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Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.
Br J Nutr. 2015 Oct 28; 114(8):1246-55.BJ

Abstract

Cocoa flavanol (CF) intake improves endothelial function in patients with cardiovascular risk factors and disease. We investigated the effects of CF on surrogate markers of cardiovascular health in low risk, healthy, middle-aged individuals without history, signs or symptoms of CVD. In a 1-month, open-label, one-armed pilot study, bi-daily ingestion of 450 mg of CF led to a time-dependent increase in endothelial function (measured as flow-mediated vasodilation (FMD)) that plateaued after 2 weeks. Subsequently, in a randomised, controlled, double-masked, parallel-group dietary intervention trial (Clinicaltrials.gov: NCT01799005), 100 healthy, middle-aged (35-60 years) men and women consumed either the CF-containing drink (450 mg) or a nutrient-matched CF-free control bi-daily for 1 month. The primary end point was FMD. Secondary end points included plasma lipids and blood pressure, thus enabling the calculation of Framingham Risk Scores and pulse wave velocity. At 1 month, CF increased FMD over control by 1·2 % (95 % CI 1·0, 1·4 %). CF decreased systolic and diastolic blood pressure by 4·4 mmHg (95 % CI 7·9, 0·9 mmHg) and 3·9 mmHg (95 % CI 6·7, 0·9 mmHg), pulse wave velocity by 0·4 m/s (95 % CI 0·8, 0·04 m/s), total cholesterol by 0·20 mmol/l (95 % CI 0·39, 0·01 mmol/l) and LDL-cholesterol by 0·17 mmol/l (95 % CI 0·32, 0·02 mmol/l), whereas HDL-cholesterol increased by 0·10 mmol/l (95 % CI 0·04, 0·17 mmol/l). By applying the Framingham Risk Score, CF predicted a significant lowering of 10-year risk for CHD, myocardial infarction, CVD, death from CHD and CVD. In healthy individuals, regular CF intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.

Authors+Show Affiliations

1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.2Department of Food and Nutritional Sciences,University of Reading,Reading,UK.2Department of Food and Nutritional Sciences,University of Reading,Reading,UK.3Mars Inc.,McLean, VA,USA.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.1Division of Cardiology,Pulmonology, and Vascular Medicine, Medical Faculty,University Duesseldorf,40225 Duesseldorf,Germany.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26348767

Citation

Sansone, Roberto, et al. "Cocoa Flavanol Intake Improves Endothelial Function and Framingham Risk Score in Healthy Men and Women: a Randomised, Controlled, Double-masked Trial: the Flaviola Health Study." The British Journal of Nutrition, vol. 114, no. 8, 2015, pp. 1246-55.
Sansone R, Rodriguez-Mateos A, Heuel J, et al. Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. Br J Nutr. 2015;114(8):1246-55.
Sansone, R., Rodriguez-Mateos, A., Heuel, J., Falk, D., Schuler, D., Wagstaff, R., Kuhnle, G. G., Spencer, J. P., Schroeter, H., Merx, M. W., Kelm, M., & Heiss, C. (2015). Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. The British Journal of Nutrition, 114(8), 1246-55. https://doi.org/10.1017/S0007114515002822
Sansone R, et al. Cocoa Flavanol Intake Improves Endothelial Function and Framingham Risk Score in Healthy Men and Women: a Randomised, Controlled, Double-masked Trial: the Flaviola Health Study. Br J Nutr. 2015 Oct 28;114(8):1246-55. PubMed PMID: 26348767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. AU - Sansone,Roberto, AU - Rodriguez-Mateos,Ana, AU - Heuel,Jan, AU - Falk,David, AU - Schuler,Dominik, AU - Wagstaff,Rabea, AU - Kuhnle,Gunter G C, AU - Spencer,Jeremy P E, AU - Schroeter,Hagen, AU - Merx,Marc W, AU - Kelm,Malte, AU - Heiss,Christian, AU - ,, Y1 - 2015/09/09/ PY - 2015/9/9/entrez PY - 2015/9/9/pubmed PY - 2016/1/9/medline KW - BP blood pressure KW - Blood pressure KW - CF cocoa flavanol KW - Cardiovascular health KW - DBP KW - FMD flow-mediated dilation KW - Flavanols KW - Flow-mediated dilation KW - PWV pulse wave velocity KW - SBP systolic blood pressure KW - diastolic blood pressure SP - 1246 EP - 55 JF - The British journal of nutrition JO - Br. J. Nutr. VL - 114 IS - 8 N2 - Cocoa flavanol (CF) intake improves endothelial function in patients with cardiovascular risk factors and disease. We investigated the effects of CF on surrogate markers of cardiovascular health in low risk, healthy, middle-aged individuals without history, signs or symptoms of CVD. In a 1-month, open-label, one-armed pilot study, bi-daily ingestion of 450 mg of CF led to a time-dependent increase in endothelial function (measured as flow-mediated vasodilation (FMD)) that plateaued after 2 weeks. Subsequently, in a randomised, controlled, double-masked, parallel-group dietary intervention trial (Clinicaltrials.gov: NCT01799005), 100 healthy, middle-aged (35-60 years) men and women consumed either the CF-containing drink (450 mg) or a nutrient-matched CF-free control bi-daily for 1 month. The primary end point was FMD. Secondary end points included plasma lipids and blood pressure, thus enabling the calculation of Framingham Risk Scores and pulse wave velocity. At 1 month, CF increased FMD over control by 1·2 % (95 % CI 1·0, 1·4 %). CF decreased systolic and diastolic blood pressure by 4·4 mmHg (95 % CI 7·9, 0·9 mmHg) and 3·9 mmHg (95 % CI 6·7, 0·9 mmHg), pulse wave velocity by 0·4 m/s (95 % CI 0·8, 0·04 m/s), total cholesterol by 0·20 mmol/l (95 % CI 0·39, 0·01 mmol/l) and LDL-cholesterol by 0·17 mmol/l (95 % CI 0·32, 0·02 mmol/l), whereas HDL-cholesterol increased by 0·10 mmol/l (95 % CI 0·04, 0·17 mmol/l). By applying the Framingham Risk Score, CF predicted a significant lowering of 10-year risk for CHD, myocardial infarction, CVD, death from CHD and CVD. In healthy individuals, regular CF intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/26348767/Cocoa_flavanol_intake_improves_endothelial_function_and_Framingham_Risk_Score_in_healthy_men_and_women:_a_randomised_controlled_double_masked_trial:_the_Flaviola_Health_Study_ L2 - https://www.cambridge.org/core/product/identifier/S0007114515002822/type/journal_article DB - PRIME DP - Unbound Medicine ER -