Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis

Tokede, Oluwabunmi A.; Gaziano, J. Michael; Djoussé, Luc

doi:10.1038/ejcn.2011.64

Cited by 183 publications

(123 citation statements)

References 34 publications

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“…Since they were all short-term studies, no effect on BMI or worsening of diabetes was evident (78). Similar results were found in a smaller meta-analysis (83). Conclusions from these particular metaanalyses need to be considered with extreme caution, since most of the studies included in these analyses did not have appropriate blinding, randomization, or placebo controls.…”

Section: E682supporting

confidence: 59%

Mechanisms for food polyphenols to ameliorate insulin resistance and endothelial dysfunction: therapeutic implications for diabetes and its cardiovascular complications

Munir

Chandrasekaran

Gao

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

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Munir KM, Chandrasekaran S, Gao F, Quon MJ. Mechanisms for food polyphenols to ameliorate insulin resistance and endothelial dysfunction: therapeutic implications for diabetes and its cardiovascular complications. Am J Physiol Endocrinol Metab 305: E679 -E686, 2013. First published July 30, 2013 doi:10.1152/ajpendo.00377.2013.-The rising epidemic of diabetes is a pressing issue in clinical medicine worldwide from both healthcare and economic perspectives. This is fueled by overwhelming increases in the incidence and prevalence of obesity. Obesity and diabetes are characterized by both insulin resistance and endothelial dysfunction that lead to substantial increases in cardiovascular morbidity and mortality. Reciprocal relationships between insulin resistance and endothelial dysfunction tightly link metabolic diseases including obesity and diabetes with their cardiovascular complications. Therefore, therapeutic approaches that target either insulin resistance or endothelial dysfunction alone are likely to simultaneously improve both metabolic and cardiovascular pathophysiology and disease outcomes. Moreover, combination therapies with agents targeting distinct mechanisms are likely to have additive or synergistic benefits. Conventional therapies for diabetes and its cardiovascular complications that are both safe and effective are insufficient to meet rising demand. Large, robust, epidemiologic studies demonstrate beneficial metabolic and cardiovascular health effects for many functional foods containing various polyphenols. However, precise molecular mechanisms of action for food polyphenols are largely unknown. Moreover, translation of these insights into effective clinical therapies has not been fully realized. Nevertheless, some functional foods are likely sources for safe and effective therapies and preventative strategies for metabolic diseases and their cardiovascular complications. In this review, we emphasize recent progress in elucidating molecular, cellular, and physiological actions of polyphenols from green tea (EGCG), cocoa (ECG), and citrus fruits (hesperedin) that are related to improving metabolic and cardiovascular pathophysiology. We also discuss a rigorous comprehensive approach to studying functional foods that is essential for developing novel, effective, and safe medications derived from functional foods that will complement existing conventional drugs. insulin resistance; endothelial dysfunction; functional foods; polyphenols OBESITY, PREDIABETES, METABOLIC SYNDROME, and diabetes are characterized by insulin resistance, endothelial dysfunction and resultant cardiovascular complications (38,39,45).

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Section: E682supporting

confidence: 59%

Mechanisms for food polyphenols to ameliorate insulin resistance and endothelial dysfunction: therapeutic implications for diabetes and its cardiovascular complications

Munir

Chandrasekaran

Gao

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

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“…Although changes in blood lipids induced by the consumption of cocoa products remain controversial, another recent meta-analysis involving 215 participants from 8 clinical trials clearly indicates that the short-term consumption of flavanols-rich cocoa could significantly reduce plasma LDL cholesterol without affecting HDL concentrations [Jia et al 2010]. The meta-analysis of Tokede and colleagues, carried out to examine the effects of flavanol-rich cocoa products on the lipid profile, led to consistent conclusions [Tokede et al 2011]. Although cocoa contains saturated fat and is a source of dietary calories, short-term intervention trials (2-12 weeks of intervention) with flavonoid-rich cocoa products or dark chocolate provide beneficial effects on total and LDL cholesterol and induce no major effects on HDL and triglycerides [Tokede et al 2011].…”

