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Flavonoid-Rich Cocoa Consumption Affects Multiple Cardiovascular Risk Factors in a Meta-Analysis of Short-Term Studies

2011; Elsevier BV; Volume: 141; Issue: 11 Linguagem: Inglês

10.3945/jn.111.145482

1541-6100

Mark G. Shrime, Scott R. Bauer, Anna C. E. McDonald, Nubaha H. Chowdhury, Cordelia Coltart, Eric L. Ding,

Blood Pressure and Hypertension Studies

A growing body of evidence suggests that the consumption of foods rich in polyphenolic compounds, particularly cocoa, may have cardioprotective effects. No review, however, has yet examined the effect of flavonoid-rich cocoa (FRC) on all major cardiovascular risk factors or has examined potential dose-response relationships for these effects. A systematic review and meta-analysis of randomized, controlled trials was performed to evaluate the effect of FRC on cardiovascular risk factors and to assess a dose-response relationship. Inclusion and exclusion criteria as well as dependent and independent variables were determined a priori. Data were collected for: blood pressure, pulse, total cholesterol, HDL cholesterol, LDL cholesterol, TG, BMI, C-reactive protein, flow-mediated vascular dilation (FMD), fasting glucose, fasting insulin, serum isoprostane, and insulin sensitivity/resistance indices. Twenty-four papers, with 1106 participants, met the criteria for final analysis. In response to FRC consumption, systolic blood pressure decreased by 1.63 mm Hg (P= 0.033), LDL cholesterol decreased by 0.077 mmol/L (P= 0.038), and HDL cholesterol increased by 0.046 mmol/L (P= 0.037), whereas total cholesterol, TG, and C-reactive protein remained the same. Moreover, insulin resistance decreased (HOMA-IR: –0.94 points; P< 0.001), whereas FMD increased (1.53%;P< 0.001). A nonlinear dose-response relationship was found between FRC and FMD (P= 0.004), with maximum effect observed at a flavonoid dose of 500 mg/d; a similar relationship may exist with HDL cholesterol levels (P= 0.06). FRC consumption significantly improves blood pressure, insulin resistance, lipid profiles, and FMD. These short-term benefits warrant larger long-term investigations into the cardioprotective role of FRC.