Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults

Njike, Valentine Yanchou; Faridi, Zubaida; Shuval, Kerem; Dutta, Suparna; Kay, Colin D.; West, Sheila G.; Kris-Etherton, Penny M.; Katz, David L.

doi:10.1016/j.ijcard.2009.12.010

Cited by 94 publications

(116 citation statements)

References 33 publications

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“…This increase was significantly different than the small increase (5%) observed in the control group, which only received 12 g sugar daily (15). At least three studies found no effect of cocoa beverage consumption on blood lipids (45,178,188), including one which tested a combination of liquid cocoa and solid dark chocolate (45).…”

Section: Effects On Lipidsmentioning

confidence: 69%

“…Whether the potential negative effects of over-consumption of sugar-namely, endothelial dysfunction (140), insulin resistance, and weight gain (109)-negate any benefit of increased plasma flavanol concentrations is not yet understood. In one trial, a sugar-free cocoa beverage produced greater improvements in BP and endothelial function than a sugar-sweetened cocoa; however, the differences were not statistically significant (188). If artificially sweetened cocoa is determined to have greater benefit than cocoa with sugar, palatability of such products will be an important consideration.…”

Section: B Effects Of Food Processing On Flavonoidsmentioning

confidence: 99%

“…In the second phase of the study, participants were randomized to one of six possible permutations of treatment sequences (188). All received each treatment (two cups of sugared, sugar-free, or placebo cocoa providing 805, 805, and 0 mg flavanols, respectively) with 7-day washout periods between each treatment assignment.…”

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confidence: 99%

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Cocoa and Chocolate in Human Health and Disease

Katz

Doughty

Ali

2011

Antioxidants & Redox Signaling

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345

256

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Cocoa contains more phenolic antioxidants than most foods. Flavonoids, including catechin, epicatechin, and procyanidins predominate in antioxidant activity. The tricyclic structure of the flavonoids determines antioxidant effects that scavenge reactive oxygen species, chelate Fe2+ and Cu+, inhibit enzymes, and upregulate antioxidant defenses. The epicatechin content of cocoa is primarily responsible for its favorable impact on vascular endothelium via its effect on both acute and chronic upregulation of nitric oxide production. Other cardiovascular effects are mediated through anti-inflammatory effects of cocoa polyphenols, and modulated through the activity of NF-jB. Antioxidant effects of cocoa may directly influence insulin resistance and, in turn, reduce risk for diabetes. Further, cocoa consumption may stimulate changes in redox-sensitive signaling pathways involved in gene expression and the immune response. Cocoa can protect nerves from injury and inflammation, protect the skin from oxidative damage from UV radiation in topical preparations, and have beneficial effects on satiety, cognitive function, and mood. As cocoa is predominantly consumed as energy-dense chocolate, potential detrimental effects of overconsumption exist, including increased risk of weight gain. Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks. Antioxid. Redox Signal. 15, 2779-2811.

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Section: Effects On Lipidsmentioning

confidence: 69%

Section: B Effects Of Food Processing On Flavonoidsmentioning

confidence: 99%

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Cocoa and Chocolate in Human Health and Disease

Katz

Doughty

Ali

2011

Antioxidants & Redox Signaling

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345

256

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“…Furthermore, a statistically significant reduction in DBP and mean BP, and a parallel improvement in FMD was shown after high-flavanol cocoa intake in obese and overweight subjects (55). Moreover, the positive effect of cocoa consumption on endothelial function was not associated with weight gain (48). Conversely, in a subsequent study, an increase in basal and peak brachial artery diameter, with no consequent change in FMD, was assessed in a group of 30 overweight patients after 30 days high-flavanol chocolate intake (71).…”

Section: Cocoa and Vascular Function: Interventional Studiesmentioning

confidence: 80%

“…In particular, they documented a decrease in BP (SBP: −4.8 ± 1.03 mmHg, p < 0.0001; DBP: −3.03 ± 1.07 mmHg, p = 0.0011), and an improvement in endothelial function (23). However, in four different studies, flavanol-rich cocoa (234, 259, 550, 805 mg flavanols per day, respectively) did not improve BP levels compared to placebo in normotensive subjects (45)(46)(47)(48).…”

Section: Epidemiological Evidencementioning

confidence: 96%

Cocoa, Blood Pressure, and Vascular Function

et al. 2012

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Cardiovascular disease (CVD) represents the most common cause of death worldwide. The consumption of natural polyphenol-rich foods, and cocoa in particular, has been related to a reduced risk of CVD, including coronary heart disease and stroke. Intervention studies strongly suggest that cocoa exerts a beneficial impact on cardiovascular health, through the reduction of blood pressure (BP), improvement of vascular function, modulation of lipid and glucose metabolism, and reduction of platelet aggregation. These potentially beneficial effects have been shown in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Several potential mechanisms are supposed to be responsible for the positive effect of cocoa; among them activation of nitric oxide (NO) synthase, increased bioavailability of NO as well as antioxidant, and anti-inflammatory properties. It is the aim of this review to summarize the findings of cocoa and chocolate on BP and vascular function.

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