Cocoa flavanols offer ‘modest but significant’ benefits for heart disease risk factors

If a spoonful of sugar helps the medicine go down, a serving of cocoa could help avoid the need for medicine in the first place – at least when it comes to some heart disease risk factors. 

A new meta-analysis of 19 randomized controlled trials published in the Journal of Nutrition found the flavanols in cocoa products, including chocolate, have “modest but significant benefits in lipid metabolism, insulin resistance and systemic inflammation,” which are all major risk factors for cardio metabolic diseases. 

Specifically, the research found cocoa flavanol intake lowered triglycerides 0.10 mmol/L compared to placebos and boosted good cholesterol 0.06 nmol/L compared to the control group.

In addition, the fasting insulin concentrations were significantly lower in the study participants who took cocoa flavanols to the tune of about -2.33 uIU/mL on average.

Based on their review of the studies, the researchers explain flavanols could benefit insulin concentrations by inhibiting glucosidase & glucose absorption from the intestines, increasing insulin secretion, activating insulin receptors and other mechanisms of action.

The insights gleaned by the researchers about flavanols’ impact on lipid metabolism, insulin resistance, systemic inflammation, renal function and oxidative stress are additions to the overall body of knowledge, according to the study.

As are the conclusions that sex, age and existing comorbidities do not impact the results.

The form in which the flavanols were consumed and the duration of intervention also did not change the results, but the greatest effects were among study participants who consumed 200 to 600 milligrams of flavanols daily. Those with lower doses of flavanols only saw a benefit in good cholesterol while those with more saw a steeper drop in triglycerides and benefit in insulin resistance, according to the study.

Based on this discovery, the researchers say there is an “urgent need for large long-term RCTs that improve our understanding of how the short-term benefits of cocoa flavanol intake on cardiometabolic biomarkers may be translated into clinical outcomes.”

Source: Journal of Nutrition

Published online ahead of print, doi: 10.3945/​jn.116.237644

“Cocoa Flavanol Intake and Biomarkers for Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”

Authors: X. Lin et al