title: High-flavanol and high-theobromine versus low-flavanol and low-theobromine chocolate to improve uterine artery pulsatility index: a double blind randomized clinical trial.
abstract: OBJECTIVE
  To evaluate the impact of high-flavanol and high-theobromine (HFHT) chocolate in women at risk of preeclampsia (PE).
  
  
  METHODS
  We conducted a single-center randomized controlled trial including women with singleton pregnancy between 11 and 14 weeks gestation who had bilateral abnormal uterine artery (UtA) waveforms (notching) and elevated pulsatility index (PI). Participants were randomized to either HFHT or low-flavanol and low-theobromine (LFLT) chocolate (30 grams daily for a total of 12 weeks). UtA PI, reported as multiple of medians (MoM) adjusted for gestational age, was assessed at baseline and 12 weeks after randomization.
  
  
  RESULTS
  One hundred thirty-one women were randomized with mean gestational age of 12.4 ± 0.6 weeks and a mean UtA PI of 1.39 ± 0.31 MoM. UtA PI adjusted for gestational age significantly decreased from baseline to the second visit (12 weeks later) in the two groups (p < 0.0001) but no significant difference was observed between the groups (p = 0.16).
  
  
  CONCLUSIONS
  Compared with LFLT chocolate, daily intake of HFHT chocolate was not associated with significant changes of UtA PI. Nevertheless, the improvement observed in both groups suggests that chocolate could improve placental function independently of flavanol and/or theobromine content.
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.|b Department of Obstetric and Gynecology , Université Laval , Québec , Canada , and.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
authors.affiliation: c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Vicky
authors.initials: V
authors.lastname: Leblanc
authors.affiliation: c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Élise
authors.initials: É
authors.lastname: Lavoie-Lebel
authors.affiliation: b Department of Obstetric and Gynecology , Université Laval , Québec , Canada , and.|c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Asma
authors.initials: A
authors.lastname: Babar
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.
authors.forename: Mario
authors.initials: M
authors.lastname: Girard
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.
authors.forename: Lionel
authors.initials: L
authors.lastname: Poungui
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.|c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Claudine
authors.initials: C
authors.lastname: Blanchet
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marc
authors.affiliation: c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Simone
authors.initials: S
authors.lastname: Lemieux
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.
authors.forename: Abdous
authors.initials: A
authors.lastname: Belkacem
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.
authors.forename: Elhadji Laouan
authors.initials: EL
authors.lastname: Sidi
authors.affiliation: a Research Center, Center Hospitalier Universitaire de Québec , Québec , Canada.|b Department of Obstetric and Gynecology , Université Laval , Québec , Canada , and.|c Institute of Nutrition and Functional Foods (INAF), Université Laval , Québec , Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dodin
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D000069956:Chocolate; D004311:Double-Blind Method; D005260:Female; D044948:Flavonols / Q000008:administration & dosage*; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011673:Pulsatile Flow / Q000187:drug effects*; D013805:Theobromine / Q000008:administration & dosage*; D018608:Ultrasonography, Doppler / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D044948:Flavonols; D014665:Vasodilator Agents; D013805:Theobromine
keywords: Doppler; Pregnancy; chocolate; flavanol; preeclampsia