Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide
A Randomized Controlled Trial
JAMA. 2007;298:49-60.
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 Randomized, 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 randomly 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 resulted 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 clinicaltrials.gov Identifier: NCT00421499
Author Affiliations: Departments of Pharmacology (Drs Taubert, Roesen, and Schömig) and Internal Medicine (Drs Lehmann and Jung), University Hospital of Cologne, Cologne, Germany.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?RELATED LETTER
 |
Cocoa Intake and Blood Pressure
Dimitrios Tsikas and Ranieri Rossi
JAMA. 2007;298(16):1862-1863.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Effects on Peripheral and Central Blood Pressure of Cocoa With Natural or High-Dose Theobromine: A Randomized, Double-Blind Crossover Trial
van den Bogaard et al.
Hypertension 2010;56:839-846.
Consumption of cocoa flavanols results in acute improvements in mood and cognitive performance during sustained mental effort
Scholey et al.
J Psychopharmacol 2010;24:1505-1514.
Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials
Jia et al.
Am. J. Clin. Nutr. 2010;92:218-225.
Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults
Buijsse et al.
Eur Heart J 2010;31:1616-1623.
Chocolate consumption, blood pressure, and cardiovascular risk
Heiss and Kelm
Eur Heart J 2010;31:1554-1556.
Does Dark Chocolate Have a Role in the Prevention and Management of Hypertension?: Commentary on the Evidence
Egan et al.
Hypertension 2010;55:1289-1295.
Fish, Vitamin D, and Flavonoids in Relation to Renal Cell Cancer Among Smokers
Wilson et al.
Am J Epidemiol 2009;170:717-729.
Milk decreases urinary excretion but not plasma pharmacokinetics of cocoa flavan-3-ol metabolites in humans
Mullen et al.
Am. J. Clin. Nutr. 2009;89:1784-1791.
Cocoa and Cardiovascular Health
Corti et al.
Circulation 2009;119:1433-1441.
Cocoa consumption for 2 wk enhances insulin-mediated vasodilatation without improving blood pressure or insulin resistance in essential hypertension
Muniyappa et al.
Am. J. Clin. Nutr. 2008;88:1685-1696.
Reduction of C-reactive protein with isoflavone supplement reverses endothelial dysfunction in patients with ischaemic stroke
Chan et al.
Eur Heart J 2008;29:2800-2807.
Complementary and alternative medicine approaches to blood pressure reduction: An evidence-based review
Nahas
cfp 2008;54:1529-1533.
Regular Consumption of Dark Chocolate Is Associated with Low Serum Concentrations of C-Reactive Protein in a Healthy Italian Population
di Giuseppe et al.
J. Nutr. 2008;138:1939-1945.
Blood Pressure Is Reduced and Insulin Sensitivity Increased in Glucose-Intolerant, Hypertensive Subjects after 15 Days of Consuming High-Polyphenol Dark Chocolate
Grassi et al.
J. Nutr. 2008;138:1671-1676.
Tea, Flavonoids, and Nitric Oxide-Mediated Vascular Reactivity
Grassi et al.
J. Nutr. 2008;138:1554S-1560S.
Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial
Faridi et al.
Am. J. Clin. Nutr. 2008;88:58-63.
A new favourable effect of cocoa on atherosclerosis?
Paramo
Cardiovasc Res 2008;79:3-4.
Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial.
Balzer et al.
J Am Coll Cardiol 2008;51:2141-2149.
Daily Consumption of a Dark Chocolate Containing Flavanols and Added Sterol Esters Affects Cardiovascular Risk Factors in a Normotensive Population with Elevated Cholesterol
Allen et al.
J. Nutr. 2008;138:725-731.
What's new in hypertension 2007?
Mann
Nephrol Dial Transplant 2008;23:466-470.
Cocoa Intake and Blood Pressure
Tsikas and Rossi
JAMA 2007;298:1862-1863.
Evidently...
Lehman
Evid. Based Med. 2007;12:135-135.
Other articles noted
Evid. Based Med. 2007;12:159-160.
Dark Chocolate for Your Blood Pressure?
JWatch Women's Health 2007;2007:1-1.
Beneficial Effects of Cocoa
JWatch General 2007;2007:3-3.
Geen opmerkingen:
Een reactie posten
Sharing is caring ;-)
website:
http://www.rawchock.com
facebook:
http://www.facebook.com/xocohealthnl
contact:+31619727294