Effects of chocolate, cocoa, and flavan-3-ols on cardiovascular health: a systematic review and meta-analysis of randomized trials
Open accessAbstract
Background There is substantial interest in chocolate and flavan-3-ols for the prevention of cardiovascular disease (CVD).Objective The objective was to systematically review the effects of chocolate, cocoa, and flavan-3-ols on major CVD risk factors.Design We searched Medline, EMBASE, and Cochrane databases for randomized controlled trials (RCTs) of chocolate, cocoa, or flavan-3-ols. We contacted authors for additional data and conducted duplicate assessment of study inclusion, data extraction, validity, and random-effects meta-analyses.Results We included 42 acute or short-term chronic (≤18 wk) RCTs that comprised 1297 participants. Insulin resistance (HOMA-IR: -0.67; 95% CI: -0.98, -0.36) was improved by chocolate or cocoa due to significant reductions in serum insulin. Flow-mediated dilatation (FMD) improved after chronic (1.34%; 95% CI: 1.00%, 1.68%) and acute (3.19%; 95% CI: 2.04%, 4.33%) intakes. Effects on HOMA-IR and FMD remained stable to sensitivity analyses. We observed reductions in diastolic blood pressure (BP; -1.60 mm Hg; 95% CI: -2.77, -0.43 mm Hg) and mean arterial pressure (-1.64 mm Hg; 95% CI: -3.27, -0.01 mm Hg) and marginally significant effects on LDL (-0.07 mmol/L; 95% CI: -0.13, 0.00 mmol/L) and HDL (0.03 mmol/L; 95% CI: 0.00, 0.06 mmol/L) cholesterol. Chocolate or cocoa improved FMD regardless of the dose consumed, whereas doses >50 mg epicatechin/d resulted in greater effects on systolic and diastolic BP. GRADE (Grading of Recommendations, Assessment, Development and Evaluation, a tool to assess quality of evidence and strength of recommendations) suggested low- to moderate-quality evidence of beneficial effects, with no suggestion of negative effects. The strength of evidence was lowered due to unclear reporting for allocation concealment, dropouts, missing data on outcomes, and heterogeneity in biomarker results in some studies.Conclusions We found consistent acute and chronic benefits of chocolate or cocoa on FMD and previously unreported promising effects on insulin and HOMA-IR. Larger, longer-duration, and independently funded trials are required to confirm the potential cardiovascular benefits of cocoa flavan-3-ols.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The flavanol levels used in this study are comparable to those in earlier studies that found improvements in brain blood flow, vascular function, and blood pressure.
“In this regard, the level of flavanols used in this current study is comparable to the level of cocoa flavanols fed in previous studies where improvements in brain blood flow, 19 vascular function, and blood pressure were observed.25”
Flavonoids improve nitric oxide bioavailability in the vasculature, which in turn plays a pivotal role in modulating cerebrovascular tone.
“In this regard, although we did not specifically evaluate the effect of cocoa flavanols on endothelial function, a number of studies, some also from our group, clearly demonstrated the ability of flavonoids to improve NO bioavailability in vasculature, 17,18,25 which, in turn, plays a pivotal role in modulating cerebrovascular tone.28”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · see citing works
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · see citing works
Prediction of coronary heart disease using risk factor categories
Wilson, P. W. F., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998) · Circulation · doi:10.1161/01.cir.97.18.1837 · Cited by 9,581 · see citing works
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634 · see citing works
Moher, D., Pham, B., Jones, A., Cook, D. J., Jadad, A. R., Moher, M., Tugwell, P., & Klassen, T. P. (1998) · The Lancet · doi:10.1016/s0140-6736(98)01085-x · Cited by 3,560 · see citing works
Publication bias in clinical research
Easterbrook, P. J., Gopalan, R., Berlin, J. A., & Matthews, D. R. (1991) · The Lancet · doi:10.1016/0140-6736(91)90201-y · Cited by 3,109 · see citing works
Publication and related bias in meta-analysis
Sterne, J. A. C., Gavaghan, D., & Egger, M. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00242-0 · Cited by 2,282 · see citing works
D'Agostino, R. B., Grundy, S., Sullivan, L. M., Wilson, P., & for the CHD Risk Prediction Group (2001) · JAMA · doi:10.1001/jama.286.2.180 · Cited by 2,108 · see citing works
Kim, J.-A., Montagnani, M., Koh, K. K., & Quon, M. J. (2006) · Circulation · doi:10.1161/circulationaha.105.563213 · Cited by 1,652 · see citing works
Hooper, L., Kroon, P. A., Rimm, E. B., Cohn, J. S., Harvey, I., Le Cornu, K. A., Ryder, J. J., Hall, W. L., & Cassidy, A. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.1.38 · Cited by 1,097 · see citing works
Self-citation(–)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans
Schroeter, H., Heiss, C., Balzer, J., Kleinbongard, P., Keen, C. L., Hollenberg, N. K., Sies, H., Kwik-Uribe, C., Schmitz, H. H., & Kelm, M. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0510168103 · Cited by 1,052 · see citing works
The appropriateness of asymmetry tests for publication bias in meta-analyses: A large survey
Ioannidis, J. P. A., & Trikalinos, T. A. (2007) · Canadian Medical Association Journal · doi:10.1503/cmaj.060410 · Cited by 1,052 · see citing works
Dissemination and publication of research findings: an updated review of related biases
Song, F., Parekh, Hooper, L., Loke, Y., Ryder, J., Sutton, A., Hing, C., Kwok, C., Pang, C., & Harvey, I. (2010) · Health Technology Assessment · doi:10.3310/hta14080 · Cited by 1,039 · see citing works
Self-citationFlavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women
Mink, P. J., Scrafford, C. G., Barraj, L. M., Harnack, L., Hong, C.-P., Nettleton, J. A., & Jacobs, D. R. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.895 · Cited by 945 · see citing works
Inaba, Y., Chen, J. A., & Bergmann, S. R. (2010) · The International Journal of Cardiovascular Imaging · doi:10.1007/s10554-010-9616-1 · Cited by 820 · see citing works
Hanley, A. J., Williams, K., D, M. P. S. M., & Haffner, S. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.7.1177 · Cited by 637 · see citing works
