Cited by 209Phytochemicals and Antioxidant ActivitiesFood Chemistry and Fat AnalysisNutritional Studies and Diet

Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease

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Monagas, Maria, Khan, Nasiruddin, Andres-Lacueva, Cristina, Casas, Rosa, Urpí-Sardà, Mireia, Llorach, Rafael, Lamuela-Raventós, Rosa Maria, Estruch, Ramón·2009·The American Journal of Clinical Nutrition

Abstract

Background Epidemiologic studies have suggested that flavonoid intake plays a critical role in the prevention of coronary heart disease. Because atherosclerosis is considered a low-grade inflammatory disease, some feeding trials have analyzed the effects of cocoa (an important source of flavonoids) on inflammatory biomarkers, but the results have been controversial.Objective The objective was to evaluate the effects of chronic cocoa consumption on cellular and serum biomarkers related to atherosclerosis in high-risk patients.Design Forty-two high-risk volunteers (19 men and 23 women; mean +/- SD age: 69.7 +/- 11.5 y) were included in a randomized crossover feeding trial. All subjects received 40 g cocoa powder with 500 mL skim milk/d (C+M) or only 500 mL skim milk/d (M) for 4 wk. Before and after each intervention period, cellular and serum inflammatory biomarkers related to atherosclerosis were evaluated.Results Adherence to the dietary protocol was excellent. No significant changes in the expression of adhesion molecules on T lymphocyte surfaces were found between the C+M and M groups. However, in monocytes, the expression of VLA-4, CD40, and CD36 was significantly lower (P = 0.005, 0.028, and 0.001, respectively) after C+M intake than after M intake. In addition, serum concentrations of the soluble endothelium-derived adhesion molecules P-selectin and intercellular adhesion molecule-1 were significantly lower (both P = 0.007) after C+M intake than after M intake.Conclusions These results suggest that the intake of cocoa polyphenols may modulate inflammatory mediators in patients at high risk of cardiovascular disease. These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis. This trial was registered in the Current Controlled Trials at London, International Standard Randomized Controlled Trial Number, at controlled-trials.com as ISRCTN75176807.

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Crossref · 10.3945/ajcn.2009.27716

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Authors
Monagas, M., Khan, N., Andres-Lacueva, C., Casas, R., Urpí-Sardà, M., Llorach, R., Lamuela-Raventós, R. M., & Estruch, R.
Affiliations
Instituto de Salud Carlos III (ES)
Corresponding author
Estruch, Ramón
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2009-11
Volume
90
Issue
5
Pages
1144-1150
ISSN
0002-9165 (ISSN-L)
OpenAlex
W1964861389
Cited by
209
References
41
Citations by year
2026: 3 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 7 · 2020: 10 · 2019: 13 · 2018: 11 · 2017: 15 · 2016: 22 · 2015: 14 · 2014: 14 · 2013: 31 · 2012: 24
FWCI
10.46
Type
journal article
Language
en
Open access
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • DIGITAL.CSIC (Spanish National Research Council (CSIC)) (acceptedVersion, other-oa)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, public-domain)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion)
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 › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
cocoa powder, cocoa polyphenols, flavonoids, atherosclerosis, inflammation, inflammatory markers, cardiovascular risk, monocytes, adhesion molecules, VLA-4, CD40, CD36, P-selectin, ICAM-1, T cells, dietary intervention
MeSH terms
Aged, Aged, 80 and over, Blood Pressure, Body Weight, Cacao, Cardiovascular Diseases, Coronary Disease, Female, Flavonoids, Humans, Inflammation, Leukocytes, Mononuclear, Male, Middle Aged, Monocytes, Obesity, Risk Factors, Smoking, T-Lymphocytes, Immunophenotyping, Patient Selection, Cross-Over Studies

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