title: Changes in body weight, blood pressure and selected metabolic biomarkers with an energy-restricted diet including twice daily sweet snacks and once daily sugar-free beverage.
abstract: OBJECTIVE
  The type of sweet snack incorporated into an energy-restricted diet (ERD) may produce differential effects on metabolic improvements associated with body weight (BW) loss. This study compared effects of incorporating either twice daily energy-controlled dark chocolate snacks plus once daily sugar-free cocoa beverage (DC) to non-chocolate snacks plus sugar-free non-cocoa beverage (NC) into an ERD on BW loss and metabolic outcomes.
  
  
  METHODS
  In an 18-week randomized comparative trial, 60 overweight/obese premenopausal women were assigned to DC (n = 30) or NC group (n = 30). Dietary intake was measured at baseline and week 18, and BW, anthropometrics, blood pressure (BP) and serum glucose, insulin and lipid concentrations were measured at baseline, and weeks 6, 12 and 18. Data were analyzed using repeated measures ANOVA.
  
  
  RESULTS
  Using intention-to-treat analysis, women in DC and NC groups reduced energy intake (both P < 0.001) and lost 4.4 ± 0.6 kg and 5.0 ± 0.9 kg (both P < 0.001), respectively. Both groups lowered systolic and diastolic BP [DC = 2.7 (P < 0.05), 2.7 (P < 0.01); NC = 3.4 (P < 0.01), 4.2 (P < 0.01) mmHg, respectively]. Glucose and insulin concentrations decreased by 0.72 mmol/L (P < 0.001) and 13.20 pmol/L (P < 0.01) in DC group and by 0.83 mmol/L (P < 0.001) and 13.20 pmol/L (P < 0.01), respectively, in NC group. Total cholesterol increased in NC group (P < 0.05), with no significant lipid changes in DC group. There were no significant differences in biomarker outcomes between groups.
  
  
  CONCLUSIONS
  Overweight/obese premenopausal women following an 18-week ERD that included either DC or NC sweet snack and sugar-free beverage lost equivalent amounts of BW and improved BP measurements and glucose and insulin concentrations.
authors.affiliation: Department of Food Science and Human Nutrition, The University of Illinois, Urbana-Champaign, 260A Bevier Hall, 905 S. Goodwin Ave.Urbana, IL 61801 USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Nickols-Richardson
authors.affiliation: Dietitian, 924 Washington St. SE, Albuquerque, NM 87108 USA.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Piehowski
authors.affiliation: Department of Food Science and Human Nutrition, The University of Illinois, Urbana-Champaign, 260A Bevier Hall, 905 S. Goodwin Ave.Urbana, IL 61801 USA.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Metzgar
authors.affiliation: The Hershey Company, 1025 Reese Avenue, Hershey, PA 17033 USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Miller
authors.affiliation: The Hershey Company, 1025 Reese Avenue, Hershey, PA 17033 USA.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Preston
keywords: Cocoa; dark chocolate; dietary intervention; obesity; randomized comparative trial