Tzounis, X., Rodriguez‐Mateos, A., Vulevic, J., Gibson, G. R., Kwik-Uribe, C. L., & Spencer, J. P. E. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.000075 · Cited by 582 · see citing works
Buckley, D., Fu, R. F., Freeman, M., Rogers, K. R., & Helfand, M. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-7-200910060-00009 · Cited by 557 · see citing works
Grassi, D., Necozione, S., Lippi, C., Croce, G., Valeri, L., Pasqualetti, P., Desideri, G., Blumberg, J. B., & Ferri, C. (2005) · Hypertension · doi:10.1161/01.hyp.0000174990.46027.70 · Cited by 546 · see citing works
Grassi, D., Lippi, C., Necozione, S., Desideri, G., & Ferri, C. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.3.611 · Cited by 510 · see citing works
Grassi, D., Desideri, G., Necozione, S., Lippi, C., Casale, R., Properzi, G., Blumberg, J. B., & Ferri, C. (2008) · The Journal of Nutrition · doi:10.1093/jn/138.9.1671 · Cited by 481 · see citing works
Taubert, D., Roesen, R., Lehmann, C., Jung, N., & Schömig, E. (2007) · JAMA · doi:10.1001/jama.298.1.49 · Cited by 476 · see citing works
Engler, M. B., Engler, M. M., Chen, C. Y., Malloy, M. J., Browne, A., Chiu, E. Y., Kwak, H., Milbury, P. E., Paul, S. M., Blumberg, J. B., et al. (2004) · Journal of the American College of Nutrition · doi:10.1080/07315724.2004.10719361 · Cited by 465 · see citing works
Inhibition of the intestinal glucose transporter GLUT2 by flavonoids
Kwon, O., Eck, P., Chen, S., Corpe, C. P., Lee, J., Kruhlak, M. J., & Levine, M. N. (2006) · The FASEB Journal · doi:10.1096/fj.06-6620com · Cited by 450 · see citing works
Geleijnse, J. M., Kok, F. J., & Grobbee, D. E. (2003) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001575 · Cited by 446 · see citing works
Vascular effects of cocoa rich in flavan-3-ols
Heiss, C. (2003) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.290.8.1030 · Cited by 425 · see citing works
Cocoa and Cardiovascular Health
Corti, R., Flammer, A. J., Hollenberg, N. K., & Lüscher, T. F. (2009) · Circulation · doi:10.1161/circulationaha.108.827022 · Cited by 424 · see citing works
Relationship between Funding Source and Conclusion among Nutrition-Related Scientific Articles
Lesser, L. I., Ebbeling, C. B., Goozner, M., Wypij, D., & Ludwig, D. S. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040005 · Cited by 421 · see citing works
Dietary flavanols and procyanidin oligomers from cocoa (Theobroma cacao) inhibit platelet function
Murphy, K. J., Chronopoulos, A., Singh, I., Francis, M., Moriarty, H., Pike, M. J., Turner, A., Mann, N. J., & Sinclair, A. J. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.6.1466 · Cited by 374 · see citing works
Acute Consumption of Flavanol-Rich Cocoa and the Reversal of Endothelial Dysfunction in Smokers
Heiß, C., Kleinbongard, P., Dejam, A., Perré, S., Schroeter, H., Sies, H., & Kelm, M. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.06.055 · Cited by 346 · see citing works
Balzer, J., Rassaf, T., Heiss, C., Kleinbongard, P., Lauer, T., Merx, M., Heussen, N., Gross, H. B., Keen, C. L., Schroeter, H., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.01.059 · Cited by 345 · see citing works
Wan, Y., Vinson, J. A., Etherton, T. D., Proch, J., Lazarus, S. A., & Kris‐Etherton, P. M. (2001) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/74.5.596 · Cited by 341 · see citing works
Chocolate and Blood Pressure in Elderly Individuals With Isolated Systolic Hypertension
Taubert, D. (2003) · JAMA · doi:10.1001/jama.290.8.1029 · Cited by 300 · see citing works
Effect of Cocoa and Tea Intake on Blood Pressure
Taubert, D. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.7.626 · Cited by 282 · see citing works
Chocolate and Prevention of Cardiovascular Disease: A Systematic Review
Ding, E. L., Hutfless, S. M., Ding, X., & Girotra, S. R. (2006) · Nutrition & Metabolism · doi:10.1186/1743-7075-3-2 · Cited by 267 · see citing works
Effect of Cocoa Products on Blood Pressure: Systematic Review and Meta-Analysis
Desch, S., Schmidt, J., Kobler, D., Sonnabend, M., Eitel, I., Sareban, M., Rahimi, K., Schuler, G., & Thiele, H. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.213 · Cited by 259 · see citing works
Baba, S., Osakabe, N., Kato, Y., Natsume, M., Yasuda, A., Kido, T., Fukuda, K., Muto, Y., & Kondo, K. N. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.709 · Cited by 245 · see citing works
Cocoa Intake, Blood Pressure, and Cardiovascular Mortality: The Zutphen Elderly Study
Buijsse, B. (2006) · Archives of Internal Medicine · doi:10.1001/.411 · Cited by 245 · see citing works
How do dietary flavanols improve vascular function? A position paper
SCHEWE, T., Steffen, Y., & Sies, H. (2008) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2008.03.004 · Cited by 242 · see citing works
Inhibition of angiotensin converting enzyme (ACE) activity by flavan‐3‐ols and procyanidins
Actis‐Goretta, L., Ottaviani, J. I., Keen, C. L., & Fraga, C. G. (2003) · FEBS Letters · doi:10.1016/s0014-5793(03)01355-3 · Cited by 241 · see citing works
Buijsse, B., Weikert, C., Drogan, D., Bergmann, M. M., & Boeing, H. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq068 · Cited by 227 · see citing works
Cocoa polyphenols and inflammatory mediators
Sies, H., SCHEWE, T., Heiß, C., & Kelm, M. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.1.304s · Cited by 221 · see citing works
Faridi, Z., Njike, V. Y., Dutta, S., Ali, A., & Katz, D. L. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.1.58 · Cited by 217 · see citing works
Davison, K., Coates, A. M., Buckley, J. D., & Howe, P. R. C. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.66 · Cited by 210 · see citing works
Monagas, M., Khan, N., Andres-Lacueva, C., Casas, R., Urpí-Sardà, M., Llorach, R., Lamuela-Raventós, R. M., & Estruch, R. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.27716 · Cited by 209 · see citing works
Heiß, C., Finis, D., Kleinbongard, P., Hoffmann, A., Rassaf, T., Kelm, M., & Sies, H. (2007) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0b013e31802d0001 · Cited by 207 · see citing works
Polyphenols in Cocoa and Cocoa Products: Is There a Link between Antioxidant Properties and Health?
