Dose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adults

Abstract

Monahan KD, Feehan RP, Kunselman AR, Preston AG, Miller DL, Lott ME. Dose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adults. J Appl Physiol 111: 1568 -1574. First published September 8, 2011 doi:10.1152/japplphysiol.00865.2011.-An inverse relation exists between intake of flavonoid-rich foods, such as cocoa, and cardiovascular-related mortality. Favorable effects of flavonoids on the endothelium may underlie these associations. We performed a randomized, double-blind, placebo-controlled study to test the hypothesis that acute cocoa ingestion dose dependently increases endothelium-dependent vasodilation, as measured by an increase in brachial artery flow-mediated dilation (FMD), in healthy older adults. Measurements were obtained before (preingestion) and after (1-and 2-h postingestion) ingestion of 0 (placebo), 2, 5, 13, and 26 g of cocoa in 23 adults (63 Ϯ 2 yr old, mean Ϯ SE). Changes in brachial artery FMD 1-and 2-h postingestion compared with preingestion were used to determine the effects of cocoa. FMD was unchanged 1 (⌬Ϫ0.3 Ϯ 0.2%)-and 2-h (⌬0.1 Ϯ 0.1%) after placebo (0 g cocoa). In contrast, FMD increased both 1-h postingestion (2 g cocoa ⌬0.0 Ϯ 0.2%, 5 g cocoa ⌬0.8 Ϯ 0.3%, 13 g cocoa ⌬1.0 Ϯ 0.3%, and 26 g cocoa ⌬1.6 Ϯ 0.3%: P Ͻ 0.05 compared with placebo for 5, 13, and 26 g cocoa) and 2-h postingestion (2 g cocoa ⌬0.5 Ϯ 0.3%, 5 g cocoa ⌬1.0 Ϯ 0.3%, 13 g cocoa ⌬1.4 Ϯ 0.2%, and 26 g cocoa ⌬2.5 Ϯ 0.4%: P Ͻ 0.05 compared with placebo for 5, 13, and 26 g cocoa) on the other study days. A serum marker of cocoa ingestion (total epicatechin) correlated with increased FMD 1-and 2-h postingestion (r ϭ 0.44 -0.48; both P Ͻ 0.05). Collectively, these results indicate that acute cocoa ingestion dose dependently increases brachial artery FMD in healthy older humans. These responses may help to explain associations between flavonoid intake and cardiovascular-related mortality in humans.flavonoid; flavanol; chocolate; endothelium; endothelial function THE ENDOTHELIUM CONTRIBUTES critically to cardiovascular homeostasis by influencing factors such as vascular tone, vascular permeability, platelet aggregation, and thrombosis. As abnormal function of the endothelium is a key event in the atherosclerotic process (15), it is not surprising that endothelial dysfunction is a hallmark feature of many cardiovascular disease states (33). Moreover, it is not surprising that aging, which is a primary risk factor for the development of cardiovascular disease and atherosclerosis (29,36), is associated with marked endothelial dysfunction. Specifically, in response to stimulation of the vascular endothelium via pharmacological substances, such as acetylcholine, or physiological stimuli, such as increases in vascular shear stress, a reduced endothelium-dependent vasodilatory response occurs in healthy older adults compared with healthy young adults (7,11,12,41). As low levels of brachial artery flow-mediated dilation (FMD), a commonly used method to assess endothelium-dependent vasodi...

Modulation of Endothelial Function by Korean Red Ginseng (Panax ginseng C.A. Meyer) and its Components in Healthy Individuals: A Randomized Controlled Trial

“…Moreover, peripheral arterial function has been closely associated with coronary vasomotor function and increased future cardiovascular risk, with recent evidence that every 1% increase in FMD is associated with 13% reduction in risk of cardiovascular events [18]. Therefore, ginseng may join the ranks of promising alternative agents that can affect endothelial function [41,42] and may reduce progression of atherosclerotic conditions, a common feature of nearly all cardiovascular risk factors [43].…”

Comparison of antioxidant activity and flavanol content of cacao beans processed by modern and traditional Mesoamerican methods

“…Despite the implementation of fermentation, dark chocolate and cocoa powder still have some of the highest concentrations of flavanols of any food in our diet [26]. In fact a recent dose response study using conventionally processed cocoa powder in ever increasing amounts has found that as little as 5 g is sufficient to elicit significant vasodilation of the brachial artery, as measured by Flow Mediated Dilation [27].…”

Acute cocoa flavanol supplementation improves muscle macro- and microvascular but not anabolic responses to amino acids in older men

“…As with other forms of flavanols numerous studies have provided evidence that cocoa flavanols can enhance endothelial function in healthy individuals (Monahan et al 2011), smokers (Heiss et al 2005), diabetics (Balzer et al 2008), hypertensive patients (Grassi et al 2005), patients with coronary artery disease (Heiss et al 2010) and heart transplant recipients (Flammer et al 2007). However, whether cocoa flavanols can improve microvascular responses to nutrition is wholly unknown.…”