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Chocolate intake is associated with better cognitive function: The Maine-Syracuse Longitudinal Study

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Abstract

Chocolate and cocoa flavanols have been associated with improvements in a range of health complaints dating from ancient times, and has established cardiovascular benefits. Less is known about the effects of chocolate on neurocognition and behavior. The aim of this study was to investigate whether chocolate intake was associated with cognitive function, with adjustment for cardiovascular, lifestyle and dietary factors. Cross-sectional analyses were undertaken on 968 community-dwelling participants, aged 23-98 years, from the Maine-Syracuse Longitudinal Study (MSLS). Habitual chocolate intake was related to cognitive performance, measured with an extensive battery of neuropsychological tests. More frequent chocolate consumption was significantly associated with better performance on the Global Composite score, Visual-Spatial Memory and Organization, Working Memory, Scanning and Tracking, Abstract Reasoning, and the Mini-Mental State Examination. With the exception of Working Memory, these relations were not attenuated with statistical control for cardiovascular, lifestyle and dietary factors. Prospective analyses revealed no association between cognitive function and chocolate intake measured up to 18 years later. Further intervention trials and longitudinal studies are needed to explore relations between chocolate, cocoa flavanols and cognition, and the underlying causal mechanisms.

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... We found six studies investigating the impacts of caffeine-containing food intake on cognition: one cross-sectional study evaluated the effectiveness of chocolate alone [78], one prospectively treated the effectiveness of coffee and tea together [63], and another considered prospectively the effectiveness of coffee and chocolate together [79]; three studies focused instead on the effectiveness of tea consumption: one placebo RCT [80], one cross-sectional plus prospective study [81], and one cross-sectional study [82]. ...
... Chocolate intake was evaluated in 968 non-demented, community-dwelling subjects aged 23-98 years-old, participating in a cross-sectional study by Crichton, a cohort of the Maine-Syracuse Longitudinal Study (MSLS), a community-based study of cardiovascular risk factors and cognitive functioning in adults [78]. Dietary intake was assessed using a validated questionnaire, without differentiating according to the type of chocolate. ...
... Cocoa is one of the most flavonoid-rich foods, containing large amounts of flavan-3-ol, epicatechin, catechin, and additional oligomeric procyanidins [4]. Its flavonoids have been shown to benefit cognition across all ages and exert acute and chronic effects [47,57,62,78,101]. Cocoa flavonoids have been implicated in enhanced neurogenesis and neuroplasticity by stimulating brain-derived neurotrophic factor (BDNF) synthesis [4]. ...
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Oxidative stress can compromise central nervous system integrity, thereby affecting cognitive ability. Consumption of plant foods rich in antioxidants could thereby protect cognition. We systematically reviewed the literature exploring the effects of antioxidant-rich plant foods on cognition. Thirty-one studies were included: 21 intervention, 4 cross-sectional (one with a cohort in prospective observation as well), and 6 prospective studies. Subjects belonged to various age classes (young, adult, and elderly). Some subjects examined were healthy, some had mild cognitive impairment (MCI), and some others were demented. Despite the different plant foods and the cognitive assessments used, the results can be summarized as follows: 7 studies reported a significant improvement in all cognitive domains examined; 19 found significant improvements only in some cognitive areas, or only for some food subsets; and 5 showed no significant improvement or no effectiveness. The impact of dietary plant antioxidants on cognition appears promising: most of the examined studies showed associations with significant beneficial effects on cognitive functions-in some cases global or only in some specific domains. There was typically an acute, preventive, or therapeutic effect in young, adult, and elderly people, whether they were healthy, demented, or affected by MCI. Their effects, however, are not attributable only to anti-oxidation.
... Besides, there is an increasing in the potential benefits of cocoa and chocolate for health (Steinberg et al., 2003). Cocoa and kinds of chocolate have antioxidants and phytochemicals like flavonoids that participate in improving deficits in brain function (Crichton et al., 2016). Cocoa flavonoids can exhibit beneficial impacts on cognition, mood and behavior (Sokolov et al., 2013). ...
... Cocoa flavonoids can exhibit beneficial impacts on cognition, mood and behavior (Sokolov et al., 2013). There were different kinds of chocolate including white, milk and dark chocolates, based on the amount of cocoa (Crichton et al., 2016;Kemsawasd et al., 2016); however, among the various kinds, dark chocolate is most effective type on brain functions and glucocorticoid levels (Martin et al., 2009;Sokolov et al., 2013). Correspondingly, the consumption of dark chocolate may optimize cognitive functions over the life span of an individual (Crichton et al., 2016), especially under stress conditions (Simadibrata, 2011). ...
... There were different kinds of chocolate including white, milk and dark chocolates, based on the amount of cocoa (Crichton et al., 2016;Kemsawasd et al., 2016); however, among the various kinds, dark chocolate is most effective type on brain functions and glucocorticoid levels (Martin et al., 2009;Sokolov et al., 2013). Correspondingly, the consumption of dark chocolate may optimize cognitive functions over the life span of an individual (Crichton et al., 2016), especially under stress conditions (Simadibrata, 2011). Furthermore, dietary changes are major lifestyle factors that can influence the progression of chronic disorders (Shah et al., 2017). ...
Article
Introduction: Stress influences cognitive behavior adversely, whereas dark chocolate exhibits positive effects on memory processes. This study investigated the effects of different dark chocolate diets on various aspects of brain functions in rats under chronic stress Methods: Thirty-five rats were randomly allocated into five groups: control, stress, stress with different (compulsory, optional and restricted) dark chocolate diets. Latency, dark stay (DS) time and the number of entrance to the dark compartment were respectively evaluated as memory, memory consolidation and locomotor activity by passive avoidance test. Results: There were significant differences between initial latency and latency after 1 day in all groups. In the stress-compulsory and restricted dark chocolate diet groups, latency after 1 day increased significantly. Moreover, the DS time was not significantly higher in the stressed group than the control group. The DS time and number of entrance to dark compartment decreased significantly in the stress-compulsory dark chocolate diet group compared to the stressed group. Furthermore, the number of entrance to dark compartment was significantly higher for the stress- optional dark chocolate diet compared to those with the compulsory diet. Additionally, serum and hippocampal corticosterone levels, except in the frontal cortex, were significantly lower only in the stress-compulsory dark chocolate diet group compared to the stressed group. Conclusion: Different dark chocolate diets had various effects on brain functions under chronic stress. Respectively, the compulsory and optional dark chocolate diets had the best and least effects on brain function improvement. Only the compulsory dark chocolate diet could improve brain functions such as memory, memory consolidation and locomotor activity.
... Although cacao is rich in fat and carbohydrates-representing 50% and 25% of the total weight, respectively-the most noteworthy ingredients in this regard are flavonoids and methylxanthines [5,6]. Both flavonoids and methylxanthines appear to improve cognitive and cardiovascular function [7][8][9]. The flavonoids that are most often found in cocoa are epicatechin and catechin [10,11]. ...
... Previous research [7,10] stated that habitual chocolate intake is related to cognitive performance and that frequent chocolate consumption is significantly associated with improved memory. However, little is known about the effects of the habitual dark chocolate intake on cognitive function and neurotrophins in comparison with nondark chocolate intake. ...
... Several existing studies [1,2,[7][8][9][10][11][30][31][32] have shown that chocolate intake may have beneficial effects on health, including cardiovascular function, cholesterol metabolism, and cognitive function. Notably, habitual chocolate intake has been linked to cognitive performance [10]. ...