Section: Blood Lipidsmentioning

confidence: 96%

“…The meta-analysis of Tokede and colleagues, carried out to examine the effects of flavanol-rich cocoa products on the lipid profile, led to consistent conclusions [Tokede et al 2011]. Although cocoa contains saturated fat and is a source of dietary calories, short-term intervention trials (2-12 weeks of intervention) with flavonoid-rich cocoa products or dark chocolate provide beneficial effects on total and LDL cholesterol and induce no major effects on HDL and triglycerides [Tokede et al 2011]. Interestingly, it appears that responses to blood lipids were dependent on the dose of cocoa regularly consumed and could be influenced by the individual's health status.…”

Section: Blood Lipidsmentioning

confidence: 99%

Evidence for a protective effect of polyphenols-containing foods on cardiovascular health: an update for clinicians

Habauzit¹,

Morand²

2011

Therapeutic Advances in Chronic Disease

239

145

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Growing evidence suggests that polyphenols could be serious candidates to explain the protective effects of plant-derived foods and beverages. Based on current studies, a general consensus has been achieved to sustain the hypothesis that the specific intake of foods and beverages containing relatively high concentrations of flavonoids may play a meaningful role in reducing cardiovascular disease (CVD) risk through an improvement in vascular function and a modulation of inflammation. This review aims at providing an update on the effects of the consumption of polyphenols-rich foods on intermediate clinical markers of CVD in humans, namely cholesterolemia, blood pressure, endothelial function and platelet function. To date, on the basis of clinical studies, the demonstration is particularly convincing for flavonoids from cocoa-derived products and to a lesser extent for those of tea. While additional studies in this area are clearly needed, incorporating plant foods that are rich in flavanols in the diet of healthy individuals could help to reduce CVD risk. For flavonoids from fruits such as berries, pomegranate, grapes or citrus fruits and those from beverages such as red wine or coffee, the evidence is so far inconclusive. This is primarily due to the limited number and the weakness of experimental designs of the studies performed with these dietary sources. Future long-term well-designed investigations with polyphenols-rich foods but also with isolated phenolic compounds would provide valuable information to establish public health recommendations on polyphenols, taking into account both the nature of the compounds and the optimal dose, for cardiovascular health protection. Therapeutic Advances in Chronic Disease 3 (2) 88 http://taj.sagepub.com mediators. The early phase of atherosclerosis is characterized by the accumulation of cholesterol deposits in macrophages in the intima of the arteries. These foam cells can aggregate to form fatty streaks that progressively mature into a fibrous plaque which is a hallmark of established atherosclerosis. Fibrous plaque is covered by a connective tissue cap with embedded smooth muscle cells. If the plaque continues to grow, it gradually restricts the blood flow causing ischaemia. The clinically important complications of atheroma usually involve rupture of the fibrous cap, causing exposure of highly thrombogenic collagen and resulting intraluminal thrombus. Activated platelets trigger vasoconstriction and further propagation of the thrombus, which may result in total cease in blood flow, and subsequent clinical event. KeywordsEvidence from epidemiological studies indicates a positive association between reduction in the incidence of CVD and consumption of plant-based foods such as fruit and vegetables, nuts, whole grains, plant-derived beverages [Dauchet et al. 2005;Hu and Willett, 2002]. In 2009, Dauchet and collaborators offered a review on the evidence for a relationship between fruit and vegetable consumption and the occurrence of CVD events [Dauchet et a...

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“…A gordura do chocolate, derivada do cacau, é constituída por dois ácidos graxos saturados, o ácido palmítico e o esteárico, e o ácido oleico monoinsaturado, em adição de uma pequena quantidade (menos do que 5%) de outros ácidos graxos 139 . Embora seja conhecido que o consumo de gorduras saturadas aumente os níveis de colesterol, o consumo regular de manteiga de cacau e chocolate rico em cacau (chocolate escuro) não se relaciona a esse aumento 140 . As quantidades de ácido graxo esteárico são responsáveis pelo efeito neutro sobre o metabolismo do colesterol.…”

Section: Chocolateunclassified