Habitual Intake of Cocoa and Red Berries Beneficial for Cardiovascular Health

by | Jun 22, 2023 | 2023, Cardiovascular Health, Flavonoids, Fruits and Vegetables

Written by Taylor Woosley, Staff Writer. 12-week consumption of cocoa (197.5 mg total polyphenols) significantly increased FMD values and decreased TMAO levels, while red berry consumption (104 mg total polyphenols) significantly improved heart rate values. 

heart healthCardiovascular disease (CVD) is the leading cause of mortality across both sexes and all races and ethnicities in the United States1. Processes such as endothelial dysfunction, chronic inflammation, hyperglycemia, and oxidative stress cause atherosclerosis, a complex process present in CVDs2. Although genetic factors play a role in CVD pathogenesis, research has shown that they may only account for 20% of the risk of developing CVD3.

Evidence supports the intake of specific food components to positively influence or lower the risk of CVD4. Cocoa has potential health benefits due to its flavanol and procyanidin content, which may help enhance the vascular system5. Additionally, red berries contain resveratrol, a phenolic substance, that shows vasculoprotective benefits that are mediated by different mechanisms, including the lowering of oxidative stress and inflammation, increasing nitric oxide (NO) synthesis by endothelial cells, and promoting autophagy6.

Garcia-Cordero et al. conducted a randomized, single-blind, parallel-group study to investigate the effects of red fruit anthocyanins and cocoa flavanols on cardiovascular biomarkers, including flow mediated dilation (FMD), blood pressure, lipid and glycemic profile, and angiotensin-converting enzyme (ACE). Subject inclusion was men or postmenopausal women aged 45 to 85 years. Participants were assigned to one of three groups for a 12-week intervention: group 1 (n=20) that consumed 5 g/day of red berries in the form of dried redcurrants, blackcurrants, raspberries, and blueberries (RB), group 2 (n=20) which consumed 2.5 g/day of a polyphenol-rich cocoa powder, and group 3 (n=19) who consumed 7.5 g/day of a cocoa and red berry mixture (RB+C). The cocoa powder provided a daily intake of 197.5 mg total polyphenols and 9.6 mg flavanols, including 4.7 mg epicatechin. The red berry mixture contained a daily intake of 104 mg total polyphenols and 13.9 mg total anthocyanins, including 4.8 mg delphinidin-3-O-rutinoside and 2.5 mg cyanidin-3-O-rutinoside.

All subjects completed three different visits for data collection. The first visit confirmed subject eligibility. Visit two was the baseline and visit three was the end of the study intervention. Each visit consisted of collecting a blood sample, urine sample, blood pressure, anthropometric measurements, and a 24-h diet record. The three 24-h diet records were utilized to record the frequency of consumption of main sources of anthocyanins, flavanols, caffeine and theobromine to calculate the total daily intake.

The Kolmogorov-Smirnov and Levene tests were utilized to evaluate the normality of distribution and homogeneity of variance. A Wilcoxon test was used to compare the results of the three diets between baseline and after intervention at 12 weeks. No significant difference was found between groups at baseline regarding age, sex, height, or percentage of smokers. Significant findings of the study are as follows:

  • No significant differences between the three groups after the 12-week intervention was noted in the concentrations of total serum protein, NO, homocysteine, and ACE activity corrected by total protein.
  • A statistically significant increase for FMD values was noted between visits in the cocoa powder group (p = 0.03) and a decrease in TMAO levels was observed at 12 weeks (p = 0.03). Furthermore, a significant reduction in creatinine concentration (p = 0.03) and uric acid (p = 0.01) levels were noted in the cocoa group after the intervention.
  • A significant increase in heart rate values was observed in the RB (p > 0.00) and cocoa (p = 0.01) group after the 12-week intervention.

Results of the study show that consumption of cocoa for 12 weeks significantly reduced TMAO levels and increased FMD values, while both cocoa and red berry consumption improved heart rate values. Further research should continue to explore the benefits of cocoa and red berry consumption on cardiovascular health using larger study samples and higher polyphenolic amounts of cocoa and red berries.

Source: García-Cordero, Joaquín, Alba Martinez, Carlos Blanco-Valverde, Alicia Pino, Verónica Puertas-Martín, Ricardo San Román, and Sonia de Pascual-Teresa. “Regular Consumption of Cocoa and Red Berries as a Strategy to Improve Cardiovascular Biomarkers via Modulation of Microbiota Metabolism in Healthy Aging Adults.” Nutrients 15, no. 10 (2023): 2299.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Posted June 22, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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