- In this study, the researchers looked PubMed, Web of Science, and the Cochrane Library for RCTs that assessed the impacts of cocoa flavanols on biomarkers relevant to vascular disease pathways among adults.
- Information were extracted following a standardized protocol.
- They utilized DerSimonian and Laird random-effect models to compute the weighted mean differences (WMDs) and 95% CIs.
- They additionally inspected potential modification by intervention duration, design, age, sex, comorbidities, and the form and amount of cocoa flavanol intake.
- 19 RCTs that involved 1131 members were included, and the number of studies for a specific biomarker varied.
- The amount of cocoa flavanols ranged from 166 to 2110 mg/d, and intervention duration ranged from 2 to 52 wk.
- Cocoa flavanol intake significantly enhanced insulin sensitivity and lipid profile.
- The WMDs between treatment and placebo were -0.10 mmol/L (95% CI: -0.16, -0.04 mmol/L) for total triglycerides, 0.06 mmol/L (95% CI: 0.02, 0.09 mmol/L) for HDL cholesterol, -2.33 μIU/mL (95% CI: -3.47, -1.19 μIU/mL) for fasting insulin, -0.93 (95% CI: -1.31, -0.55) for the homeostatic model assessment of insulin resistance, 0.03 (95% CI: 0.01, 0.05) for the quantitative insulin sensitivity check index, 2.54 (95% CI: 0.63, 4.44) for the insulin sensitivity index, -0.83 mg/dL (95% CI: -0.88, -0.77 mg/dL) for C-reactive protein, and 85.6 ng/mL (95% CI: 16.0, 155 ng/mL) for vascular cell adhesion molecule 1.
- No significant affiliations were found for other biomarkers.
- None of the modifiers appeared to qualitatively modify the effects of cocoa flavanol intake.