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 |