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Previous research has shown that habitual chocolate intake is related to cognitive performance and that frequent chocolate consumption is significantly associated with improved memory. However, little is known about the effects of the subchronic consumption of dark chocolate (DC) on cognitive function and neurotrophins. Eighteen healthy young subjects (both sexes; 20–31 years old) were randomly divided into two groups: a DC intake group (n = 10) and a cacao-free white chocolate (WC) intake group (n = 8). The subjects then consumed chocolate daily for 30 days. Blood samples were taken to measure plasma levels of theobromine (a methylxanthine most often present in DC), nerve growth factor (NGF), and brain-derived neurotrophic factor, and to analyze hemodynamic parameters. Cognitive function was assessed using a modified Stroop color word test and digital cancellation test. Prefrontal cerebral blood flow was measured during the tests. DC consumption increased the NGF and theobromine levels in plasma, enhancing cognitive function performance in both tests. Interestingly, the DC-mediated enhancement of cognitive function was observed three weeks after the end of chocolate intake. WC consumption did not affect NGF and theobromine levels or cognitive performance. These results suggest that DC consumption has beneficial effects on human health by enhancing cognitive function.
... Regular consumption of cocoa flavanols may reduce blood pressure, improve insulin sensitivity, reduce fat oxidation, and induce vasodilation, thus increasing blood flow in the brain, which is essential for optimal brain function (Grassi et al., 2005;Grassi et al., 2008;Sorond et al., 2013;Lamport et al., 2014;Dower et al., 2015). Similarly, epidemiological studies show that cocoa consumption has been associated with better cognition and decreased Alzheimer's disease (AD) risk (Commenges et al., 2000;Crichton et al., 2016). Moreover, flavonoid and other polyphenol-rich foods have been able to improve some cognitive domains in short-time trials (Nooyens et al., 2011;Kean et al., 2015;Alharbi et al., 2016;Kent et al., 2017;Miller et al., 2018). ...
... In recent years, an increasing amount of evidence supports the role of cocoa-derived product and chocolate consumption in the neurocognitive and neuroprotective enhancement of executive functions, attention, and memory, particularly among subjects with cognitive decline (Socci et al., 2017). In a cross-sectional study with community-dwelling adults, high dark chocolate consumption was associated with better cognitive function, including very old people, and the relationship was not attenuated when adjusted for cardiovascular, lifestyle, and dietary factors (Crichton et al., 2016). The few intervention studies on cocoa flavanol intake and cognitive performance have shown mixed results. ...
Article
Background Cocoa flavanols in the diet have had positive effects on cognition, blood lipid levels, and glucose metabolism. Methods Cognitively healthy older adults aged 65–75 years were recruited for an eight-week randomized, double-blind controlled trial to investigate the effectiveness of cocoa flavanols on cognitive functions. At baseline, nutrient and polyphenol intakes from diet were assessed with three-day food diaries. The intervention group received 50 g dark chocolate containing 410 mg of flavanols per day, and the control group 50 g dark chocolate containing 86 mg of flavanols per day, for eight weeks. Cognition was assessed with Verbal Fluency (VF) and the Trail Making Test (TMT) A and B as the main outcome measures. Changes in blood lipids and glucose were also measured. Results The older adults participating numbered 100 (63% women), mean 69 y (range 65 to 74). They were highly educated with a mean 14.9 years of education (SD 3.6). No differences in changes in cognition were seen between groups. The mean change (± SEs) in the time to complete the TMT A and B in the intervention group was −4.6 s (−7.1 to −2.1) and −16.1 s (−29.1 to −3.1), and in the controls −4.4 s (−7.0 to −1.9) and −12.5 s (−22.8 to −2.1)(TMT A p = 0.93; TMT B p = 0.66). No difference was apparent in the changes in blood lipids, glucose levels, or body weight between the groups. Conclusions The healthy older adults showed no effect from the eight-week intake of dark chocolate flavanols on cognition.
... Cocoa is another polyphenol-rich food studied for its effects on cognition (91)(92)(93). In a recent review (94) cognitive benefits were noted following acute treatment with cocoa flavanols, but conflicting results were seen in longer trials. ...
... Recent studies have shown promising results, however. A cross-sectional study in adults (aged 23-98 y) found improved cognition in subjects consuming chocolate at least once per week compared with less than once per week for global composite memory and visuospatial memory and organization (92). A prospective cohort study of cognitively healthy older adults found a significantly lower risk of gross cognitive decline (RR of 0.59) among chocolate consumers compared with nonconsumers, but only in participants consuming <1 serving size of chocolate per week (∼120 g chocolate bar or 7 g cocoa powder) and <75 mg of caffeine per day (95). ...
Article
The aging population is expanding, as is the prevalence of age-related cognitive decline (ARCD). Of the several risk factors that predict the onset and progression of ARCD, 2 important modifiable risk factors are diet and physical activity. Dietary patterns that emphasize plant foods can exert neuroprotective effects. In this comprehensive review, we examine studies in humans of plant-based dietary patterns and polyphenol-rich plant foods and their role in either preventing ARCD and/or improving cognitive function. As yet, there is no direct evidence to support the benefits of a vegetarian diet in preventing cognitive decline. However, there is emerging evidence for brain-health-promoting effects of several plant foods rich in polyphenols, anti-inflammatory dietary patterns, and plant-based dietary patterns such as the Mediterranean diet that include a variety of fruits, vegetables, legumes, nuts, and whole grains. The bioactive compounds present in these dietary patterns include antioxidant vitamins, polyphenols, other phytochemicals, and unsaturated fatty acids. In animal models these nutrients and non-nutrients have been shown to enhance neurogenesis, synaptic plasticity, and neuronal survival by reducing oxidative stress and neuroinflammation. In this review, we summarize the mounting evidence in favor of plant-centered dietary patterns, inclusive of polyphenol-rich foods for cognitive well-being. Randomized clinical trials support the role of plant foods (citrus fruits, grapes, berries, cocoa, nuts, green tea, and coffee) in improving specific domains of cognition, most notably frontal executive function. We also identify knowledge gaps and recommend future studies to identify whether plant-exclusive diets have an added cognitive advantage compared with plant-centered diets with fish and/or small amounts of animal foods.
... For the purposes of this paper, cacao and cocoa are used interchangeably. Flavonoids and flavanols, subclasses of antioxidants found in cacao 27 have been correlated with improved cognitive processing, alertness, and processing speed. Cocoa's physiological and neurological benefits are vast and include improved cardiovascular activity, insulin resistance, blood pressure, lipid peroxidation, enhanced gamma frequency, and increased cerebral blood flow. ...
... Cocoa's physiological and neurological benefits are vast and include improved cardiovascular activity, insulin resistance, blood pressure, lipid peroxidation, enhanced gamma frequency, and increased cerebral blood flow. 21,27,28,29,30 In addition, cocoa protects neurons from apoptosis, promotes angiogenesis, and thus leads to more optimal brain functioning, which enhances delivery and receipt of oxygen and nutrient supply. 31 The aforementioned studies summarize the inherent value in cacao as a natural functional food for the mind and the body, which may be of significant value to neurocognitive disorders, such as ASD. ...
