Flavonoid Intake From Cocoa-Based Products and Adiposity Parameters in Adolescents in Spain

Abstract

BackgroundCocoa-based products are a good source of flavonoids, which may have beneficial effects on metabolic health.ObjectiveThe aim of this study is to assess the relationship between flavonoids from cocoa-based products and adiposity parameters in adolescents.MethodsA cross-sectional study was conducted involving 944 adolescents aged 11–14 years enrolled in the SI! Program for Secondary Schools trial in Spain with available baseline data from food frequency questionnaires and anthropometric measurements [weight, height, waist circumference (WC), and fat mass percentage (% FM) by bioimpedance analysis]. Fat mass index (FMI) and waist-to-height ratio (WHtR) were obtained by dividing fat mass by height and WC by height, respectively. Body mass index (BMI), WC, and FMI for age and gender z-score were calculated. Overweight/obesity was defined as BMI ≥ 85th percentile and excess adiposity as %FM or FMI ≥ 75th percentile. WC ≥ 90th percentile and WHtR with a 0.5 threshold were considered as criteria of abdominal obesity. Multilevel mixed-effect regressions were used to evaluate the association between flavonoids from cocoa-based products and adiposity parameters. Municipalities and schools were considered random effects.ResultsParticipants with a higher flavonoid intake from cocoa-based products had lower WC z-score [B = −0.04, 95% CI (−0.07; −0.01), P-for trend = 0.045] and WHtR [B = −0.01, 95% CI (−0.02; −0.01), P- for trend < 0.001]. They also had lower probability of having abdominal obesity [OR 0.66, 95% CI (0.52; 0.85), P- for trend = 0.001]. Inverse associations were observed between flavonoids from cocoa powder and BMI z-score [B = −0.08, 95% CI (−0.12; −0.05), P < 0.001], WC z-score [B = −0.06, 95% CI (−0.11; −0.02), P = 0.003], WHtR [B = −0.01, 95% CI (−0.01; −0.00), P < 0.001], %FM [B = −1.11, 95% CI (−1.48; −0.75), P < 0.001], and FMI z-score [B = −0.18, 95% CI (−0.20; −0.17), P < 0.001]. Regarding dark chocolate, an inverse association only with WC z-score [B = −0.06, 95% CI (−0.08; −0.05), P < 0.001] was found. However, no association was observed between flavonoids from milk chocolate intake and anthropometric parameters.ConclusionsA higher intake of flavonoids from cocoa-based products was associated with lower adiposity parameters and a lower probability of presenting abdominal obesity.

Dietary (poly)phenol intake is associated with cardiometabolic health parameters in adolescents

“…In our sample population, flavonoids were the most consumed phenolic compounds, the highest energy-adjusted intake being associated with a lower WC z-score and HDL-c compared to the lowest intake. In a previous study, we found that flavonoids from cocoa-based products (among the major food contributors to flavonoid intake) were associated with lower adiposity parameters, such as the WC z-score and waist-height ratio, and a lower probability of having abdominal obesity [13]. Results from the TOSCA.IT cohort indicated that T2DM adults with a high flavonoid intake had lower levels of TG, SBP, and DBP [39].…”

“…Moreover, a panel of experts on (poly)phenols has developed the first-ever guideline recommendations for dietary flavanol or flavan-3-ol intake, highlighting the role of this subclass of flavonoids in the prevention of cardiometabolic diseases in adults [8]. Nevertheless, to date, few studies about (poly)phenols and cardiometabolic health have been carried out in adolescents, generating the question of whether dietary (poly)phenols could have an effect on cardiometabolic health in this target population [9][10][11][12][13][14][15]. In the HELENA study, Wisnuwardani et al estimated dietary (poly)phenol intake in European adolescents through 2 non-consecutive 24h dietary recalls, and they found associations between total (poly)phenol intake (TPI) and body mass index (BMI) in a cross-sectional analysis and between lignan intake and a lower metabolic syndrome risk over time [9,10,16].…”