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

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Shrime, Mark G., Bauer, Scott R., McDonald, Anna C., Chowdhury, Nubaha H., Coltart, Cordelia E.M., Ding, Eric L.·2011·The Journal of Nutrition

DOI 10.3945/jn.111.145482

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Abstract

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.

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Authors: Shrime, M. G., Bauer, S. R., McDonald, A. C., Chowdhury, N. H., Coltart, C. E. M., & Ding, E. L.
Affiliations: Harvard University (US)
Brigham and Women's Hospital (US)
University of North Carolina at Chapel Hill (US)
Corresponding author: Shrime, Mark G.
Ding, Eric L.
ORCID: Shrime, Mark G.
Bauer, Scott R.
McDonald, Anna C.
Coltart, Cordelia E.M.
Ding, Eric L.
Venue: The Journal of Nutrition
Publisher: Elsevier BV
Published: 2011-11
Volume: 141
Issue: 11
Pages: 1982-1988
ISSN: 0022-3166 (ISSN-L)
DOI: 10.3945/jn.111.145482
OpenAlex: W2149628027
Cited by: 234
References: 41
Citations by year: 2026: 2 · 2025: 7 · 2024: 11 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 12 · 2019: 17 · 2018: 23 · 2017: 27 · 2016: 23 · 2015: 17 · 2014: 22 · 2013: 27 · 2012: 14
FWCI: 1.89
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4123 d)
Locations: Journal of Nutrition (publishedVersion)
PubMed (publishedVersion)
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 › Pharmacology (medical) › Coffee research and impacts
Keywords: cocoa consumption, cardiovascular risk factors, blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, C-reactive protein, flow-mediated dilation, insulin resistance, HOMA-IR, dose-response relationship, polyphenols, cardioprotection, insulin sensitivity
MeSH terms: Cacao, Cardiovascular System, Dose-Response Relationship, Drug, Flavonoids, Humans, Risk Factors, Cross-Over Studies

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

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