Jalil, A. M. M., & Ismail, A. (2008) · Molecules · doi:10.3390/molecules13092190 · Cited by 206 · see citing works
Heiss, C., Jahn, S., Taylor, M., Real, W. M., Angeli, F. S., Wong, M. L., Amabile, N., Prasad, M., Rassaf, T., Ottaviani, J. I., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.03.039 · Cited by 202 · see citing works
Effect of Dark Chocolate on Arterial Function in Healthy Individuals
Vlachopoulos, C. V., Aznaouridis, K., Alexopoulos, N. A., Economou, E. N., Andreadou, I., & Stefanadis, C. (2005) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2004.12.008 · Cited by 200 · see citing works
Baba, S., Natsume, M., Yasuda, A., Nakamura, Y., Tamura, T., Osakabe, N., Kanegae, M., & Kondo, K. N. (2007) · Journal of Nutrition · doi:10.1093/jn/137.6.1436 · Cited by 183 · see citing works
Regular Consumption of a Flavanol‐rich Chocolate can Improve Oxidant Stress in Young Soccer Players
Fraga, C. G., Actis‐Goretta, L., Ottaviani, J. I., Carrasquedo, F., LOTITO, S. B., Lazarus, S. A., Schmitz, H. H., & Keen, C. L. (2004) · Journal of Immunology Research · doi:10.1080/10446670410001722159 · Cited by 178 · see citing works
Sarwar, N., Aspelund, T., Eiriksdottir, G., Gobin, R., Seshasai, S. R. K., Forouhi, N. G., Sigurdsson, G., Danesh, J., & Gudnason, V. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000278 · Cited by 175 · see citing works
Does chocolate reduce blood pressure? A meta-analysis
Ried, K., Sullivan, T., Fakler, P., Frank, O. R., & Stocks, N. (2010) · BMC Medicine · doi:10.1186/1741-7015-8-39 · Cited by 175 · see citing works
Dark chocolate improves endothelial and platelet function: Figure 1
Hermann, M., Spieker, L. E., Ruschitzka, F., Sudano, I., Hermann, M., Binggeli, C., Lüscher, T. F., Riesen, W., Noll, G., & Corti, R. (2005) · Heart · doi:10.1136/hrt.2005.063362 · Cited by 175 · see citing works
Crews, W. D., Harrison, D. W., & Wright, J. W. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.4.872 · Cited by 169 · see citing works
Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans
PhD, F. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s2310 · Cited by 162 · see citing works
High‐cocoa polyphenol‐rich chocolate improves HDL cholesterol in Type 2 diabetes patients
Mellor, D. D., Sathyapalan, T., Kilpatrick, E. S., Beckett, S. T., & Atkin, S. L. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.03108.x · Cited by 158 · see citing works
Muniyappa, R., Hall, G., Kolodziej, T. L., Karne, R. J., Crandon, S. K., & Quon, M. J. (2008) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26457 · Cited by 155 · see citing works
Wang, J. F., Villablanca, A. C., Polagruto, J. A., Lee, L., Holt, R. R., Schrader, H. R., Ensunsa, J. L., Steinberg, F. M., Schmitz, H. H., & Keen, C. L. (2006) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200606001-00013 · Cited by 153 · see citing works
Jia, L., Liu, X., Bai, Y. Y., Li, S. H., Sun, K., He, C., & Hui, R. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28202 · Cited by 152 · see citing works
Schnorr, O., Brossette, T., Momma, T. Y., Kleinbongard, P., Keen, C. L., Schroeter, H., & Sies, H. (2008) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2008.02.040 · Cited by 127 · see citing works
Hypertension, the Kuna, and the Epidemiology of Flavanols
McCullough, M. L., Chevaux, K. A., Jackson, L., Preston, M., Martinez, G., Schmitz, H. H., Coletti, C. M., Campos, H., & Hollenberg, N. K. (2006) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200606001-00003 · Cited by 124 · see citing works
Farouque, H. M. O., Leung, M., Hope, S. A., Baldi, M. A., Schechter, C. B., Cameron, J. D., & Meredith, I. T. (2006) · Clinical Science · doi:10.1042/cs20060048 · Cited by 118 · see citing works
Kottra, G., & Daniel, H. (2007) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.107.124040 · Cited by 118 · see citing works
Janszky, I., Mukamal, K. J., Ljung, R., Ahnve, S., Ahlbom, A., & Hallqvist, J. (2009) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2009.02088.x · Cited by 113 · see citing works
Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults
Njike, V. Y., Faridi, Z., Shuval, K., Dutta, S., Kay, C. D., West, S. G., Kris‐Etherton, P. M., & Katz, D. L. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.12.010 · Cited by 111 · see citing works
Self-citationCerebral blood flow response to flavanol-rich cocoa in healthy elderly humans-1
Sorond, F. A., Lipsitz, L. A., Hollenberg, N. K., & Fisher, N. D. L. (2011) · Figshare · doi:10.6084/m9.figshare.87623 · Cited by 109 · see citing works
Dark chocolate or tomato extract for prehypertension: a randomised controlled trial
Ried, K., Frank, O. R., & Stocks, N. (2009) · BMC Complementary and Alternative Medicine · doi:10.1186/1472-6882-9-22 · Cited by 104 · see citing works
Shiina, Y., Funabashi, N., Lee, K., Murayama, T., Nakamura, K., Wakatsuki, Y., Daimon, M., & Komuro, I. (2007) · International Journal of Cardiology · doi:10.1016/j.ijcard.2007.07.131 · Cited by 101 · see citing works
Owen, J., Carroll, C., Cooke, J., Formby, E., Hayter, M., Hirst, J., Jones, M. L., Stapleton, H., Stevenson, M., & Sutton, A. (2010) · Health Technology Assessment · doi:10.3310/hta14300 · Cited by 96 · see citing works
Madonna, R., Pandolfi, A., Massaro, M., Consoli, A., & Caterina, R. D. (2004) · Diabetologia · doi:10.1007/s00125-004-1330-x · Cited by 96 · see citing works