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Background: Autism spectrum disorder (ASD) is a heterogeneous neurocognitive disorder with primary symptomology related to maladaptive behaviors and communication deficits. Children with ASD tend to have higher free radicals than antioxidants compared with their matched controls. This disequilibrium of oxidative stress has been associated with the pathogenesis of this neurocognitive disorder. The aim of this pilot feasibility study was to examine the effect of high antioxidant cacao consumption on behavior in children with ASD. Methods: This was a 4-wk repeated measures experimental pilot study of high antioxidant cacao and children with ASD. Participants consumed 8 squares (or 16 g) per day of the dark chocolate that had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant activity was 8320 μmoles TE/100 g). The 2 main behavioral measures, Aberrant Behavior Checklist, 2nd ed (ABC-2) and the Autism Spectrum Rating Scale (ASRS), were completed by the child's parent at baseline, end of week 2, and end of week 4. Results: Seventeen participants were recruited for this study. Follow-up data were available for 16 participants (12 males, 4 females, aged 4 to 17 y). Significant improvements were noted on the ABC-2 subscales of irritability (P = .03, η2= 0.25), social withdrawal (P = .01, η2= 0.29), stereotypic behavior (P = .05, η2 = 0.13), hyperactivity/noncompliance (P = .04, η2 = 0.20), and inappropriate speech (P = .05, η2 = 0.16). Significant improvements were noted on the ASRS subscales of social/communication (P = .04, η2 = 0.25), unusual behaviors (P = .003, η2= 0.20), self-regulation (P = .02, η2= 0.32), and total scores (P < .001, η2= 0.54). Conclusion: Results from this study support previous literature on antioxidant intake as an adjunct therapy to improve behaviors of children with ASD. More robust randomized controlled trials are now necessary to validate and elaborate on these findings.
... Increased consumer interest and consumption of dark chocolate is presumably due to the putative health benefits and properties of dark chocolate that have been widely reported in mass media. For example, various reports suggest bioactive components in cocoa may have a beneficial effect on cognitive function and cognitive decline 6 , may help increase HDL cholesterol levels 7 and may have anti-inflammatory activity 8 . By definition, dark chocolate does not contain dairy fat, making it a slightly simpler system than milk chocolate for the study of texture; given this, as well as its global commercial relevance, we used dark chocolate as our model system. ...
... All experiments were performed in accordance with relevant guidelines and regulations for research with human participants. For Experiment 1, all procedures were exempted from full IRB review by the Penn State Office of Research Protections under the consumer testing exemption in 45 CFR 46.101(b) (6). For Experiment 2, the protocol was reviewed and approved by Penn State Institutional Review Board (Protocol #00006365). ...
Article
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Texture affects liking or rejection of many foods for clinically relevant populations and the general public. Phenotypic differences in chemosensation are well documented and influence food choices, but oral touch perception is less understood. Here, we used chocolate as a model food to explore texture perception, specifically grittiness perception. In Experiment 1, the Just Noticeable Difference (JND) for particle size in melted chocolate was ~5 μm in a particle size range commonly found in commercial chocolates; as expected, the JND increased with particle size, with a Weber Fraction of ~0.17. In Experiment 2, individual differences in touch perception were explored: detection and discrimination thresholds for oral point pressure were determined with Von Frey Hairs. Discrimination thresholds varied across individuals, allowing us to separate participants into high and low sensitivity groups. Across all participants, two solid commercial chocolates (with particle sizes of 19 and 26 μm; i.e., just above the JND) were successfully discriminated in a forced-choice task. However, this was driven entirely by individuals with better oral acuity: 17 of 20 of more acute individuals correctly identified the grittier chocolate versus 12 of 24 less acute individuals. This suggests phenotypic differences in oral somatosensation can influence texture perception of foods.
... Optimistically, there is an increasing in cocoa and chocolate potential benefits for human organs health [45] especially brain functions. Especially, DC has antioxidants and phytochemicals like flavonoids [46]. A previous study by [47] reported that, DC and its components participate in memory consolidate and improve neurocognitive status [46]. ...
... Especially, DC has antioxidants and phytochemicals like flavonoids [46]. A previous study by [47] reported that, DC and its components participate in memory consolidate and improve neurocognitive status [46]. Likewise, all those harmful effects of ACR and willing to find a possible, available and acceptable antioxidant, this study focused on DC protective role against ACR cerebellar neurotoxicity. ...
Article
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Acrylamide (ACR) is selective neurotoxicity, could be found in foods processed by high temperature. This work aimed to evaluate the protective role of the dark chocolate (DC) against cerebellar neurotoxicity induced by subchronic ACR exposure in recently weaned rat pups and to propose it as protective supplement against dietary ACR hazards. Eighteen weaning pups were used in the current study and divided into three groups, six rats in each group; group 1 (control group), group 2 (ACR group), and group 3 (ACR + DC group). The pups were sacrificed after 21 days and the cerebellums were removed for light microscope using H&E stain, ultrastructural study, morphometric analysis of the neurons count, biochemical analysis of oxidant and antioxidant markers and real-time quantitative PCR to evaluate the nuclear receptor subfamily 4, group A, member 2 (Nr4a2) gene expression. Pups with ACR consumption showed signs of neuronal degeneration and reduced Nr4a2 expression. On the other hand, pups with ACR + DC consumption showed relative signs of neuronal restoration and enhanced Nr4a2 expression. In conclusion, DC can be used as effective supplement to decrease the dietary ACR cerebellar neuronal risks.
... 30 Also, a higher frequency of chocolate consumption has been associated with improved cognitive function. 29 Furthermore, a positive influence of cocoa polyphenols on physiological processes has been reported, with a neuroprotective effect 31 and improved cognitive performance. 32 In this regard, it has been suggested that the brain-derived neurotrophic factor plays a role in the cognitive enhancement induced by the flavonoides. ...
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Introduction The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women. Methods and analysis Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019. Ethics and dissemination This study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials.gov provided by the US National Library of Medicine, number NCT03492983 . The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.
... Several studies in the last decade have indicated that cacao-containing foods, such as chocolate, may have beneficial effects on several aspects of human health, such as cognitive function. 14,15 In particular, dark chocolate with high concentrations of cacao may have more beneficial effects and has recently become a popular choice for consumption. Cacao contains many flavonoids that have pleiotropic anti-oxidant and anti-inflammatory effects. ...
Article
Theobromine is a caffeine derivative and the primary methylxanthine in Theobroma cacao. We have shown previously that theobromine inhibits the Akt‐mammalian target of rapamycin (mTOR) signal in vitro. In this study, we investigated whether orally administered theobromine could inhibit mTOR activity in rats. mTOR is phosphorylated by Akt. Thus, the level of phosphorylated mTOR was used as an index of mTOR activity. Male Wistar rats were divided into two groups. The control group (CN) was fed a normal diet, while the theobromine group (TB) was fed a diet supplemented with 0.05% theobromine for 40 days. We measured body and tissue weights, food and water intake, blood count, concentrations of theobromine in the plasma, liver and brain, and the levels of phosphorylated mTOR in the liver and brain. Orally administered theobromine did not affect the body and tissue weights, food and water intake, and blood count as determined by comparison with levels in rats that were fed standard chow. Theobromine was detected in the plasma, liver and brain obtained from TB rats, but was not detected in tissues obtained from CN rats. The phosphorylated mTOR levels in the liver and brain were significantly lower in TB rats than in CN rats. The results suggest that oral theobromine inhibits mTOR signalling in vivo. This article is protected by copyright. All rights reserved.
... 103 In longitudinal studies, regular dietary chocolate consumption has also been shown to reduce the risk of experiencing cognitive decline. 104,105 In addition, in a meta-analysis of 17 independent observational studies, tea consumption was found to have an inverse linear relationship with the incidence of cognitive disorders. 6 Other observational studies have also shown that green and black tea consumption is related to a lower risk of experiencing cognitive impairment. ...
