa flavonoids per day increased FMD ( P < 0.0001 ) . Cocoa dose-dependently decreased PWV ( P < 0.0001 ) . Cocoa intake decreased office blood pressure ( BP ) ( SBP : −4.8 ± 1.03 mmHg , P < 0.0001 ; DBP : −3.03 ± 1.07 mmHg , P = 0.0011 ) . With respect to control , cocoa ingestion decreased 24-h ( P = 0.05 ) and daytime ( P = 0.038 ) SBP , and 24-h ( P = 0.0064 ) , daytime ( P = 0.0088 ) and night-time ( P = 0.0352 ) pulse pressure . Compared with the control , cocoa dose-dependently decreased ET-1 levels [ from 17.1 ( control ) to 15.2 , 14.5 , 14.2 and 14.1 pg/ml , after the different flavonoid doses , respectively ( P for treatment < 0.05 ) ] . Compared with the control , significant changes were observed for all doses of flavonoids ( ET-1 ; P < 0.05 ) . Conclusion : Our study showed for the first time that cocoa dose-dependently improved FMD and decreased PWV and ET-1 also by ameliorating office and monitored BP . Our findings are clinical ly relevant , suggesting cocoa , with very low calorie intake , might be reasonably incorporated into a dietary approach , representing a consistent tool in cardiovascular prevention Evidence suggests that flavonoid-containing diets reduce cardiovascular risk , but the mechanisms responsible are unclear . In the present study , we sought to determine the effect of flavanol-rich cocoa on vascular function in individuals with CAD ( coronary artery disease ) . Forty subjects ( 61+/-8 years ; 30 male ) with CAD were recruited to a 6-week r and omized double-blind placebo-controlled study . Subjects consumed either a flavanol-rich chocolate bar and cocoa beverage daily ( total flavanols , 444 mg/day ) or matching isocaloric placebos daily ( total flavanols , 19.6 mg/day ) for 6 weeks . Brachial artery FMD ( flow-mediated dilation ) and SAC ( systemic arterial compliance ) were assessed at baseline , 90 min following the first beverage and after 3 and 6 weeks of daily consumption . Soluble cellular adhesion molecules and FBF ( forearm blood flow ) responses to ACh ( acetylcholine chloride ; 3 - 30 microg/min ) and SNP ( sodium nitroprusside ; 0.3 - 3 microg/min ) infusions , forearm ischaemia and isotonic forearm exercise were assessed at baseline and after 6 weeks . FMD , SAC and FBF responses did not differ between groups at baseline . No acute or chronic changes in FMD or SAC were seen in either group . No difference in soluble cellular adhesion molecules , FBF responses to ischaemia , exercise , SNP or ACh was seen in the group receiving flavanol-rich cocoa between baseline and 6 weeks . These data suggest that over a 6-week period , flavanol-rich cocoa does not modify vascular function in patients with established CAD
Conclusion : Cocoa/DC supplementation does not reduce anthropometric measures significantly .
However subgroup analysis regarding dose ( ≥ 30 g/day ) and duration ( between 4 to 8 weeks ) revealed significant reduction of body weight and BMI
ABSTRACT Background : Cocoa and dark chocolate ( DC ) have been reported to be effective for health promotion ; however the exact effect of cocoa/DC on anthropometric measures have not been yet defined .