Allgrove, J. E., Farrell, E., Gleeson, M., Williamson, G., & Cooper, K. (2011) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.21.2.113 · Cited by 88 · see citing works
Dose-related effects of flavanol-rich cocoa on blood pressure
Davison, K., Berry, N., Misan, G., Coates, A. M., Buckley, J. D., & Howe, P. R. C. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2009.105 · Cited by 80 · see citing works
Impact of cocoa flavanol consumption on blood pressure responsiveness to exercise
Berry, N., Davison, K., Coates, A. M., Buckley, J. D., & Howe, P. R. C. (2010) · British Journal Of Nutrition · doi:10.1017/s0007114509993382 · Cited by 78 · see citing works
Sathyapalan, T., Beckett, S. T., Rigby, A. S., Mellor, D. D., & Atkin, S. L. (2010) · Nutrition Journal · doi:10.1186/1475-2891-9-55 · Cited by 78 · see citing works
van den Bogaard, B., Draijer, R., Westerhof, B., van den Meiracker, A. H., van Montfrans, G. V., & van den Born, B. H. (2010) · HYPERTENSION · doi:10.1161/hypertensionaha.110.158139 · Cited by 72 · see citing works
Endothelial Function, Nitric Oxide, and Cocoa Flavanols
Heiß, C., Schroeter, H., Balzer, J., Kleinbongard, P., Matern, S., Sies, H., & Kelm, M. (2006) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200606001-00007 · Cited by 69 · see citing works
Cardioprotective effects of chocolate and almond consumption in healthy women
Kurlandsky, S. B., & Stote, K. S. (2006) · Nutrition Research · doi:10.1016/j.nutres.2006.08.007 · Cited by 66 · see citing works
Blood pressure and cardiovascular risk: What about cocoa and chocolate?
Grassi, D., Desideri, G., & Ferri, C. (2010) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2010.05.020 · Cited by 63 · see citing works
Lawlor, D. A., Fraser, A., Ebrahim, S. B. J., & Smith, G. D. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040263 · Cited by 61 · see citing works
Cocoa Intake, Blood Pressure, and Cardiovascular Mortality
Buijsse, B., Feskens, E. J. M., Kok, F. J., & Kromhout, D. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.4.411 · Cited by 17 · see citing works
Reply to PM Kris-Etherton et al
Hu, F. B., Stampfer, M. J., & Willett, W. C. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.4.1059a · Cited by 11 · see citing works
No evidence for a link between consumption of chocolate and coronary heart disease
Kris‐Etherton, P. M., Pelkman, C., Zhao, G., & Wang, Y. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.4.1059 · Cited by 10 · see citing works
van den Bogaard, B., Draijer, R., van Montfrans, G. A., & van den Born, B. (2010) · Journal of Hypertension · doi:10.1097/01.hjh.0000379757.07636.92 · Cited by 1 · see citing works
Flammer, A. J., Sudano, I., Wolfrum, M., Thomas, R., Enseleit, F., Periat, D., Lüscher, T. F., Ruschitzka, F. T., Noll, G., & Corti, R. (2010) · Journal of Hypertension · doi:10.1097/01.hjh.0000378240.06072.2c · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Corti R, Flammer AJ, Hollenberg NK, Luscher TF. Cocoa and car- diovascular health. Circulation 2009;119:1433-41.
- Review Manager (RevMan). Version 5.0. Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, 2008.
- Hermann F, Spieker LE, Ruschitzka F, Sudano I, Hermann M, Binggeli C, Luscher TF, Riesen W, Noll G, Corti R. Dark chocolate improves endothelial and platelet function. Heart 2006;92:119-20.
Cited by
Sorted by citations
Mozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216 · see citing works
Benefits of polyphenols on gut microbiota and implications in human health
Cardona, F., Andrés‐Lacueva, C., Tulipani, S., Tinahones, F. J., & Queipo‐Ortuño, M. I. (2013) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2013.05.001 · Cited by 1,615 · see citing works
The effects of polyphenols and other bioactives on human health
Fraga, C. G., Croft, K. D., Kennedy, D. O., & Tomás-Barberán, F. A. (2019) · Food & Function · doi:10.1039/c8fo01997e · Cited by 1,150 · see citing works
Rodriguez‐Mateos, A., Vauzour, D., Krueger, C. G., Shanmuganayagam, D., Reed, J. D., Calani, L., Mena, P. R., Rio, D. D., & Crozier, A. (2014) · Archives of Toxicology · doi:10.1007/s00204-014-1330-7 · Cited by 608 · see citing works
Williamson, G., Kay, C. D., & Crozier, A. (2018) · Comprehensive Reviews in Food Science and Food Safety · doi:10.1111/1541-4337.12351 · Cited by 607 · see citing works
Self-citationPolyphenols and Glycemic Control
Kim, Y., Keogh, J. B., & Clifton, P. M. (2016) · Nutrients · doi:10.3390/nu8010017 · Cited by 557 · see citing works
Cassidy, A., Mukamal, K., Liu, L., Franz, M., Eliassen, A., & Rimm, E. (2013) · Circulation · doi:10.1161/circulationaha.112.122408 · Cited by 442 · see citing works
Self-citationResveratrol and Clinical Trials: The Crossroad from In Vitro Studies to Human Evidence
Tomé‐Carneiro, J., Larrosa, M., González‐Sarrías, A., Tomás-Barberán, F. A., García‐Conesa, M., & Espı́n, J. C. (2013) · Current Pharmaceutical Design · doi:10.2174/13816128113199990407 · Cited by 451 · see citing works
Natural Products for the Treatment of Type 2 Diabetes Mellitus
Rı́os, J. L., Francini, F., & Schinella, G. R. (2015) · Planta Medica · doi:10.1055/s-0035-1546131 · Cited by 447 · see citing works
