Effect of cocoa products and flavanols on platelet aggregation in humans: a systematic review

Abstract

Previous evidence suggested an active role of cocoa products and flavanols in modulating platelet aggregation. However, cocoa flavanols are characterized by a low bioavailability that can deeply affect their presence in biological fluids and raise questions on their biological effect in humans. We performed a systematic search on Medline, Embase, Cochrane and ProQuest databases, until April 2015, on the effect of cocoa products on platelet aggregation in human intervention studies. We identified 13 interventions, of which only five involved repeated administration. Different effects were observed on the basis of the platelet aggregation test used, whereas neither a longer duration of treatment nor a higher dose was associated with a higher inhibition of platelet aggregation. In conclusion, the reviewed results suggest that consumption of cocoa products in bolus administration positively affects platelet aggregation in both healthy subjects and diseased patients. On the other hand, more evidence is required in order to assess the effect of long-term cocoa product ingestion and to identify the bioactive components involved.

The urinary metabolomic profile following the intake of meals supplemented with a cocoa extract in middle-aged obese subjects

“…11,12 Cocoa is a rich source of antioxidants due to its content in flavanols, 13 the consumption of which has been associated with the prevention or improvement of some health disorders such as hypertension, endothelial dysfunction, inflammation and oxidative stress, among others. [14][15][16] Indeed, the European Food Safety Authority (EFSA) has approved a claim concerning the benefits of cocoa consumption to endothelial function. 17 Nevertheless, it seems that the bioavailability of cocoa flavanols is poor.…”

The mechanisms of action of flavonoids in the brain: Direct versus indirect effects

“…There is strong evidence to suggest that flavonoids are capable of promoting clinically significant improvements in cardiovascular health through their potential to lower blood pressure (159)(160)(161)(162)(163)(164), improve endothelial function (18,20,27,165), inhibit platelet aggregation (166)(167)(168)(169)(170) and reduce inflammation (171,172). In particular, flavanols (20,(173)(174)(175) and anthocyanins (24, 25) have been…”

Flavanols protect the yeastSaccharomyces cerevisiaeagainst heating and freezing/thawing injury

“…), positively modulate blood platelet aggregation (Peluso et al . ), improve endothelial function (Aprotosoaie et al . ) as well as protect against obesity (Akhlaghi et al .…”

“…However, in the body they exert a plethora of other effects which can be only partly or not at all related to their antioxidant action. They have been reported to lower blood pressure, especially in prehypertensive and hypertensive individuals, modulate metabolism and respiration including maximal oxygen uptake, O 2 cost of exercise and energy expenditure, and reduce inflammation, resulting in increased skeletal muscle efficiency and endurance capacity (Al-Dashti et al 2018), positively modulate blood platelet aggregation (Peluso et al 2015), improve endothelial function (Aprotosoaie et al 2016) as well as protect against obesity (Akhlaghi et al 2018). Flavanols influence also positively insulin signalling by relieving insulin-signalling pathways from oxidative stress (OS) and inflammation and/or via a heightened incretin response (Strat et al 2016).…”