Article
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Although deficiencies in polyphenol intake do not result in specific deficiency diseases, adequate intake of polyphenols could confer health benefits, especially with regard to chronic diseases. Tea, cocoa, fruits, and berries, as well as vegetables, are rich in polyphenols. Flavan-3-ols from cocoa have been found to be associated with a reduced risk of stroke, myocardial infarction, and diabetes, as well as improvements in lipids, endothelial-dependent blood flow and blood pressure, insulin resistance, and systemic inflammation. The flavonoid quercetin and the stilbene resveratrol have also been associated with cardiometabolic health. Although polyphenols have been associated with improved cerebral blood flow, evidence of an impact on cognition is more limited. The ability of dietary polyphenols to produce clinical effects may be due, at least in part, to a bi-directional relationship with the gut microbiota. Polyphenols can impact the composition of the gut microbiota (which are independently associated with health benefits), and gut bacteria metabolize polyphenols into bioactive compounds that produce clinical benefits. Another critical interaction is that of polyphenols with other phytochemicals, which could be relevant to interpreting the health parameter effects of polyphenols assayed as purified extracts, whole foods, or whole food extracts.
... Methylxanthines, caffeine and theobromine are also components of chocolate which have been proposed to have psychoactive activity, affecting cognitive function and neuropsychologial actions, including learning and memory or blood flow promoting angiogenesis [160]. Consumption of chocolate can result in euphoria, resulting from stimulation of the neurotransmitter anandamide (a name derived from the Sanskrit word "ananda" meaning bliss). ...
Article
Chocolate is a widely appreciated foodstuff with historical appreciation as a food from the gods. In addition to its highly palatable taste, it is a rich source of (poly)phenolics, which have several proposed salutogenic effects, including neuroprotective anti-inflammatory, anti-oxidant and cardioprotective capabilities. Despite the known benefits of this ancient foodstuff, there is a paucity of information on the effects of chocolate on in the context of chronic kidney disease (CKD). This review focusses on the potential salutogenic contribution of chocolate intake, to mitigate inflammatory and oxidative burden in CKD, its potential, for cardiovascular protection and on the maintenance of diversity in gut microbiota, as well as clinical perspectives, on regular chocolate intake by CKD patients.
... A cross-sectional study in the Netherlands revealed a cumulative effect on cognitive performance tests after consumption of polyphenols from different sources (chocolate, wine, and tea; 127). At least two distinct longitudinal studies confirmed the protective effect over cognitive decline (128,129). These results are not sufficient to distinguish between physiological age-related decline and the development of Alzheimer disease, as the incidence of neurodegenerative diseases was not recorded in these studies, but they certainly argue in favor of the continuation of this direction of research. ...
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Dark chocolate is not the most popular chocolate; the higher concentration in antioxidants pays tribute to the increment in bitterness. The caloric density of dark chocolate is potentially lower but has a large variability according to recipes and ingredients. Nevertheless, in the last decade, the interest in dark chocolate as a potential functional food has constantly increased. In this review, we present the nutritional composition, factors influencing the bioavailability, and health outcomes of dark chocolate intake. We have extracted pro- and counter-arguments to illustrate these effects from both experimental and clinical studies in an attempt to solve the dilemma. The antioxidative and anti-inflammatory abilities, the cardiovascular and metabolic effects, and influences on central neural functions were selected to substantiate the main positive consequences. Beside the caloric density, we have included reports placing responsibility on chocolate as a migraine trigger or as an inducer of the gastroesophagial reflux in the negative effects section. Despite an extensive literature review, there are not large enough studies specifically dedicated to dark chocolate that took into consideration possible confounders on the health-related effects. Therefore, a definite answer on our initial question is, currently, not available.
... One hundred grams of dark chocolate contain ca. 100 mg of flavanols, whereas 100 g of cocoa powder contains ca. 250 mg of flavanols [89]. The content of polyphenols in chocolate is influenced not only by contents of cocoa pulp and cocoa powder, but also by cocoa beans species and parameters of its processing. ...
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Chocolate is one of the most desired confectionery products in the world. Its production technology includes a series of processes conducted in appropriate conditions of the temperature and time. Most of these operations contribute to the degradation of valuable, natural and desired bioactive compounds; hence, producers search for novel technologies and solutions that would enable minimizing these losses. In 2012, the EFSA confirmed advantages of components within cocoa powder to health. This review is focused on analyzing the effect of particular stages of the production process, with consideration given over to the kind of raw ingredients of the finished product on the bioactive compound’s make-up in the products made in cocoa beans products subjected to the “traditional” process using both high and low temperatures. Due to the high temperature used during roasting, it is witch is one of the main processes affecting both the quality and sensory properties of the cocoa beans and products made from them. Each variety differs in size and beans color, resistance to the climatic resistance, and beans composition. Collected data allow us to establish which stages and which processes require further studies and analyses to be most useful for chocolate manufacturers not only in terms of the manufacturing repeatability of products, but also in developing an assortment of products having a positive effect on human health and well-being.
... Covariates were employed to statistically adjust for demographic, cardiovascular and lifestyle factors likely to influence cognitive function. Covariates were based on previous MSLS analyses [26,27] and cognitive Mediterranean diet investigations [11,18] and were included in the model if they were significantly correlated with both the predictor and outcome variable. Covariates were organised into two models: ...
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Background: Adherence to a Mediterranean diet is associated with higher cognitive function and reduced risk of dementia in Mediterranean populations. However, few studies have investigated the association between Mediterranean diet adherence and cognition in populations outside of the Mediterranean basin. Furthermore, it is currently unknown whether the association between Mediterranean diet adherence and cognitive function differs between middle-aged and older individuals. Methods: Cross-sectional (n = 894) and longitudinal (n = 530) multivariable analyses were undertaken using data from community-dwelling adults from the Maine-Syracuse Longitudinal Study (MSLS). Mediterranean diet adherence was measured by applying a literature-based Mediterranean diet score to food frequency questionnaire data. Cognitive function was assessed with a battery of tests and composites scores were computed for global cognitive function, Visual-Spatial Organisation and Memory, verbal memory, working memory, scanning and tracking and abstract reasoning. Results: No cross-sectional associations between Mediterranean diet adherence and cognitive function were detected. Over a period of five years, higher adherence to a Mediterranean diet was associated with improvements in Global Cognitive Function, Visual-Spatial Organisation and Memory and scanning and tracking in participants ≥70 years. No significant longitudinal associations were observed for participants <70 years. Conclusion: Our findings suggest that higher adherence to a Mediterranean diet is associated with better cognitive performance, and therefore less cognitive decline, in older but not middle-aged individuals.
... Chocolate is a source of biologically active substances such as theobromine alkaloids, phenylethylamine, polyphenols, and tocopherols. There is strong evidence proving that chocolate consumption is beneficial to brain health and for alleviating stressful situations [8,9]. Chocolate is a functional food, and there are increasing efforts to further enhance its functionality [10]. ...
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Some food-derived bioactive peptides have demonstrated positive effects on stress reduction. This study was an attempt to evaluate the effectiveness of daily consumption of 12 g of sugar-free chocolate containing 150 mg of αs1-casein (91-100) peptide in alleviating stress in healthy, normal-weight participants. Methods: Salivary cortisol concentration and self-report questionnaire data were obtained before and after chocolate consumption. Sixty participants completed the Cattle Anxiety Scale (CSI), the Beck Depression Inventory (BDI), and the Depression Anxiety Stress Scales 21 (DASS-21). Results: Results from the CAS and DASS-21 questionnaires showed that consumption of chocolate containing bioactive peptide reduced anxiety and stress (p < 0.05). Salivary cortisol measurement showed more than 30% reduction in cortisol level in the intervention group. The peptide had a 95% recovery rate and also demonstrated thermal and mechanical stability during the production process. Conclusion: Findings confirmed the undenatured structure of the αs1-casein peptide in chocolate and its resistance to the chocolate processing condition.