Mastroiacovo, D., Kwik-Uribe, C. L., Grassi, D., Necozione, S., Raffaele, A., Pistacchio, L., Righetti, R., Bocale, R., Lechiara, M. C., Marini, C., et al. (2014) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.092189 · Cited by 344 · see citing works
Polyphenols, Inflammation, and Cardiovascular Disease
Tangney, C., & Rasmussen, H. E. (2013) · Current Atherosclerosis Reports · doi:10.1007/s11883-013-0324-x · Cited by 340 · see citing works
Desideri, G., Kwik-Uribe, C., Grassi, D., Necozione, S., Ghiadoni, L., Mastroiacovo, D., Raffaele, A., Ferri, L., Bocale, R., Lechiara, M. C., et al. (2012) · Hypertension · doi:10.1161/hypertensionaha.112.193060 · Cited by 311 · see citing works
Cervantes-Gracia, K., Llanas-Cornejo, D., & Husi, H. (2017) · Journal of Clinical Medicine · doi:10.3390/jcm6020022 · Cited by 314 · see citing works
Flavonoids, Dairy Foods, and Cardiovascular and Metabolic Health
Mozaffarian, D., & Wu, J. H. Y. (2018) · Circulation Research · doi:10.1161/circresaha.117.309008 · Cited by 305 · see citing works
Guasch-Ferré, M., Merino, J., Sun, Q., Fitó, M., & Salas-Salvadó, J. (2017) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2017/6723931 · Cited by 297 · see citing works
Lifestyle Medicine: The Health Promoting Power of Daily Habits and Practices
Rippe, J. M. (2018) · American Journal of Lifestyle Medicine · doi:10.1177/1559827618785554 · Cited by 304 · see citing works
Optimal dietary patterns for prevention of chronic disease
Wang, P., Song, M., Eliassen, A. H., Wang, M., Fung, T. T., Clinton, S. K., Rimm, E. B., Hu, F. B., Willett, W. C., Tabung, F. K., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02235-5 · Cited by 294 · see citing works
Self-citationLiu, A. G., Ford, N. A., Hu, F. B., Zelman, K. M., Mozaffarian, D., & Kris‐Etherton, P. M. (2017) · Nutrition Journal · doi:10.1186/s12937-017-0271-4 · Cited by 287 · see citing works
Publication bias: what is it? How do we measure it? How do we avoid it?
Song, F., Hooper, L., & Loke, Y. (2013) · Open Access Journal of Clinical Trials · doi:10.2147/oajct.s34419 · Cited by 261 · see citing works
Self-citationThe Health Potential of Fruits and Vegetables Phytochemicals: Notable Examples
Rodríguez‐Casado, A. (2014) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2012.755149 · Cited by 267 · see citing works
Jennings, A., Welch, A. A., Fairweather-Tait, S. J., Kay, C. D., Minihane, A. M., Chowienczyk, P., Jiang, B., Cecelja, M., Spector, T. D., MacGregor, A. J., et al. (2012) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.042036 · Cited by 266 · see citing works
Self-citationImmunomodulatory Effects of Dietary Polyphenols
Shakoor, H. I., Feehan, J., Apostolopoulos, V., Platat, C., Dhaheri, A. S. A., Ali, H. I., Ismail, L. C., Bosevski, M., & Stojanovska, L. (2021) · Nutrients · doi:10.3390/nu13030728 · Cited by 257 · see citing works
Jones, J. A., Vernacchio, V. R., Sinkoe, A. L., Collins, S. M., Ibrahim, M. H. A., Lachance, D. M., Hahn, J., & Koffas, M. A. G. (2016) · Metabolic Engineering · doi:10.1016/j.ymben.2016.01.006 · Cited by 249 · see citing works
Novel Insights into the Pharmacology of Flavonoids
Romano, B., Pagano, E., Montanaro, V., Fortunato, A. L., Milić, N., & Borrelli, F. (2013) · Phytotherapy Research · doi:10.1002/ptr.5023 · Cited by 246 · see citing works
Brüll, V., Burak, C., Stoffel‐Wagner, B., Wolffram, S., Nickenig, G., Müller, C., Langguth, P., Alteheld, B., Fimmers, R., Naaf, S., et al. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515002950 · Cited by 239 · see citing works
Manach, C., Milenković, D., de Wiele, T. V., Rodriguez‐Mateos, A., de Roos, B., García‐Conesa, M., Landberg, R., Gibney, E. R., Heinonen, M., Tomás-Barberán, F. A., et al. (2016) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201600557 · Cited by 236 · see citing works
Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men,
Cassidy, A., Bertoia, M. L., Chiuve, S. E., Flint, A., Forman, J. P., & Rimm, E. B. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.133132 · Cited by 235 · see citing works
Self-citationCocoa Polyphenols and Their Potential Benefits for Human Health
Andújar, I., Recio, M. C., Giner, R. M., & Rı́os, J. L. (2012) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2012/906252 · Cited by 232 · see citing works
Dietary flavonoids intake and risk of type 2 diabetes: A meta-analysis of prospective cohort studies
Liu, Y., Zhan, J., Liu, X., Wang, Y., Ji, J., & He, Q. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.03.011 · Cited by 221 · see citing works
Jennings, A., Welch, A. A., Spector, T. D., MacGregor, A. J., & Cassidy, A. (2013) · Journal of Nutrition · doi:10.3945/jn.113.184358 · Cited by 220 · see citing works
Self-citationDower, J. I., Geleijnse, J. M., Gijsbers, L., Zock, P. L., Kromhout, D., & Hollman, P. C. H. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.098590 · Cited by 216 · see citing works
miRNA as molecular target of polyphenols underlying their biological effects
Milenković, D., Jude, B., & Morand, C. (2013) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2013.05.046 · Cited by 218 · see citing works
Fruit-Derived Polyphenol Supplementation for Athlete Recovery and Performance
Bowtell, J., & Kelly, V. (2019) · Sports Medicine · doi:10.1007/s40279-018-0998-x · Cited by 213 · see citing works
van Dam, R. M., Naidoo, N., & Landberg, R. (2013) · Current Opinion in Lipidology · doi:10.1097/mol.0b013e32835bcdff · Cited by 212 · see citing works
