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Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial.
J Am Coll Cardiol 2008; 51(22):2141-9JACC

Abstract

OBJECTIVES

Our goal was to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabetic patients.

BACKGROUND

Even in fully medicated diabetic patients, overall prognosis is unfavorable due to deteriorated cardiovascular function. Based on epidemiological data, diets rich in flavanols are associated with a reduced cardiovascular risk.

METHODS

In a feasibility study with 10 diabetic patients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability after an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75, 371, and 963 mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabetic patients were assessed after a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321 mg flavanols per dose) or a nutrient-matched control (25 mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Primary and secondary outcome measures included changes in FMD and plasma flavanol metabolites, respectively.

RESULTS

A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2 h: from 3.7 +/- 0.2% to 5.5 +/- 0.4%, p < 0.001). A 30-day, thrice-daily consumption of flavanol-containing cocoa increased baseline FMD by 30% (p < 0.0001), while acute increases of FMD upon ingestion of flavanol-containing cocoa continued to be manifest throughout the study. Treatment was well tolerated without evidence of tachyphylaxia. Endothelium-independent responses, blood pressure, heart rate, and glycemic control were unaffected.

CONCLUSIONS

Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease.

Authors+Show Affiliations

Department for Cardiology, Pulmonology, and Vascular Medicine, University Hospital RWTH Aachen, Aachen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18510961

Citation

Balzer, Jan, et al. "Sustained Benefits in Vascular Function Through Flavanol-containing Cocoa in Medicated Diabetic Patients a Double-masked, Randomized, Controlled Trial." Journal of the American College of Cardiology, vol. 51, no. 22, 2008, pp. 2141-9.
Balzer J, Rassaf T, Heiss C, et al. Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. J Am Coll Cardiol. 2008;51(22):2141-9.
Balzer, J., Rassaf, T., Heiss, C., Kleinbongard, P., Lauer, T., Merx, M., ... Kelm, M. (2008). Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. Journal of the American College of Cardiology, 51(22), pp. 2141-9. doi:10.1016/j.jacc.2008.01.059.
Balzer J, et al. Sustained Benefits in Vascular Function Through Flavanol-containing Cocoa in Medicated Diabetic Patients a Double-masked, Randomized, Controlled Trial. J Am Coll Cardiol. 2008 Jun 3;51(22):2141-9. PubMed PMID: 18510961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. AU - Balzer,Jan, AU - Rassaf,Tienush, AU - Heiss,Christian, AU - Kleinbongard,Petra, AU - Lauer,Thomas, AU - Merx,Marc, AU - Heussen,Nicole, AU - Gross,Heidrun B, AU - Keen,Carl L, AU - Schroeter,Hagen, AU - Kelm,Malte, PY - 2007/11/14/received PY - 2008/01/07/revised PY - 2008/01/21/accepted PY - 2008/5/31/pubmed PY - 2008/7/3/medline PY - 2008/5/31/entrez SP - 2141 EP - 9 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 51 IS - 22 N2 - OBJECTIVES: Our goal was to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabetic patients. BACKGROUND: Even in fully medicated diabetic patients, overall prognosis is unfavorable due to deteriorated cardiovascular function. Based on epidemiological data, diets rich in flavanols are associated with a reduced cardiovascular risk. METHODS: In a feasibility study with 10 diabetic patients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability after an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75, 371, and 963 mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabetic patients were assessed after a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321 mg flavanols per dose) or a nutrient-matched control (25 mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Primary and secondary outcome measures included changes in FMD and plasma flavanol metabolites, respectively. RESULTS: A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2 h: from 3.7 +/- 0.2% to 5.5 +/- 0.4%, p < 0.001). A 30-day, thrice-daily consumption of flavanol-containing cocoa increased baseline FMD by 30% (p < 0.0001), while acute increases of FMD upon ingestion of flavanol-containing cocoa continued to be manifest throughout the study. Treatment was well tolerated without evidence of tachyphylaxia. Endothelium-independent responses, blood pressure, heart rate, and glycemic control were unaffected. CONCLUSIONS: Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18510961/Sustained_benefits_in_vascular_function_through_flavanol_containing_cocoa_in_medicated_diabetic_patients_a_double_masked_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)01027-9 DB - PRIME DP - Unbound Medicine ER -