This study aimed to evaluate the effects of the intake of 10 g of cocoa-rich chocolate on blood pressure, other cardiovascular risk factors, and vascular structure and function in postmenopausal women. A total of 140 postmenopausal women participated in this randomized and controlled parallel clinical trial. For six months, the intervention group (IG; n = 73) consumed daily 10 g of chocolate (99% cocoa) added to their usual food intake, whereas the control group (CG; n = 67) did not receive any intervention. Blood pressure, pulse pressure (PP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), augmentation index, and laboratory variables were measured at baseline and six months. ANCOVA analyses adjusted for baseline values revealed no significant differences for systolic blood pressure (−1.45 mm Hg; 95% confidence interval (CI): −4.79, 1.88; p = 0.391) or baPWV (0.18 m/s; 95% CI: −0.14, 0.50; p = 0.263) between groups. A decrease in PP was observed in the IG compared to the CG (−2.05 mm Hg; 95% CI: −4.08, −0.02; p = 0.048). The rest of the vascular structure and function parameters and other measured variables remained unchanged. The daily intake of 10 g of cocoa-rich chocolate seems to provide little improvement to cardiovascular health, but neither does it cause any adverse effects on the parameters evaluated in postmenopausal women in the long term.

IntroductionThe intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women.Methods and analysisHere we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of ​​at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019.Ethics and disseminationThis study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials.gov provided by the US National Library of Medicine, number NCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.

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During menopause, women undergo a series of physiological changes that include a redistribution of fat tissue. This study was designed to investigate the effect of adding 10g of cocoa-rich chocolate to the habitual diet of postmenopausal women daily on body composition. We conducted a 6-month, 2-arm randomized, controlled trial. Postmenopausal women (57.2±3.6 years, n = 132) were recruited in primary care clinics. Participants in the control group (CG) did not receive any intervention. Those of the intervention group (IG) received 10g daily of 99%-cocoa chocolate in addition to their habitual diet for 6-months. This quantity comprises 59 Kcal and 65.4 mg of polyphenols. The primary outcomes were the between-group differences in body composition variables, measured by impendancemetry at the end of the study. The main effect of the intervention showed a favourable reduction in the IG with respect to the CG in body fat mass (-0.63 kg [95%CI: -1.15 to -0.11], p=0.019), (Cohen’s d = -0.450) and body fat percentage (-0.79% [95%CI: -1.31 to -0.26], p=0.004), (Cohen’s d = -0.539). A non-significant decrease was also observed in body mass index (-0.20 kg/m2 [95%CI: -0.44 to 0.03], p=0.092), (Cohen’s d = -0.345). Both the body fat mass and the body fat percentage showed a decrease in the IG for the 3 body segments analysed (trunk, arms and legs). Daily addition of 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women reduces their body fat mass and body fat percentage without modifying their weight.

BackgroundDiet quality indices address the diet’s complexity and are calculated by a combination of foods and/or nutrients which together represent a dietary pattern. The current study analysed the relationship between the common carotid artery intima media thickness (cIMT), the presence of plaque and the carotid target organ damage (cTOD) with the diet quality assessed through the Diet Quality Index (DQI) questionnaire in a Spanish adult population.MethodsA cross-sectional study. The target population comprised of 500 individuals aged between 35 to 74 years who had intermediate cardiovascular risk. The diet was evaluated by DQI which included beneficial and detrimental foods scored 3, 2 or 1. The total possible score ranges from 18 (the lowest quality) to 54 (the highest quality). Carotid ultrasound was used to assess the cIMT, the presence of plaque and the cTOD.ResultsAmong the 500 participants (mean age 60.3 ± 8.4 years), 54.4% were male. DQI mean was 40.08 ± 2.79, with no differences between men and women. The cIMT was lower in women (p = 0.002) and 16.6% of the participants presented plaque. No significant association was found between DQI and cIMT after adjusting by age and sex, and other confounders (p = 0.690). The logistic regression analysis showed no association of DQI with thickened cIMT (p = 0.890), the presence of plaques (p = 0.799) or cTOD (p = 0.942).ConclusionsThe diet quality index was not associated with subclinical atherosclerosis in this Spanish population at intermediate risk of cardiovascular disease.Trial registrationClinicalTrials.gov; Identifier: NCT01428934.