... The associations between more frequent weekly chocolate consumption and cognitive performance remained significant after adjustment for a number of cardiovascular risk factors, including total and LDLcholesterol, glucose levels, and hypertension. Associations were not attenuated with the addition of dietary variables (alcohol, meats, vegetables, and dairy foods), suggesting that chocolate may be associated with cognition irrespective of other dietary habits [105]. ...
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Background: The use of biomarkers in basic and clinical research as well as in clinical practice has become so common that their presence as primary endpoints in clinical trials is now accepted. A biomarker refers to a broad subcategory of medical signs. The aims of this article are to consider the of use biomarkers in Mild stages of Alzheimer’s disease (AD) in research and clinical settings, in addition to defining their utility in clinical practice relating this with nutritional and lifestyle factors as possible treatment. Methods: We searched MEDLINE, PubMed, and AgeLine databases using different keywords.Conclusions: A summary of the utility of biomarkers in AD and nutritional and lifestyle factors used as treatment in mild stages are described.Key words: Biomarkers, Alzheimer’s disease, Dementia, Utility, Clinical practice, Nutritional
... Results from a cross-sectional analysis in subjects aged 23-98 years showed a better cognitive performance in those consuming chocolate more frequently. However, following a prospective observation, a relationship between cognitive function and chocolate intake was not confirmed when measured up to 18 years later [98]. ...
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Chocolate is well known for its fine flavor, and its history began in ancient times, when the Maya considered chocolate (a cocoa drink prepared with hot water) the “Food of the Gods”. The food industry produces many different types of chocolate: in recent years, dark chocolate, in particular, has gained great popularity. Interest in chocolate has grown, owing to its physiological and potential health effects, such as regulation of blood pressure, insulin levels, vascular functions, oxidation processes, prebiotic effects, glucose homeostasis, and lipid metabolism. However, further translational and epidemiologic studies are needed to confirm available results and to evaluate other possible effects related to the consumption of cocoa and chocolate, verifying in humans the effects hitherto demonstrated only in vitro, and suggesting how best to consume (in terms of dose, mode, and time) chocolate in the daily diet.
... W pierwszym flawonoidy oddziałują z kaskadami przekazywania sygnałów neuronalnych (głównie z kaskadami sygnałowymi kinaz białkowych i lipidowych), w drugim indukują obwodowy i mózgowy przepływ krwi w sposób prowadzący do angiogenezy i wzrostu nowych komórek nerwowych w hipokampie. Regularne spożywanie flawonoidów może zatem potencjalnie zmniejszyć neurodegradację skutkującą różnymi zaburzeniami neurologicznymi, nie tylko zmniejszyć częstość występowania upośledzenia funkcji poznawczych, ale wręcz je wzmocnić [70,71,72]. W krajach o wysokim poziomie spożycia czekolady w przeliczeniu na jednego mieszkańca odnotowano największą liczbę laureatów Nagrody Nobla [73]. ...
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Ostatnie badania potwierdzają prozdrowotne właściwości czekolady, chociaż historia kakao jako leku sięga kilku tysięcy lat. Drzewo kakaowca rosnące w klimacie równikowym, w wierzeniach starożytnych Majów i Azteków, było boskim darem dla ludzkości zapewniającym mądrość i wiedzę uniwersalną. Z jego ziaren uzyskiwany jest proszek kakaowy służący do produkcji czekolady zawierającej wiele składników bioaktywnych, w tym witaminy, składniki mineralne, polifenole i kwasy tłuszczowe. Czekolada pozytywnie wpływa na nastrój, zmniejsza podatność na stany depresyjne oraz stres oksydacyjny. Spożycie czekolady w trakcie ciąży może poprawić stan psychiczny przyszłych matek i zmniejszyć negatywny wpływ matczynego stresu na niemowlę. Dzięki wysokiej zawartości flawanoli wykazuje właściwości przeciwzapalne, przeciwalergiczne, przeciwwirusowe oraz przeciwnowotworowe. Pozytywnie wpływa na pamięć i umiejętności poznawcze, może zmniejszyć ryzyko demencji. Regularne spożywanie produktów zawierających kakao zmniejsza ryzyko zgonu z przyczyn sercowo-naczyniowych, a zwłaszcza udaru mózgu, oraz może zmniejszyć obwodową oporność na insulinę u kobiet z cukrzycą typu 2. Działa pobudzająco po wysiłku psychicznym lub fizycznym. Zapewnia uczucie sytości, dlatego była dodawana do żołnierskich racji żywnościowych w czasie I wojny światowej. Należy jednak pamiętać, że spożycie czekolady podnosi poziom kwasu szczawianowego w moczu oraz może prowadzić do zaostrzenia objawów trądziku pospolitego. Jest toksyczna dla zwierząt. Czekolada zawiera również związki, których znaczenie dla zdrowia nie zostało szczegółowo poznane.
... A cross-sectional study in the Netherlands revealed a cumulative effect on cognitive performance tests after consumption of polyphenols from different sources (chocolate, wine, and tea; 127). At least two distinct longitudinal studies confirmed the protective effect over cognitive decline (128,129). These results are not sufficient to distinguish between physiological age-related decline and the development of Alzheimer disease, as the incidence of neurodegenerative diseases was not recorded in these studies, but they certainly argue in favor of the continuation of this direction of research. ...
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Dark chocolate is not the most popular chocolate; the higher concentration in antioxidants pays tribute to the increment in bitterness. The caloric density of dark chocolate is potentially lower but has a large variability according to recipes and ingredients. Nevertheless, in the last decade, the interest in dark chocolate as a potential functional food has constantly increased. In this review, we present the nutritional composition, factors influencing the bioavailability, and health outcomes of dark chocolate intake. We have extracted pro- and counter-arguments to illustrate these effects from both experimental and clinical studies in an attempt to solve the dilemma. The antioxidative and anti-inflammatory abilities, the cardiovascular and metabolic effects, and influences on central neural functions were selected to substantiate the main positive consequences. Beside the caloric density, we have included reports placing responsibility on chocolate as a migraine trigger or as an inducer of the gastroesophagial reflux in the negative effects section. Despite an extensive literature review, there are not large enough studies specifically dedicated to dark chocolate that took into consideration possible confounders on the health-related effects. Therefore, a definite answer on our initial question is, currently, not available.
... From the overall result, it showed that an increase in the percentage mean score of item in each trial for both groups. This was happened because regular intake of cocoa flavanols may have a beneficial effect on cognitive function and possibly protect against normal age related to cognitive decline [21]. In control group, the result showed that respondents able to memorize 52.5% of the score list items at trial 5. ...
... Yet, these existing observational studies have many notable limitations. These include the use of cross-sectional design, which precludes the establishment of a causal relationship between flavonoid intake and cognition (25)(26)(27)(28)(29) . Longitudinal studies of the relation between flavonoid intake and age-related cognitive changes also have limitations such as the lack of repeated assessments of flavonoid intake during follow-up (30)(31)(32) , the utilisation of incomplete flavonoid databases (33) and the use of insensitive cognitive assessment tools such as the Mini-Mental State Examination (MMSE) (31,32,34) . ...
Article
Objective To examine the association between long-term intake of total and the six classes of dietary flavonoids and decline in cognitive function over a follow-up period of up to 15 years. Design In this longitudinal study, we evaluated change in eight cognitive domain scores (verbal and visual memory, verbal learning, attention and concentration, abstract reasoning, language, visuoperceptual organisation and the global function) based on three neuropsychological exams and characterised the annualised change between consecutive exams. Long-term intakes of total and six flavonoid classes were assessed up to four times by a validated FFQ. Repeated-measures regression models were used to examine the longitudinal association between total and six flavonoid classes and annualised change in the eight cognitive domains. Setting The Framingham Heart Study (FHS), a prospective cohort study. Participants One thousand seven hundred and seventy-nine subjects who were free of dementia, aged ≥45 years and had attended at least two of the last three FHS Offspring cohort study exams. Results Over a median follow-up of 11·8 years with 1779 participants, nominally significant trends towards a slower decline in cognitive function were observed among those with higher flavanol and flavan-3-ol intakes for global function, verbal and visual memory; higher total flavonoids and flavonoid polymers for visual memory; and higher flavanols for verbal learning. Conclusions In spite of modest nominal trends, overall, our findings do not support a clear association between higher long-term flavonoid intake and slowing age-related cognitive decline.
