Effects of Cocoa Consumption on Cardiometabolic Risk Markers: Meta-Analysis of Randomized Controlled Trials.

Tainah O P Arisi, Diego Silveira da Silva, Elana Stein, Camila Weschenfelder, Patrícia Caetano de Oliveira, Aline Marcadenti, Alexandre Machado Lehnen, Gustavo Waclawovsky

Journal: Nutrients 2024;16(12):1919

PMID: 38931273

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Plain Language Summary

Theobroma cacao, popularly known as cocoa, is a fruit rich in polyphenols, mostly flavonoids. Cocoa might exert beneficial cardiovascular effects that are probably mediated by this group of molecules. This study aimed to examine the long-term effects of dietary cocoa consumption on cardiometabolic risk markers, including anthropometric measurements, lipid profile, and blood pressure levels, in adults with and without established comorbidities. This research was a systematic review and meta-analysis of thirty-one randomised controlled trials. Results showed that the consumption of cocoa as a dietary supplement in cocoa extract capsules or dark-chocolate products had a protective effect on most cardiometabolic risk markers evaluated namely, total cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, blood pressure. Authors concluded that based on their findings the consumption of cocoa rich in polyphenols can be considered as a cardioprotective approach.

Abstract

BACKGROUND

We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and blood pressure levels in adults, with and without comorbidities.

METHODS

The databases used were MEDLINE (PubMed), EMBASE, Web of Science, Cochrane, LILACS, and SciELO. The eligible studies were randomized clinical trials (RCTs) involving adults undergoing cocoa consumption (cocoa extract or ≥70% cocoa dark chocolate) for ≥4 weeks that evaluated at least one of the following markers: body weight, body mass index (BMI), waist/abdominal circumference, total cholesterol, LDL-c, triglycerides, HDL-c, blood glucose, glycated hemoglobin (HbA1c), and systolic and diastolic blood pressure (SBP/DBP).

RESULTS

Thirty-one studies were included, totaling 1986 participants. Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c. Yet, there was a reduction in total cholesterol (-8.35 mg/dL, 95% CI -14.01; -2.69 mg/dL), LDL-c (-9.47 mg/dL, 95% CI -13.75; -5.20 mg/dL), fasting blood glucose (-4.91 mg/dL, 95% CI -8.29; -1.52 mg/dL), SBP (-2.52 mmHg, 95% CI -4.17; -0.88 mmHg), and DBP (-1.58 mmHg, 95% CI -2.54; -0.62 mmHg).

CONCLUSIONS

The consumption of cocoa showed protective effects on major cardiometabolic risk markers that have a clinical impact in terms of cardiovascular risk reduction.

Address: Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre 90620-001, RS, Brazil.; Instituto de Pesquisa Hcor (IP-Hcor), Hcor, São Paulo 04005-909, SP, Brazil.; Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo 01246-904, SP, Brazil.

DOI: 10.3390/nu16121919

Patient Centred Factor

Triggers: Cocoa consumption

Clinical Imbalances

Immune and inflammation

Modifiable Lifestyle Factors

Diet

Nutrition Evidence Keywords

BMI Polyphenols Cholesterol Triglycerides Glucose LDL HbA1c Body mass index Antioxidant Lipids HDL Low-density lipoprotein High-density lipoprotein Cardiovascular disease Glycated haemoglobin Cardiometabolic Cocoa

Bioactive Substances

Polyphenols Flavonoids

Link outs

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Medical:

https://medlineplus.gov/bloodglucose.html

MeSH Terms: Humans, Randomized Controlled Trials as Topic, Cacao, Cardiometabolic Risk Factors, Blood Pressure, Blood Glucose, Biomarkers, Glycated Hemoglobin, Cardiovascular Diseases, Chocolate, Male, Female, Adult, Body Mass Index, Body Weight, Waist Circumference, Middle Aged, Triglycerides, Diet, Lipids