Chocolate Improves Cardiovascular Health
In this systematic review and meta-analysis investigating the effects of chocolate, cocoa, and flavan-3-ols on major cardiovascular disease (CVD) risk factors, data from 42 studies including acute or short-term chronic (<=18 wk) randomized controlled trials (RCTs) of chocolate, cocoa, or flavan-3-ols, involving a total of 1297 participants, was analyzed. Researchers conducted duplicate assessment of study inclusion, data extraction, validity, and random-effects meta-analyses. Researchers found insulin resistance (HOMA-IR: -0.67) was improved by chocolate or cocoa due to significant reductions in serum insulin. Flow-mediated dilatation (FMD) improved after chronic (1.34%) and acute (3.19%) intakes. Effects on HOMA-IR and FMD remained stable to sensitivity analyses. Reductions in diastolic blood pressure (BP; -1.60 mm Hg; 95% CI: -2.77, -0.43 mm Hg) and mean arterial pressure (-1.64 mm Hg; 95% CI: -3.27, -0.01 mm Hg) and marginally significant effects on LDL (-0.07 mmol/L; 95% CI: -0.13, 0.00 mmol/L) and HDL (0.03 mmol/L; 95% CI: 0.00, 0.06 mmol/L) cholesterol. Chocolate or cocoa improved FMD regardless of the dose consumed, whereas doses >50 mg epicatechin/day resulted in greater effects on systolic and diastolic BP. Results suggest consistent acute and chronic benefits of chocolate or cocoa on FMD and promising effects on insulin and HOMA-IR.