Gut Microbiota, Host Organism, and Diet Trialogue in Diabetes and Obesity
Lazăr, V., Diţu, L.-M., Pîrcălăbioru, G. G., Picu, A. A., Petcu, L. M., Cucu, N., & Chifiriuc, M. C. (2019) · Frontiers in Nutrition · doi:10.3389/fnut.2019.00021 · Cited by 207 · see citing works
Polyphenol intake and mortality risk: a re-analysis of the PREDIMED trial
Tresserra‐Rimbau, A., Rimm, E. B., Medina‐Remón, A., Martínez‐González, M. Á., López‐Sabater, M. C., Covas, M. I., Corella, D., Salas‐Salvadó, J., Gómez‐Gracia, E., Lapetra, J., et al. (2014) · BMC Medicine · doi:10.1186/1741-7015-12-77 · Cited by 205 · see citing works
Self-citationBowtell, J. L., Bakkar, Z. A., Conway, M. E., Adlam, A., & Fulford, J. (2017) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2016-0550 · Cited by 202 · see citing works
Cassidy, A., Rogers, G. T., Peterson, J. J., Dwyer, J. T., Lin, H., & Jacques, P. F. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.108555 · Cited by 195 · see citing works
Self-citationBerry anthocyanin intake and cardiovascular health
Cassidy, A. (2017) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2017.05.002 · Cited by 192 · see citing works
Self-citationSesso, H. D., Manson, J. E., Aragaki, A. K., Rist, P. M., Johnson, L. G., Friedenberg, G., Copeland, T., Clar, A., Mora, S., Moorthy, M. V., et al. (2022) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqac055 · Cited by 187 · see citing works
Flavonoid Intake in European Adults (18 to 64 Years)
Vogiatzoglou, A., Mulligan, A. A., Lentjes, M. A. H., Luben, R., Spencer, J. P. E., Schroeter, H., Khaw, K., & Kuhnle, G. (2015) · PLoS ONE · doi:10.1371/journal.pone.0128132 · Cited by 191 · see citing works
Potential Role of Seaweed Polyphenols in Cardiovascular-Associated Disorders
Gómez‐Guzmán, M., Rodríguez‐Nogales, A., Algieri, F., & Gálvez, J. (2018) · Marine Drugs · doi:10.3390/md16080250 · Cited by 185 · see citing works
Sansone, R., Rodriguez‐Mateos, A., Heuel, J., Falk, D., Schuler, D., Wagstaff, R., Kuhnle, G., Spencer, J. P. E., Schroeter, H., Merx, M. W., et al. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515002822 · Cited by 178 · see citing works
The mechanisms of action of flavonoids in the brain: Direct versus indirect effects
Rendeiro, C., Rhodes, J. S., & Spencer, J. P. E. (2015) · Neurochemistry International · doi:10.1016/j.neuint.2015.08.002 · Cited by 182 · see citing works
Chocolate and the brain: Neurobiological impact of cocoa flavanols on cognition and behavior
Sokolov, A. N., Pavlova, M. A., Klosterhalfen, S., & Enck, P. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.06.013 · Cited by 178 · see citing works
Cardozo, E. L., & Morand, C. (2016) · Journal of Functional Foods · doi:10.1016/j.jff.2015.12.010 · Cited by 160 · see citing works
Bernátová, I. (2018) · Biotechnology Advances · doi:10.1016/j.biotechadv.2018.01.009 · Cited by 159 · see citing works
Atheroprotective effects of (poly)phenols: a focus on cell cholesterol metabolism
Zanotti, I., Dall’Asta, M., Mena, P. R., Mele, L., Bruni, R., Ray, S., & Rio, D. D. (2014) · Food & Function · doi:10.1039/c4fo00670d · Cited by 158 · see citing works
Cordero‐Herrera, I., Martín, M. Á., Goya, L., & Ramos, S. (2013) · Food and Chemical Toxicology · doi:10.1016/j.fct.2013.11.014 · Cited by 156 · see citing works
Kay, C. D., Hooper, L., Kroon, P. A., Rimm, E. B., & Cassidy, A. (2012) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201200363 · Cited by 151 · see citing works
Self-citationPhenolic Compounds as Nutraceuticals or Functional Food Ingredients
Caleja, C., Ribeiro, A., Barreiro, M. F., & Ferreira, I. C. F. R. (2017) · Current Pharmaceutical Design · doi:10.2174/1381612822666161227153906 · Cited by 153 · see citing works
Annuzzi, G., Bozzetto, L., Costabile, G., Giacco, R., Mangione, A., Anniballi, G., Vitale, M., Vetrani, C., Cipriano, P., Corte, G. D., et al. (2013) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.073445 · Cited by 148 · see citing works
Consumption of Plant Seeds and Cardiovascular Health
Ros, E., & Hu, F. B. (2013) · Circulation · doi:10.1161/circulationaha.112.001119 · Cited by 146 · see citing works
Postprandial Hyperlipidemia and Remnant Lipoproteins
Masuda, D., & Yamashita, S. (2017) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.rv16003 · Cited by 145 · see citing works
Lin, X., Zhang, I., Li, A., Manson, J. E., Sesso, H. D., Wang, L., & Liu, S. (2016) · The Journal of Nutrition · doi:10.3945/jn.116.237644 · Cited by 150 · see citing works
Edmands, W. M. B., Ferrari, P., Rothwell, J. A., Rinaldi, S., Slimani, N., Barupal, D. K., Biessy, C., Jenab, M., Clavel‐Chapelon, F., Fagherazzi, G., et al. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.101881 · Cited by 141 · see citing works
Elucidation of (−)-epicatechin metabolites after ingestion of chocolate by healthy humans
Actis‐Goretta, L., Lévèques, A., Giuffrida, F., Romanov‐Michailidis, F., Viton, F., Barron, D., Dueñas, M., González‐Manzano, S., Santos‐Buelga, C., Williamson, G., et al. (2012) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2012.05.023 · Cited by 140 · see citing works
Cordero‐Herrera, I., Martín, M. Á., Bravo, L., Goya, L., & Ramos, S. (2013) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201200500 · Cited by 139 · see citing works
