The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Flavonoid-Rich Cocoa Consumption Affects Multiple Cardiovascular Risk Factors in a Meta-Analysis of Short-Term Studies
Open accessAbstract
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.
Overview
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
Verification
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?
In the citing paper
“A few short-term trials of other dietary sources (e.g., tea, red wine, grapes) or specific flavonoid extracts have not consistently improved BP, lipid levels, or endothelial function.295-297”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [295]
In the citing paper
“In laboratory studies and randomized trials, flavonoid-rich cocoa has small but measurable benefits on BP, endothelial function, insulin resistance, and blood lipids.295-297”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [295]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
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
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648
Meta-analyses involving cross-over trials: methodological issues
Elbourne, D. R., Altman, D. G., Higgins, J. P., Curtin, F., Worthington, H. V., & Vail, A. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.1.140 · Cited by 2,305
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
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
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
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
Taubert, D., Roesen, R., Lehmann, C., Jung, N., & Schömig, E. (2007) · JAMA · doi:10.1001/jama.298.1.49 · Cited by 476
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
Research works printed but not linked: 1
- Higgins JP, Green S, editors. Analysing and reporting results. In:Cochrane handbook for systematic reviews of interventions 8.7.2 (updated May 2005). Cichester (UK): Wiley & Sons, Ltd; 2007.
Cited by
Sorted by citations
Del Rio, D., Rodriguez-Mateos, A., Spencer, J. P. E., Tognolini, M., Borges, G., & Crozier, A. (2013) · Antioxidants & Redox Signaling · doi:10.1089/ars.2012.4581 · Cited by 2,601
Mozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216
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 1,200
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 623
Williamson, G., Kay, C. D., & Crozier, A. (2018) · Comprehensive Reviews in Food Science and Food Safety · doi:10.1111/1541-4337.12351 · Cited by 620
Metadata
- 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.
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 141
- Issue
- 11
- Pages
- 1982-1988
- ISSN
- 0022-3166 (ISSN-L)
- 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
- 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
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
