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Table 1 Summary of Chocolate and Cocoa Feeding Trials

From: Chocolate and Prevention of Cardiovascular Disease: A Systematic Review

Author Year No. Participants Trial Design Duration Intervention Outcome(s)
Kondo [83] 1996 12 Crossover 1 meal, pre/post-meal measurement Cocoa (35 g delipidated), vs. none Decreased LDL oxidation
Rein [138] 2000 30 Parallel 1 meal, 2 & 6 hrs Cocoa beverage (300 ml, 19 g procyanidin), caffeinated beverage (17 mg caffeine), or water Decreased platelet activation, decreased platelet function
Wang [79] 2000 20 Crossover 1 meal, 1 week/phase Procyanidin-rich chocolate (27, 53, 80 g), vs. none Increased antioxidant capacity, decreased oxidative stress
Osakabe [88] 2001 15 Parallel daily, 2 weeks Cocoa powder (36 g/day), vs. sugar Decreased LDL oxidation (increased lag time)
Wan [85] 2001 23 Crossover daily, 4 weeks/phase Cocoa powder (22 g/day) + dark chocolate (12 g/day), vs. average American diet Decreased LDL oxidation (increased lag time), Increased HDL concentration
Schramm [101] 2001 10 Crossover 1 meal, 2 & 6 hrs, 1 week/phase Chocolate (35 g, high 4 mg/g vs. low 0.09 mg/g procyanidin) Increased prostacyclin, decreased leukotriene (likely decreased platelet activation, anti-inflammatory)
Holt [95] 2002 18 Crossover 1 meal, 2 hrs Chocolate chips (25 g semi-sweet), vs. none Decrease platelet function
Mathur [86] 2002 25 Crossover daily, 6 weeks/phase Dark chocolate (37 g/day), cocoa powder (31 g/day), vs. none Decreased LDL oxidizability, marginal HDL increase
Pearson [92] 2002 16 Crossover 1 meal, 1 day/phase Cocoa beverage (300 ml, 19 g flavanol cocoa powder), cocoa beverage + aspirin, or aspirin Decreased platelet activation, decreased platelet function, all additive of aspirin effects.
Heiss [99] 2003 20 Crossover 1 meal, 1 day/phase Cocoa beverages (100 ml, high or low flavan-3-ol) Increased NO bioactivity, improved endothelial function
Innes [97] 2003 30 Parallel 1 meal, 4 hrs Dark (75% cocoa, highest flavonoid content), milk (20% cocoa), or white chocolate (no flavonoids) Dark chocolate inhibited collagen-induced platelet aggregation
Murphy [94] 2003 32 Parallel daily, 28 days Cocoa flavonoid tablets (234 mg), vs. placebo Decreased platelet function, no difference oxidation status
Serrafini [76] 2003 12 Crossover 1 meal, 1 day/phase Dark chocolate (100 g), dark chocolate (100 g) + milk (200 ml), or 200 g milk chocolate Increase antioxidant capacity, in absence of milk
Taubert [118] 2003 13 Crossover daily, 14 days/phase Dark chocolate (100 g, 500 mg polyphenols), vs. white chocolate (90 g, 0 mg polyphenols) Lower systolic and diastolic blood pressure with dark chocolate
Wiswedel [90] 2004 20 Crossover 1 meal, 1 week washout High flavanol (1.87 mg/ml) vs. low flavanol (0.14 mg/ml) cocoa beverage Lower levels of lipid peroxidation indicators with high flavanol cocoa beverage
Engler [98] 2004 21 Parallel daily, 2 weeks Chocolate (high vs. low flavonoid) Improved endothelial function, no difference oxidative stress, lipids with high flavonoid choc.
Mursu [115] 2004 45 Parallel daily, 3 weeks Dark chocolate, dark chocolate enriched with cocoa polyphenols, or white chocolate Increased HDL concentration, no change LDL oxidizability
Grassi [116] 2005 15 Crossover daily, 15 days/phase Dark chocolate (100 g, 500 mg polyphenols), vs. white chocolate (90 g, 0 mg polyphenols) Lower systolic blood pressure, improved insulin sensitivity, lower insulin resistance
Zhu [139] 2005 8 Parallel 1 meal, 1–2–4–8 hrs Cocoa beverage (high flavonoid); 0.25, 0.38, 0.50 g/kg body weight dose Reduced susceptibility to free-radical induced hemolysis
Vlachopoulos [140] 2005 17 Crossover 1 meal, 1 day/phase Dark chocolate (100 g, 2.62 g procyanidin), vs. none Improved endothelial function, vasodilation of brachial artery, no change in blood pressure
Fraga [119] 2005 28 Parallel daily, 14 days High flavanol milk chocolate (105 g, 168 mg flavanols) vs. low flavonoid chocolate (<5 mg flavanols) Lower mean blood pressure, lower LDL cholesterol, lower oxidative stress markers in high flavanol chocolate group