Flavonoid-Rich Dark Chocolate Improves Endothelial Function and Increases Plasma Epicatechin Concentrations in Healthy Adults

Engler, Mary B.; Engler, Marguerite M.; Chen, Chung Y.; Malloy, Mary J.; Browne, Amanda E.M.; Chiu, Elisa Y.; Kwak, Ho‐Kyung; Milbury, Paul E.; Paul, Steven M.; Blumberg, Jeffrey B.; Mietus‐Snyder, Michele

doi:10.1080/07315724.2004.10719361

Cited by 419 publications

(315 citation statements)

References 44 publications

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“…We did not observe any differences in CBF at the time of ischemia and reperfusion, but this absence of effect might be because only a single dose of EC was used. In a small clinical study, participants who received 46 mg of EC daily for over a period of 2 weeks showed endothelium-dependant vasodilation (Engler et al, 2004). It is possible that chronic treatment rather than a single dose is required to observe differences in CBF.…”

Section: Discussionmentioning

confidence: 99%

The Flavanol (−)-Epicatechin Prevents Stroke Damage through the Nrf2/HO1 Pathway

Shah

Ahmad

et al. 2010

J Cereb Blood Flow Metab

208

125

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Epidemiologic studies have shown that foods rich in polyphenols, such as flavanols, can lower the risk of ischemic heart disease; however, the mechanism of protection has not been clearly established. In this study, we investigated whether epicatechin (EC), a flavanol in cocoa and tea, is protective against brain ischemic damage in mice. Wild-type mice pretreated orally with 5, 15, or 30 mg/kg EC before middle cerebral artery occlusion (MCAO) had significantly smaller brain infarcts and decreased neurologic deficit scores (NDS) than did the vehicle-treated group. Mice that were posttreated with 30 mg/kg of EC at 3.5 hours after MCAO also had significantly smaller brain infarcts and decreased NDS. Similarly, WT mice pretreated with 30 mg/kg of EC and subjected to N-methyl-D-aspartate (NMDA)-induced excitotoxicity had significantly smaller lesion volumes. Cell viability assays with neuronal cultures further confirmed that EC could protect neurons against oxidative insults. Interestingly, the EC-associated neuroprotection was mostly abolished in mice lacking the enzyme heme oxygenase 1 (HO1) or the transcriptional factor Nrf2, and in neurons derived from these knockout mice. These results suggest that EC exerts part of its beneficial effect through activation of Nrf2 and an increase in the neuroprotective HO1 enzyme.

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Section: Discussionmentioning

confidence: 99%

The Flavanol (−)-Epicatechin Prevents Stroke Damage through the Nrf2/HO1 Pathway

Shah

Ahmad

et al. 2010

J Cereb Blood Flow Metab

208

125

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“…Previous studies have suggested that dark chocolate consumption reduces blood pressure (Grassi et al, 2005b;Grassi et al, 2008), improves insulin sensitivity as shown by significantly higher QUICKI (quantitative insulin sensitivity check index) measurements (Grassi et al, 2008), improves vascular endothelial function and reverses vascular dysfunction (Engler et al, 2004;Grassi et al, 2005b;Wang-Polagruto et al, 2006), reduces insulin resistance as evidenced by significantly lower HOMA-IR (homeostasis model assessment of insulin resistance) (Grassi et al, 2005a) measurements, and increases serum total antioxidant capacity (Wan et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…(http://www.nal.usda.gov/fnic/ foodcomp/search/), the latter two being saturated fats. Cocoa products are also very rich in plant phytochemicals, especially flavonoids, which are now objects of increased scientific attention due to their potential health benefits (Engler et al, 2004;Grassi et al, 2005a;Wang-Polagruto et al, 2006;Almoosawi et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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

2011

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Cocoa products, which are rich sources of flavonoids, have been shown to reduce blood pressure and the risk of cardiovascular disease. Dark chocolate contains saturated fat and is a source of dietary calories; consequently, it is important to determine whether consumption of dark chocolate adversely affects the blood lipid profile. The objective was to examine the effects of dark chocolate/cocoa product consumption on the lipid profile using published trials. A detailed literature search was conducted via MEDLINE (from 1966 to May 2010), CENTRAL and ClinicalTrials.gov for randomized controlled clinical trials assessing the effects of flavanol-rich cocoa products or dark chocolate on lipid profile. The primary effect measure was the difference in means of the final measurements between the intervention and control groups. In all, 10 clinical trials consisting of 320 participants were included in the analysis. Treatment duration ranged from 2 to 12 weeks. Intervention with dark chocolate/cocoa products significantly reduced serum low-density lipoprotein (LDL) and total cholesterol (TC) levels (differences in means (95% CI) were À5.90 mg/dl (À10.47, À1.32 mg/dl) and À6.23 mg/dl (À11.60, À0.85 mg/dl), respectively). No statistically significant effects were observed for high-density lipoprotein (HDL) (difference in means (95% CI): À0.76 mg/dl (À3.02 to 1.51 mg/dl)) and triglyceride (TG) (À5.06 mg/dl (À13.45 to 3.32 mg/dl)). These data are consistent with beneficial effects of dark chocolate/ cocoa products on total and LDL cholesterol and no major effects on HDL and TG in short-term intervention trials.

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“…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%

“…Flavanol-rich chocolate (213 mg procyanidins, 46 mg epicatechin) consumption significantly improved FMD in 21 healthy subjects also over a 2-week period (p = 0.024). Moreover, plasma epicatechin concentrations markedly increased after 2 weeks in the active treatment group, suggesting that the effect on vascular function was flavanolmediated (46). In the Flaviola Health Study, a 1-month CF intake increased FMD over control by 1.2% (95% CI, 1.0-1.4) and decreased pulse wave velocity by 0.4 m/s (95% CI, 0.8-0.04 m/s) (27).…”

Section: Cocoa and Vascular Function: Interventional Studiesmentioning

confidence: 98%

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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Flavonoid-Rich Dark Chocolate Improves Endothelial Function and Increases Plasma Epicatechin Concentrations in Healthy Adults

Abstract: Flavonoid-rich dark chocolate improves endothelial function and is associated with an increase in plasma epicatechin concentrations in healthy adults. No changes in oxidative stress measures, lipid profiles, blood pressure, body weight or BMI were seen.

Cited by 419 publications

References 44 publications

The Flavanol (−)-Epicatechin Prevents Stroke Damage through the Nrf2/HO1 Pathway

The Flavanol (−)-Epicatechin Prevents Stroke Damage through the Nrf2/HO1 Pathway

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

Cocoa, Blood Pressure, and Vascular Function

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