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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