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Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease
Open accessAbstract
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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“This treatment also lowered circulating levels of the inflammatory markers P-selectin and ICAM-1, compared with monocytes from the control group (only skimmed milk) (143).”
From Immunosenescence and Its Hallmarks: How to Oppose Aging Strategically? A Review of Potential Options for Therapeutic Intervention (2019) · cites this paper as [143]
In the citing paper
“Consumption of cocoa polyphenols rich in flavonoids (40 g/day) with 500 ml of skimmed milk, by participants at high cardiovascular disease risk (≥55 years), significantly reduced the expression of cell adhesion molecule very late antigen-4, CD40, and CD36 on monocytes.”
From Immunosenescence and Its Hallmarks: How to Oppose Aging Strategically? A Review of Potential Options for Therapeutic Intervention (2019) · cites this paper as [143]
Citations
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Cited by
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Dietary factors and low-grade inflammation in relation to overweight and obesity
Calder, P. C., Ahluwalia, N., Brouns, F., Buetler, T., Clement, K., Cunningham, K., Esposito, K., Jönsson, L. S., Kolb, H., Lansink, M., et al. (2011) · British Journal of Nutrition · doi:10.1017/s0007114511005460 · Cited by 1,098
“Most recently, Monagas et al.(417) reported the effect of a 4-week randomised cross-over trial of 40 g cocoa powder in skimmed milk daily v. skimmed milk in forty-two older subjects: serum concentrations of sICAM-1 and sP-selectin were lower after the cocoa powder interven- tion.”
Aiello, A., Farzaneh, F., Candore, G., Caruso, C., Davinelli, S., Gambino, C. M., Ligotti, M. E., Zareian, N., & Accardi, G. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.02247 · Cited by 693
“This treatment also lowered circulating levels of the inflammatory markers Pselectin and ICAM-1, compared with monocytes from the control group (only skimmed milk) (143).”
BackgroundHooper, L., Kay, C., Abdelhamid, A., Kroon, P. A., Cohn, J. S., Rimm, E. B., & Cassidy, A. (2012) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.023457 · Cited by 610
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
Flavanols and Anthocyanins in Cardiovascular Health: A Review of Current Evidence
de Pascual‐Teresa, S., Moreno, D. A., & García‐Viguera, C. (2010) · International Journal of Molecular Sciences · doi:10.3390/ijms11041679 · Cited by 560
Metadata
- 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
- bronze
- doi.org
- Licence
- 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 (medical) › 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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