Cocoa, Glucose Tolerance, and Insulin Signaling: Cardiometabolic Protection

Abstract

Experimental and clinical evidence reported that some polyphenol-rich natural products may offer opportunities for the prevention and treatment of type 2 diabetes, due to their biological properties. Natural products have been suggested to modulate carbohydrate metabolism by various mechanisms, such as restoring β-cell integrity and physiology and enhancing insulin-releasing activity and glucose uptake. Endothelium is fundamental in regulating arterial function, whereas insulin resistance plays a pivotal role in pathophysiological mechanisms of prediabetic and diabetic states. Glucose and insulin actions in the skeletal muscle are improved by insulin-dependent production of nitric oxide, favoring capillary recruitment, vasodilatation, and increased blood flow. Endothelial dysfunction, with decreased nitric oxide bioavailability, is a critical step in the development of atherosclerosis. Furthermore, insulin resistance has been described, at least in part, to negatively affect endothelial function. Consistent with this, conditions of insulin resistance are usually linked to endothelial dysfunction, and the exposure of the endothelial cells to cardiovascular risk factors such as hypertension, dyslipidemia, and hyperglycemia is associated with reduced nitric oxide bioavailability, resulting in impaired endothelial-dependent vasodilatation. Moreover, endothelial dysfunction has been described as an independent predictor of cardiovascular risk and events. Cocoa and cocoa flavonoids may positively affect the pathophysiological mechanisms involved in insulin resistance and endothelial dysfunction with possible benefits in the prevention of cardiometabolic diseases.

The Bioavailability, Transport, and Bioactivity of Dietary Flavonoids: A Review from a Historical Perspective

“…Cocoa and chocolate feeding sydies often report beneficial effects on multiple biomarkers in healthy volunteers and at risk groups, including: improved glucose uptake, homeostatic model assessment of insulin resistance, quantitative insulin sensitivity check index, and insulin sensitivity indices, lipid metabolism (reduced LDL‐ and increased HDL‐cholesterol), and antioxidant defence; reduced total cholesterol‐to‐HDL ratio, plasma insulin and insulin resistance, BP (decreased overnight ambulatory SBP, DBP, and HR), angiotensin‐converting enzyme activity, platelet activity, P‐selectin expression, endothelin‐1, adhesion molecules, plasma nitrite, oxidized LDL, and urinary isoprostanes (Ellam & Williamson, ; Grassi et al., ). The cumulative benefit of affecting such a diverse array of vascular biomarkers was observed in a recent human RCT reporting a significant lowering of 10‐yr risk for CVD and CHD as established by the Framingham risk score (Sansone et al., ).…”

Cocoa Diet and Antibody Immune Response in Preclinical Studies

“…In addition to the effects of cocoa on cardiovascular health (6, 7), the nervous system (8), and cancer (9–11), cocoa also has an effect on the immune system. The immunomodulatory properties of cocoa include its potential anti-inflammatory role, demonstrated in both in vitro and in vivo studies (12–14).…”

Phytochemical and TLC Profiling of Oroxylum indicum and Milletia pachycarpa

“…Flavonoid have been found to be of great medicinal value in humans as they have been found to act as antiallergic, antiatherosclerotic, antioxidants, antifungal, antimutagenic, antithrombogenic, anti-inflammatory, antiviral antiosteoporotic, cardioprotective and radioprotective in several studies [43][44][45][46][47][48][49][50][51][52][53][54][55]. The flavonoids also stimulate signaling pathways required for various activities in the cells [56]. They have also been reported to modulate various transcription factors in different study systems [57].The organisms do not waste their energy in futile exercises and plants synthesize cardiac glycosides for defence since some of them are poisonous [58].…”