title: Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial.
abstract: BACKGROUND
  Studies suggest cardioprotective benefits of dark chocolate containing cocoa.
  
  
  OBJECTIVE
  This study examines the acute effects of solid dark chocolate and liquid cocoa intake on endothelial function and blood pressure in overweight adults.
  
  
  METHODS
  Randomized, placebo-controlled, single-blind crossover trial of 45 healthy adults [mean age: 53 y; mean body mass index (in kg/m(2)): 30]. In phase 1, subjects were randomly assigned to consume a solid dark chocolate bar (containing 22 g cocoa powder) or a cocoa-free placebo bar (containing 0 g cocoa powder). In phase 2, subjects were randomly assigned to consume sugar-free cocoa (containing 22 g cocoa powder), sugared cocoa (containing 22 g cocoa powder), or a placebo (containing 0 g cocoa powder).
  
  
  RESULTS
  Solid dark chocolate and liquid cocoa ingestion improved endothelial function (measured as flow-mediated dilatation) compared with placebo (dark chocolate: 4.3 +/- 3.4% compared with -1.8 +/- 3.3%; P < 0.001; sugar-free and sugared cocoa: 5.7 +/- 2.6% and 2.0 +/- 1.8% compared with -1.5 +/- 2.8%; P < 0.001). Blood pressure decreased after the ingestion of dark chocolate and sugar-free cocoa compared with placebo (dark chocolate: systolic, -3.2 +/- 5.8 mm Hg compared with 2.7 +/- 6.6 mm Hg; P < 0.001; and diastolic, -1.4 +/- 3.9 mm Hg compared with 2.7 +/- 6.4 mm Hg; P = 0.01; sugar-free cocoa: systolic, -2.1 +/- 7.0 mm Hg compared with 3.2 +/- 5.6 mm Hg; P < 0.001; and diastolic: -1.2 +/- 8.7 mm Hg compared with 2.8 +/- 5.6 mm Hg; P = 0.014). Endothelial function improved significantly more with sugar-free than with regular cocoa (5.7 +/- 2.6% compared with 2.0 +/- 1.8%; P < 0.001).
  
  
  CONCLUSIONS
  The acute ingestion of both solid dark chocolate and liquid cocoa improved endothelial function and lowered blood pressure in overweight adults. Sugar content may attenuate these effects, and sugar-free preparations may augment them.
authors.affiliation: Yale Prevention Research Center, Derby, CT, USA.
authors.forename: Zubaida
authors.initials: Z
authors.lastname: Faridi
authors.forename: Valentine Yanchou
authors.initials: VY
authors.lastname: Njike
authors.forename: Suparna
authors.initials: S
authors.lastname: Dutta
authors.forename: Ather
authors.initials: A
authors.lastname: Ali
authors.forename: David L
authors.initials: DL
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001628:Beverages; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D002099:Cacao / Q000737:chemistry*; D002182:Candy; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018592:Cross-Over Studies; D019422:Dietary Sucrose / Q000009:adverse effects* / Q000494:pharmacology; D004106:Dilatation; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D005419:Flavonoids / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000494:pharmacology; D050177:Overweight; D016037:Single-Blind Method; D014463:Ultrasonography
chemical_list: D019422:Dietary Sucrose; D005419:Flavonoids; D009569:Nitric Oxide