... Recently, there has been a burgeoning interest in the potential of polyphenols to improve memory, learning, and general cognitive ability [8,9,10]. A substantial body of animal behavioral research suggests that intake of blueberry or strawberry preparations is effective at reversing agerelated deficits in spatial working memory [11,12,13,14,15] and improving object recognition memory [16]. Human investigations have also suggested that fruit and vegetables may have a positive impact on memory [17,18,19,20,21]. ...
Chapter
Regular intake of flavonoid-rich foods has been associated with a 50% reduction in the risk of dementia, improving cognitive performance, and delaying the onset of Alzheimer disease. This double-blind, placebo-controlled study examined the effect of acute intake of pomegranate extract (PE; Pomanox) on cognitive function in 20 healthy adults (7 men, 13 women, aged 18–64 years). Participants were randomly assigned to PE or placebo and assessed by cognitive tests; saliva samples were collected for cortisol assay before and after these tests. Within-group comparisons of postdose scores showed that logical reasoning was significantly faster after receiving PE (P < .001). Working memory tests also improved after PE (total serial subtractions, P < .001, correct serial subtractions, P = .04, and faster Corsi block lite reaction times, P = .05). No significant changes were observed for other parameters. PE could potentially limit neurodegeneration and prevent age-dependent losses in cognitive performance.
... The recent study on human Alzheimer's disease using an in vitro model, revealed that the polyphenolic extract of cocoa spiked the BDNF/ TrkB signaling pathway thereby increasing neuroprotection [72]. Also its regular consumption has been linked to improved cognition and decrease in the risks associated with Alzheimer disease (AD) [73] [46]. The principle flavanol present in cocoa is epi-catechin and plays the great role in regulating the vascular function such as regulation of blood pressure and vascular tone due to increase in the bioavailability of nitric oxide [74]. ...
Article
The world is currently under the threat of COVID pandemic and has focused every dimension of research in finding a cure to this novel disease. In this current situation, people are facing mental stress, agony, fear, depression and other associated symptoms which are taking a toll on their overall mental health. Nanoencapsulation of certain brain boosting polyphenols including quercetin, caffeine, cocoa flavanols and proteins like lectins can become new area of interest in the present scenario. Besides the brain boosting benefits, we have also highlighted the anti- viral activities of these compounds which we assume can play a possible role in combating COVID-19 given to their previous history of action against certain viruses. This review outlines the nanoencapsulation approaches of such synergistic compounds as a novel strategy to take the ongoing research a step ahead and also provides a new insight in bringing the role of nanotechnology in addressing the issues related to COVID pandemic.
... Neuromodulation by transcranial direct current stimulation (tDCS) is a safe procedure when safety guidelines are followed (Poreisz, Boros, Antal, & Paulus, 2007), and has positive effects on multiple cognitive subdomains in healthy and neuropsychiatric populations (Hill, Fitzgerald, & Hoy, 2016;Kalu, Sexton, Loo, & Ebmeier, 2012;Summers, Kang, & Cauraugh, 2016). Cocoa bean is a rich source of flavonoids, particularly the flavonol subclass, which epidemiologic studies suggest may be associated with improved cognitive abilities, less cognitive impairment, improved dosedependent cognitive functions with normal aging, and decreased risk of cognitive decline and dementia (Commenges et al., 2000;Crichton, Elias, & Alkerwi, 2016;Letenneur, Proust-Lima, Le Gouge, Dartigues, & Barberger-Gateau, 2007;Moreira, Diógenes, de Mendonça, Lunet, & Barros, 2016;Neshatdoust et al., 2016). ...
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Background: Highly educated students and professionals in cognitively demanding careers are often at risk of acute sleep deprivation. In the past few decades, the trend toward increasing psychostimulant abuse has elicited the need for safer alternatives to cognitive enhancement. Transcranial direct cranial stimulation (tDCS) and high dose cocoa flavonoids (HDCF) have been recently studied as promising alternatives. However, these studies had methodological differences, sometimes conflicting results, and none to date have assessed their combined effects. Objective: To determine if anodal tDCS and HDCF will improve working memory (WM) scores in acutely sleepdeprived highly educated healthy participants. Methods: We propose a single-center, randomized, placebo-controlled (double-dummy), double-blind, early phase II study, in which 164 acutely sleep-deprived 21-40 year-old students or professionals in cognitively demanding fields will be randomized in a 2x2 factorial fashion to one of the following groups: anodal tDCS + HDCF, anodal tDCS + placebo CF, sham tDCS + HDCF, and sham tDCS + placebo CF. The primary outcome is a composite score of nback and dual n-back tests following the intervention. Secondary outcomes include exploratory subgroup analyses for gender, age and cognitive score adjusted for time and task, psychomotor vigilance task, mental fatigue visual analogue scale, quantitative electroencephalogram, and tDCS adverse events questionnaire. Potential impact of the study: This study will allow us to assess the effects of each intervention alone on WM as well as (for the first time) identify any potential synergistic effects resulting from the combined interventions. This, in turn, may generate hypotheses for future studies on cognitive impairment due to both acute/chronic sleep deprivation and pathologic disorders.
... Estudos têm demonstrado uma associação positiva entre o consumo de chocolate e a menor incidência de doenças cardiovasculares (KWOK et al., 2016;LARSSON et al., 2016;BUIJSSE et al., 2010), além de associação inversa com a ocorrência de Diabetes tipo 2 e resistência à insulina (CRICHTON et al., 2017;ALKERWI et al., 2016), e efeitos protetores contra declínios cognitivos em idosos (MOREIRA et al., 2016;CRICHTON et al., 2016). ...
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A procura por chocolates amargos tem aumentado visivelmente entre os consumidores, tendo em vista seu alto conteúdo de compostos fenólicos com atividade antioxidante, e sua associação positiva na prevenção de doenças cardiovasculares, hipertensão arterial e resistência à insulina. O objetivo deste estudo foi elaborar bombons de chocolate amargo adicionados de goji berry desidratado e avaliar suas características físico-químicas, sensoriais e perfil de textura durante o período de armazenamento. Foram elaboradas uma amostra controle (apenas chocolate) e duas amostras com 15% e 30% de goji berry, respectivamente, sendo utilizado chocolate amargo de origem Brasil (66,8% cacau). Foram quantificados atividade de água, pH, sólidos solúveis, acidez titulável e umidade, e análises de textura instrumental e avaliação sensorial nos tempos 1, 30 e 60 dias de armazenamento. Utilizou-se ANOVA e teste-t, ajuste de Tukey, (p ≤ 0,05) para análise dos resultados. Evidenciou-se que a amostra com 30% de goji berry apresentou maiores diferenças nos parâmetros físico-químicos, caracterizados por menor pH e maiores valores de acidez titulável e umidade, comparativamente as demais amostras. Durante o armazenamento, houve aumento significativo nos teores de umidade e atividade de água nas amostras com goji berry, especialmente após 60 dias de armazenamento. A análise de textura revelou aumento significativo da força de ruptura na amostra controle, e redução desta, nas amostras adicionadas da fruta, durante o armazenamento, especialmente após o período de 60 dias, sugerindo que as frutas interferiram na dureza dos bombons, o que corroborou com os resultados da analise sensorial de textura das amostras.