Cocoa Polyphenols and Inflammatory Markers of Cardiovascular Disease
Khan, N., Khymenets, O., Urpí-Sardà, M., Tulipani, S., Garcia‐Aloy, M., Monagas, M., Cubillos, L. X. M., Llorach, R., & Andrés‐Lacueva, C. (2014) · Nutrients · doi:10.3390/nu6020844 · Cited by 138 · see citing works
Del Bo', C., Bernardi, S., Cherubini, A., Porrini, M., Gargari, G., Hidalgo-Liberona, N., González-Domínguez, R., Zamora-Ros, R., Peron, G., Marino, M., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2020.12.014 · Cited by 133 · see citing works
Self-citationWiese, S., Esatbeyoglu, T., Winterhalter, P., Kruse, H., Winkler, S., Bub, A., & Kulling, S. E. (2014) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201400422 · Cited by 132 · see citing works
Tomé‐Carneiro, J., & Visioli, F. (2015) · Phytomedicine · doi:10.1016/j.phymed.2015.10.018 · Cited by 132 · see citing works
Menezes, R., Rodriguez‐Mateos, A., Καλτσάτου, Α., González‐Sarrías, A., Greyling, A., Giannaki, C. D., Andrés‐Lacueva, C., Milenković, D., Gibney, E. R., Dumont, J., et al. (2017) · Nutrients · doi:10.3390/nu9020117 · Cited by 132 · see citing works
Targeting Inflammation by Flavonoids: Novel Therapeutic Strategy for Metabolic Disorders
Farzaei, M. H., Singh, A. K., Kumar, R., Croley, C. R., Pandey, A. K., Coy-Barrera, E. D., Patra, J. K., Das, G., Kerry, R. G., Annunziata, G., et al. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20194957 · Cited by 134 · see citing works
Aguilera, Y., Martin-Cabrejas, M. A., & de Mejı́a, E. G. (2015) · Phytochemistry Reviews · doi:10.1007/s11101-015-9443-z · Cited by 129 · see citing works
West, S. G., McIntyre, M. D., Piotrowski, M. J., Poupin, N., Miller, D. L., Preston, A. G., Wagner, P. R., Groves, L. F., & Skulas‐Ray, A. C. (2013) · British Journal Of Nutrition · doi:10.1017/s0007114513002912 · Cited by 125 · see citing works
Polyphenols and Their Interactions With Other Dietary Compounds: Implications for Human Health
Kardum, N., & Glibetić, M. (2018) · Advances in food and nutrition research · doi:10.1016/bs.afnr.2017.12.001 · Cited by 124 · see citing works
Functional Food and Cardiovascular Disease Prevention and Treatment: A Review
Asgary, S., Rastqar, A., & Keshvari, M. (2018) · Journal of the American College of Nutrition · doi:10.1080/07315724.2017.1410867 · Cited by 132 · see citing works
Vogiatzoglou, A., Mulligan, A. A., Luben, R., Lentjes, M. A. H., Heiß, C., Kelm, M., Merx, M. W., Spencer, J. P. E., Schroeter, H., & Kuhnle, G. (2013) · British Journal Of Nutrition · doi:10.1017/s0007114513003930 · Cited by 122 · see citing works
Higher Dietary Flavonol Intake Is Associated with Lower Incidence of Type 2 Diabetes
Jacques, P. F., Cassidy, A., Rogers, G. T., Peterson, J. J., Meigs, J. B., & Dwyer, J. T. (2013) · Journal of Nutrition · doi:10.3945/jn.113.177212 · Cited by 122 · see citing works
Self-citationIslam, M. A., Alam, F., Solayman, M., Khalil, M. I., Kamal, M. A., & Gan, S. H. (2016) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2016/5137431 · Cited by 125 · see citing works
Kennedy, D. O. (2014) · Advances in Nutrition · doi:10.3945/an.114.006320 · Cited by 125 · see citing works
Dietary flavonoids and nitrate: effects on nitric oxide and vascular function
Bondonno, C. P., Croft, K. D., Ward, N., Considine, M. J., & Hodgson, J. M. (2015) · Nutrition Reviews · doi:10.1093/nutrit/nuu014 · Cited by 150 · see citing works
Sansone, R., Ottaviani, J. I., Rodriguez‐Mateos, A., Heinen, Y., Noske, D., Spencer, J. P. E., Crozier, A., Merx, M. W., Kelm, M., Schroeter, H., et al. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.140046 · Cited by 119 · see citing works
Dark chocolate: An overview of its biological activity, processing, and fortification approaches
Samanta, S., Sarkar, T., Chakraborty, R., Ребезов, М. Б., Shariati, M. A., Thiruvengadam, M., & Rengasamy, K. R. R. (2022) · Current Research in Food Science · doi:10.1016/j.crfs.2022.10.017 · Cited by 117 · see citing works
Chocolate, “Food of the Gods”: History, Science, and Human Health
Montagna, M. T., Diella, G., Triggiano, F., Caponio, G. R., Giglio, O. D., Caggiano, G., Ciaula, A. D., & Portincasa, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16244960 · Cited by 116 · see citing works
Panickar, K. S. (2012) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201200431 · Cited by 114 · see citing works
Evidence of Lifestyle Modification in the Management of Hypercholesterolemia
Mannu, G., Zaman, M., Gupta, A., Rehman, H. U., & Myint, P. K. (2013) · Current Cardiology Reviews · doi:10.2174/157340313805076313 · Cited by 114 · see citing works
The role of nutraceuticals in the prevention of cardiovascular disease
Sosnowska, B., Penson, P. E., & Banach, M. (2017) · Cardiovascular Diagnosis and Therapy · doi:10.21037/cdt.2017.03.20 · Cited by 113 · see citing works
Iglesias‐Aguirre, C. E., Cortés‐Martín, A., Ávila‐Gálvez, M. Á., Giménez‐Bastida, J. A., Selma, M. V., González‐Sarrías, A., & Espı́n, J. C. (2021) · Food & Function · doi:10.1039/d1fo02033a · Cited by 117 · see citing works
Grassi, D., Desideri, G., Necozione, S., Giosia, P. D., Barnabei, R., Allegaert, L., Bernaert, H., & Ferri, C. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000412 · Cited by 112 · see citing works
Polyphenols and atherosclerosis: A critical review of clinical effects on LDL oxidation
