According to a large-scale study led by Brigham and Women’s Hospital, a supplement containing cocoa flavanol and a multivitamin can prevent a 27 percent reduction in heart disease and cancer. The study is published in the journal “The American Journal of Clinical Nutrition.”
“When looking at the aggregate of evidence for both the primary and secondary cardiovascular endpoints in COSMOS, we see promising signs that a cocoa flavanol supplement may reduce major cardiovascular events, including death from cardiovascular disease,” said Howard Sesso. “These findings merit further research to better understand the effects of cocoa flavanols on cardiovascular health,” he added.
“Previous studies have suggested health benefits of flavanols — compounds in several plant foods, including cocoa, tea, grapes and berries,” Joann Manson said. “COSMOS was not a chocolate trial — rather, it is a rigorous trial of a cocoa extract supplement containing levels of cocoa flavanols that a person could never realistically consume from chocolate without adding excessive calories, fat and sugar to their diet,” he added. ready. Smaller, short-term studies have found cardiovascular benefits for cocoa flavanols on blood pressure and blood vessel dilation.
COSMOS provided the first opportunity to investigate whether cocoa flavanol supplementation could also reduce longer-term clinical cardiovascular events. Researchers also looked to reduce the risk of cancer. In addition, the trial was intended to test a widely used multivitamin in the prevention of cancer and cardiovascular disease.
The primary cardiovascular outcome for the cocoa flavanol intervention was a composite of total cardiovascular events, including heart attack, stroke, coronary revascularization, cardiovascular death, carotid artery disease, peripheral artery surgery, and unstable angina. More than 21,000 participants were randomized to take daily capsules containing 500 mg of cocoa flavanols (donated by Mars Edge), a multivitamin tablet (donated by GSK Consumer Healthcare), neither, or both.
The study found that cocoa flavanols reduced overall cardiovascular events by 10 percent, but this was not statistically significant. However, several secondary analyzes offered broader support for a potential benefit of cocoa flavanols on cardiovascular events.
First, those given the cocoa flavanol supplement had a significant 27 percent reduction in death from cardiovascular disease. Second, when the study team took into account adherence to the study pills (by looking at those who took their study pills regularly), the team saw a stronger 15 percent reduction in the total number of cardiovascular events and a 39 percent reduction. in mortality from cardiovascular disease. Third, a composite endpoint of major cardiovascular events (heart attacks, strokes, and cardiovascular deaths), while not a study focus, was also significantly reduced. The authors noted in their report that their promising results on cocoa flavanols and cardiovascular events warrant a cautious interpretation and underscore the need for additional research.
A daily multivitamin had no significant effect on total or individual cardiovascular events. There were no safety concerns for cocoa flavanols or any multivitamin. COSMOS concluded after about 3.6 years, which was probably too short to detect whether the supplements could have influenced cancer risk. Although a daily multivitamin improved levels of several nutritional biomarkers, it had no significant effect on total invasive cancer, the primary outcome for the multivitamin analyses. Cocoa flavanols also had no significant effect on total invasive cancer.
The authors note that continuing to monitor COSMOS participants may help elucidate any long-term effects on cancer and death. The researchers and collaborators are also using COSMOS to study cognitive decline, falls, eye disease and other aging-related outcomes that could be affected by the supplements. †
While our study suggests intriguing signs for cardiovascular protection with cocoa flavanols, any health benefits resulting from taking these supplements will need to be confirmed in a future trial,” Manson said.
Sesso added, “Our message to consumers is to eat a healthy, balanced diet rich in natural dietary sources of flavanols and to stay informed as we continue to evaluate other important health outcomes in COSMOS.”
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