... For the current study, a computerised version of the original FFQ was modified to include questions on foods of interest in the field of AD research with the resultant questionnaire termed the AD-CSIROFFQ. These new questions were selected based on current literature describing major dietary contributors associated with AD risk [7][8][9][10][11]. Questions were added to capture information in relation to dietary intake of chocolate type, oils (e.g., grape seed, coconut oil), wine type, green and white tea, pomegranates and pomegranate juice, types of grapes, types of berries, offal (e.g., kidney, liver, heart), types of meat used in stew, casserole, curry and goulash, types of rice, types of nuts and seeds, nutritional supplements, and herbs and spices. ...
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Accuracy in measuring intake of dietary constituents is an important issue in studies reporting the associations between diet and chronic diseases. We modified a Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire (FFQ) to include foods of interest in the field of Alzheimer’s disease (AD) research. The aim of the current study was to determine the reliability and validity of the AD-CSIROFFQ in 148 cognitively normal older adults. The AD-CSIROFFQ was completed before and after completion of a four-day weighed food record. Of the 508 food and beverage items reported, 309 had sufficient consumption levels for analysis of reliability. Of the 309 items, over 78% were significantly correlated between the two questionnaire administrations (Spearman’s rank correlations). We used two additional methods to assess absolute nutrient intake agreement between the AD-CSIROFFQ and the weighed food records (Pearson’s correlation coefficients and Bland–Altman plots) and quintile rankings to measure group level agreement. The adequate correlations observed between questionnaire responses suggest that the AD-CSIROFFQ is reliable. All nutrient intakes were acceptable for ranking of individuals on a group level, whilst the agreement levels with respect to the weighed food records for 11 of the 46 nutrients show validity in terms of their individual level absolute intake. The AD-CSIROFFQ makes an important contribution to the tools available for assessing usual dietary intake in groups of older adults with respect to AD research.
... There were no associations observed between chocolate intake and verbal memory. An important point to note, however, is that chocolate intake was not differentiated according to type, i.e., dark, milk, or white, all of which contain varying quantities of flavanols (Crichton et al., 2016). ...
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The purpose of this review is to examine human research studies published within the past 6 years which evaluate the role of anthocyanin, flavanol, and flavanone consumption in cognitive function, and to discuss potential mechanisms of action underlying any observed benefits. Evidence to date suggests the consumption of flavonoid-rich foods, such as berries and cocoa, may have the potential to limit, or even reverse, age-related declines in cognition. Over the last 6 years, the flavonoid subgroups of anthocyanins, flavanols, and flavanones have been shown to be beneficial in terms of conferring neuroprotection. The mechanisms by which flavonoids positively modulate cognitive function are yet to be fully elucidated. Postulated mechanisms include both direct actions such as receptor activation, neurotrophin release and intracellular signaling pathway modulation, and indirect actions such as enhancement of cerebral blood flow. Further intervention studies conducted in diverse populations with sufficient sample sizes and long durations are required to examine the effect of consumption of flavonoid groups on clinically relevant cognitive outcomes. As populations continue to focus on adopting healthy aging strategies, dietary interventions with flavonoids remains a promising avenue for future research. However, many questions are still to be answered, including identifying appropriate dosage, timeframes for intake, as well as the best form of flavonoids, before definitive conclusions can be drawn about the extent to which their consumption can protect the aging brain.
... In addition, we observed an inverse association between chocolate consumption and the risk of death from Alzheimer's disease. In fact, previous observational studies had found that chocolate consumption was associated with a decreased risk of cognitive decline [43,44]. The observed association of chocolate consumption with the risk of death from Alzheimer's disease could be attributable to the neuroprotective effects of cocoa [45]. ...
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Few studies with mixed results have examined the association between chocolate consumption and mortality. We aimed to examine this association in a US population. A population-based cohort of 91891 participants aged 55 to 74 years was identified. Chocolate consumption was assessed via a food frequency questionnaire. Cox regression was used to estimate risk estimates. After an average follow-up of 13.5 years, 19586 all-cause deaths were documented. Compared with no regular chocolate consumption, the maximally adjusted hazard ratios of all-cause mortality were 0.89 [95% confidence interval (CI) 0.84-0.94], 0.84 (95% CI 0.79-0.90), 0.86 (95% CI 0.81-0.93), and 0.87 (95% CI 0.82-0.93) for >0-0.5 servings/week, >0.5-1 serving/week, >1-2 servings/week, and >2 servings/week, respectively (Ptrend = 0.009). A somewhat stronger inverse association was observed for mortality from cardiovascular disease and Alzheimer's disease. A nonlinear dose-response pattern was found for all-cause and cardiovascular mortality (all Pnonlinearity < 0.01), with the lowest risk observed at chocolate consumption of 0.7 servings/week and 0.6 servings/week, respectively. The favorable associations with all-cause and cardiovascular mortality were found to be more pronounced in never smokers than in current or former smokers (all Pinteraction < 0.05). In conclusion, chocolate consumption confers reduced risks of mortality from all causes, cardiovascular disease, and Alzheimer's disease in this US population.
... In addition to all the effects on cardiometabolic health, polyphenols are also thought to have a beneficial role on cognitive function. For example, some longitudinal studies show that regular dietary chocolate consumption can reduce the risk of cognitive decline [39,40]. Studies of other food sources like tea show that its consumption can help lowering the risk of cognitive impairment, reduce the risk of depression, and have protective effects against some diseases like Parkinson's disease [41][42][43][44]. ...
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Dietary polyphenols are a group of natural compounds that have been proposed to have beneficial effects on human health. They were first known for their antioxidant properties, but several studies over the years have shown that these compounds can exert protective effects against chronic diseases. Nonetheless, the mechanisms underlying these potential benefits are still uncertain and contradictory effects have been reported. In this review, we analyze the potential effects of polyphenol compounds on some visual diseases, with a special focus on retinal degenerative diseases. Current effective therapies for the treatment of such retinal diseases are lacking and new strategies need to be developed. For this reason, there is currently a renewed interest in finding novel ligands (or known ligands with previously unexpected features) that could bind to retinal photoreceptors and modulate their molecular properties. Some polyphenols, especially flavonoids (e.g., quercetin and tannic acid), could attenuate light-induced receptor damage and promote visual health benefits. Recent evidence suggests that certain flavonoids could help stabilize the correctly folded conformation of the visual photoreceptor protein rhodopsin and offset the deleterious effect of retinitis pigmentosa mutations. In this regard, certain polyphenols, like the flavonoids mentioned before, have been shown to improve the stability, expression, regeneration and folding of rhodopsin mutants in experimental in vitro studies. Moreover, these compounds appear to improve the integration of the receptor into the cell membrane while acting against oxidative stress at the same time. We anticipate that polyphenol compounds can be used to target visual photoreceptor proteins, such as rhodopsin, in a way that has only been recently proposed and that these can be used in novel approaches for the treatment of retinal degenerative diseases like retinitis pigmentosa; however, studies in this field are limited and further research is needed in order to properly characterize the effects of these compounds on retinal degenerative diseases through the proposed mechanisms.
... Possible biological mechanisms of that association may involve generally high fat contents, especially high in saturated and trans-fats and lower in polyunsaturated and monounsaturated fats leading to blood brain barrier dysfunction and increased amyloid beta protein aggregation [68]. However, we observed an indication of beneficial effects from moderate consumption of chocolate products, consistent with previous studies [69,70]. Such beneficial effects, if real, may be due to the cocoa polyphenol intake [71] that might slow MCI progression to dementia [72]. ...