Ahmadi, A., Jamialahmadi, T., & Sahebkar, A. (2022) · Pharmacological Research · doi:10.1016/j.phrs.2022.106414 · Cited by 111 · see citing works
Cocoa, Blood Pressure, and Vascular Function
Ludovici, V., Barthelmes, J., Nägele, M. P., Enseleit, F., Ferri, C., Flammer, A. J., Ruschitzka, F. T., & Sudano, I. (2017) · Frontiers in Nutrition · doi:10.3389/fnut.2017.00036 · Cited by 111 · see citing works
Raman, G., Avendano, E. E., Chen, S., Wang, J., Matson, J., Gayer, B., Novotny, J. A., & Cassidy, A. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz178 · Cited by 110 · see citing works
Self-citationMilenković, D., Morand, C., Cassidy, A., Konić‐Ristić, A., Tomás-Barberán, F. A., Ordovás, J. M., Kroon, P. A., Caterina, R. D., & Rodriguez‐Mateos, A. (2017) · Advances in Nutrition · doi:10.3945/an.116.013623 · Cited by 109 · see citing works
Self-citationNatural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome
Noce, A., Lauro, M. D., Daniele, F. D., Zaitseva, A. P., Marrone, G., Borboni, P., & Daniele, N. D. (2021) · Nutrients · doi:10.3390/nu13020630 · Cited by 116 · see citing works
Yuan, S., Li, X., Jin, Y., & Lu, J. (2017) · Nutrients · doi:10.3390/nu9070688 · Cited by 108 · see citing works
Koutsos, A., Riccadonna, S., Ulaszewska, M., Franceschi, P., Trôst, K., Galvin, A., Braune, T., Fava, F., Perenzoni, D., Mattivi, F., et al. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz282 · Cited by 108 · see citing works
In vitro fermentation of juçara pulp ( Euterpe edulis ) by human colonic microbiota
Guergoletto, K. B., Costabile, A., Flores, G., García, S., & Gibson, G. R. (2015) · Food Chemistry · doi:10.1016/j.foodchem.2015.09.048 · Cited by 108 · see citing works
Grassi, D., Desideri, G., Necozione, S., Ruggieri, F., Blumberg, J. B., Stornello, M., & Ferri, C. (2012) · Hypertension · doi:10.1161/hypertensionaha.112.193995 · Cited by 106 · see citing works
The role of nutrition and nutraceutical supplements in the treatment of hypertension
Houston, M. C. (2014) · World Journal of Cardiology · doi:10.4330/wjc.v6.i2.38 · Cited by 108 · see citing works
Sutulic, S., & Williamson, G. (2013) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-071811-150642 · Cited by 105 · see citing works
Konar, N., Toker, Ö. S., Oba, Ş., & Sağdıç, O. (2016) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2016.01.002 · Cited by 106 · see citing works
Pleiotropic preventive effects of dietary polyphenols in cardiovascular diseases
Kishimoto, Y., Tani, M., & Kondo, K. (2013) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2013.29 · Cited by 104 · see citing works
van den Driessche, J. J., Plat, J., & Mensink, R. P. (2018) · Food & Function · doi:10.1039/c7fo01792h · Cited by 106 · see citing works
Clinical Advances in Immunonutrition and Atherosclerosis: A Review
Ruiz-León, A. M., Lapuente, M., Estruch, R., & Casas, R. M. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00837 · Cited by 101 · see citing works
Dietary flavonoid intake and cardiovascular risk: a population-based cohort study
Ponzo, V., Goitre, I., Fadda, M., Gambino, R., Francesco, A. D., Soldati, L., Gentile, L., Magistroni, P., Cassader, M., & Bo, S. (2015) · Journal of Translational Medicine · doi:10.1186/s12967-015-0573-2 · Cited by 111 · see citing works
Hu, Y., Pan, Z. J., Liao, W., Li, J., Gruget, P., Kitts, D. D., & Lu, X. (2016) · Food Chemistry · doi:10.1016/j.foodchem.2016.01.130 · Cited by 102 · see citing works
Antidiabetic actions of cocoa flavanols
Martín, M. Á., Goya, L., & Ramos, S. (2016) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201500961 · Cited by 101 · see citing works
Munir, K. M., Chandrasekaran, S., Gao, F., & Quon, M. J. (2013) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00377.2013 · Cited by 102 · see citing works
- Authors
- Hooper, L., Kay, C., Abdelhamid, A., Kroon, P. A., Cohn, J. S., Rimm, E. B., & Cassidy, A.
- Affiliations
- University of East Anglia (GB)
- Corresponding author
- Hooper, Lee
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 95
- Issue
- 3
- Pages
- 740-751
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2129761592
- Cited by
- 610
- References
- 90
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 32 · 2023: 24 · 2022: 29 · 2021: 35 · 2020: 37 · 2019: 43 · 2018: 63 · 2017: 56 · 2016: 64 · 2015: 54 · 2014: 50 · 2013: 66 · 2012: 22
- FWCI
- 6.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Research Portal (Queen's University Belfast) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- GlaxoSmithKline
- Directorate for Biological Sciences
- Biotechnology and Biological Sciences Research Council (BBS/E/F/00044434)
- Topics
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Chemistry and Fat Analysis
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Keywords
- chocolate, Theobroma cacao, flavan-3-ols, epicatechin, cardiovascular disease prevention, insulin resistance, flow-mediated dilation, endothelial function, blood pressure, LDL cholesterol, HDL cholesterol, cardiovascular risk factors, dose-response relationship, quality of evidence, GRADE, adverse effects
- MeSH terms
- Blood Glucose, Blood Pressure, Cacao, Candy, Cardiovascular Diseases, Cardiovascular System, Flavonoids, Humans, Insulin, Risk Factors, Reproducibility of Results, Biomarkers, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
