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Cited by 345Phytochemicals and Antioxidant ActivitiesCardiovascular Health and Disease PreventionNitric Oxide and Endothelin Effects

The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.

Sustained Benefits in Vascular Function Through Flavanol-Containing Cocoa in Medicated Diabetic Patients

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Balzer, Jan, Rassaf, Tienush, Heiss, Christian, Kleinbongard, Petra, Lauer, Thomas, Merx, Marc, Heussen, Nicole, Gross, Heidrun B., Keen, Carl L., Schroeter, Hagen, Kelm, Malte·2008·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2008.01.059
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Abstract

Objectives Our goal was to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabetic patients.Background Even in fully medicated diabetic patients, overall prognosis is unfavorable due to deteriorated cardiovascular function. Based on epidemiological data, diets rich in flavanols are associated with a reduced cardiovascular risk.Methods In a feasibility study with 10 diabetic patients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability after an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75, 371, and 963 mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabetic patients were assessed after a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321 mg flavanols per dose) or a nutrient-matched control (25 mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Primary and secondary outcome measures included changes in FMD and plasma flavanol metabolites, respectively.Results A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2 h: from 3.7 +/- 0.2% to 5.5 +/- 0.4%, p < 0.001). A 30-day, thrice-daily consumption of flavanol-containing cocoa increased baseline FMD by 30% (p < 0.0001), while acute increases of FMD upon ingestion of flavanol-containing cocoa continued to be manifest throughout the study. Treatment was well tolerated without evidence of tachyphylaxia. Endothelium-independent responses, blood pressure, heart rate, and glycemic control were unaffected.Conclusions Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease.

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Crossref · 10.1016/j.jacc.2008.01.059

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Authors
Balzer, J., Rassaf, T., Heiss, C., Kleinbongard, P., Lauer, T., Merx, M., Heussen, N., Gross, H. B., Keen, C. L., Schroeter, H., & Kelm, M.
Affiliations
  • Universitätsklinikum Aachen (DE)
  • University of California, Davis (US)
Corresponding author
Kelm, Malte
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2008-06
Volume
51
Issue
22
Pages
2141-2149
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2008.01.059
OpenAlex
W2143536568
Cited by
345
References
34
Citations by year
2026: 2 · 2025: 11 · 2024: 12 · 2023: 9 · 2022: 8 · 2021: 11 · 2020: 15 · 2019: 13 · 2018: 25 · 2017: 23 · 2016: 20 · 2015: 27 · 2014: 19 · 2013: 27 · 2012: 42
FWCI
16.42
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
Keywords
flavan-3-ols, Theobroma cacao, vascular function, flow-mediated dilation, diabetes mellitus, endothelial function, dietary intervention, brachial artery, cardiovascular risk, tachyphylaxis, glycemic control
MeSH terms
Aged, Aged, 80 and over, Brachial Artery, Cacao, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Double-Blind Method, Endothelium, Vascular, Feasibility Studies, Female, Humans, Male, Middle Aged, Prognosis, Risk Factors, Time Factors, Cross-Over Studies, Flavonols

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