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Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
... Hence dark chocolate, which has a higher cacao and polyphenol content, shows better health benefits compared to milk chocolate (Fanton et al., 2020). Recent studies have reported that chocolate products have a positive effect in combating cognitive decline due to their biologically active chemical compounds (Crichton et al., 2016;Martín et al., 2020). From a chemical point of view, chocolate contains a significant amount of polyphenols, mainly flavan-3-ols (catechin, epicatechin), proanthocyanidins, and anthocyanins. ...
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The present study evaluated the feasibility of the fortification of dark chocolate with a freeze-dried lemon balm extract rich in rosmarinic acid (RA). Given the food matrix used, it was necessary to develop an analytical and extraction method for RA determination in fortified chocolate. A simple and efficient reversed-phase high-performance liquid chromatography method (RP-HPLC) has been developed for the estimation of RA in dark chocolate. The validity of the method was demonstrated by evaluating the system suitability, linearity, precision, accuracy, the limit of detection, and limit of quantification. The extraction of RA from chocolate was optimized using maceration with shaking (MACS) and microwave-assisted extraction (MAE). The experimental conditions, namely solvent type and extraction time, were optimized using the one-factor-at-a-time methodology. Under the optimized conditions, the proposed method showed good recovery within 95% and acceptable reproducibility with intra- and inter-day relative standard deviations of <2.3%. The method was linear from 5 to 800 μg/mL with a determination coefficient of 1.000. Moreover, the functional chocolate showed a homogeneous active ingredient distribution and retained its RA amount since no significant difference was observed during storage. Overall, the present method was successfully applied to determine RA content in fortified chocolate.
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Dark chocolates are rich sources of polyphenols, widely acknowledged for eliciting several beneficial health effects. However, these compounds are key inducers of bitter taste and astringency, potentially limiting consumers’ acceptance of chocolates with higher cocoa contents. In order to gain better insight in consumers’ choices, the present study investigated the temporal profile of bitterness and astringency as well as sweet taste as covering agent, during the testing period in 5 dark origin (OR) (66.8–80.1% cocoa) and 6 non-origin (N-OR) (54.5–80.0% cocoa) chocolates with different cocoa contents, applying Temporal Dominance of Sensations (TDS). The temporal profile of the evaluated OR chocolates was characterized by the dominance of bitterness independent of cocoa contents (%cc), reaching maximum dominance rates (DR%) between 60.0 and 80.0% over approximately 75.0% of the testing period, i.e. prior to swallowing. After swallowing, astringency dominated, mostly not significantly. DR (%) of sweetness reached the level of significance only in one sample (OR 67.4%cc). N-OR chocolates with 54.5–60.0%cc were characterized by significant dominances of sweet taste along the entire evaluation period, reaching maximum DR% between 90 and 95%. The increase of cocoa contents was combined with higher DR% of bitter taste. Astringency dominated in N-OR samples at the end of the evaluation period presumably after swallowing. Finally, in N-OR chocolates, cc% highly affected the dominance of the evaluated attributes. This impact was found to be rather minor or absent in OR chocolates. Thus, the TDS-parameters showed variations in attribute's dominance in OR and N-OR chocolates indicating a strong influence of cocoa bean variety and local conditions (environmental and farming conditions as well as post-harvest treatment practices) in addition to cocoa contents.
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Consistent intake of legumes has been correlated with decreased possibility of developing colorectal cancer (CRC) due to the content of some phytochemicals like polyphenols. Bambara groundnut (BGN) is an underutilized crop with a rich nutritional profile, but have not been exploited for its nutraceutical and medicinal benefits. In this study, total polyphenol, flavonoid (flavonol and flavanol) content, antioxidant activity and cytotoxicity/antiproliferative properties of 70% ethanolic extracts of whole BGN, cotyledon and seed coat on Caco-2 and HT-29 colon cancer cells were evaluated. Seed coat had a significantly (p<0.05) higher composition of total polyphenol, flavonol and flavan-3-ol (flavanol) compared to whole seed and cotyledon. Antioxidant activity determined with ferric reducing antioxidant power (FRAP), 2,2- azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and oxygen radical absorbance capacity (ORAC) assays, showed that seed coat with higher polyphenolic content had significantly (p<0.05) greater antioxidant activity. BGN fractions demonstrated cytotoxic and antiproliferative effects against HT-29 and Caco-2 colon cancer cells in a dose-dependent manner, with seed coat and whole seed exhibiting greater cytotoxicity and higher antiproliferative activity and colon cancer cell inhibition. Extracts of the cotyledon also showed cytotoxic activity and hindered cancer cell growth/division but to a significantly (p<0.05) lower magnitude. BGN parts indicated a greater cytotoxic effect and potential to slow down Caco-2 colon cancer cell growth and division over HT-29. This result provides new knowledge on the possible health benefits of BGN, as well as the potential for product development and may influence its consumption and utilisation.
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Due to progressive population aging, a new dementia case occurs at every 3 seconds, placing a heavy burden of disease. Identifying potential risk or preventive factors is emphasized owing to a lack of effective treatment for dementia. There has been emerging evidence on the link of certain dietary components, particularly polyphenols, to brain wellness and cognitive outcomes. Findings from animal and in vitro studies appear more consistent and conclusive. However, such an association has not been investigated in depth in human beings. In this review, we examined studies on the effect of dietary polyphenols (including flavonoids, curcumin, and resveratrol) on cognitive function. Intervention in early stages of dementia/Alzheimer’s disease might be a target to slow down age-related cognitive decline before disease onset. We summarized 28 epidemiological studies (8 cross-sectional and 20 cohort studies) and 55 trials in this review. Preliminary evidence from epidemiological data provides the necessity for intervention trials, even though the measures of polyphenol intake tend to be less precise. Clinical trials are in favor of the role of some polyphenols in benefiting specific domains of cognition. This review also describes the divergence of results and current limitations of research in this field.
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The present article is exploratory in nature and studies the attributes that an Indian chocolate consumer considers while making a chocolate purchase and based on this the present article establishes the position of the popular chocolate brands on these select attributes. The study was conducted on 311 chocolate consumers in the National Capital Region (NCR). An exploratory factor analysis revealed two principal factors and further an attribute-based perceptual map was plotted on the identified factors. It was found that regardless of their demographics, Indians are increasingly preferring chocolates over traditional sweets and are consuming it both as a snack food and as a dessert. The attribute-based perceptual map had significant implications for the national and international brands available in the Indian marketplace.
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Nutritional qualities of cocoa have been acknowledged by several authors; a particular focus has been placed on its high content of flavanols, known for their excellent antioxidant properties and subsequent protective effect on cardio- and cerebrovascular systems as well as for neuromodulatory and neuroprotective actions. Other active components of cocoa are methylxanthines (caffeine and theobromine). Whereas the effects of caffeine are extensively researched, the same is not the case for theobromine; this review summarizes evidence on the effect of theobromine on cognitive functions. Considering animal studies, it can be asserted that acute exposition to theobromine has a reduced and delayed nootropic effect with respect to caffeine, whereas both animal and human studies suggested a potential neuroprotective action of long-term assumption of theobromine through a reduction of Aβ amyloid pathology, which is commonly observed in Alzheimer’s disease patients’ brains. Hence, the conceivable action of theobromine alone and associated with caffeine or other cocoa constituents on cognitive modulation is yet underexplored and future studies are needed to shed light on this promising molecule.
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Chocolate has been used as a fatigue recovery and energy source as a food having various effects not only from luxury items but also from the nutrition side in the past history. In recent years, studies of ingredients contained in cacao have progressed, and excellent physiological functions of antioxidant polyphenols and other ingredients have been revealed to be useful for health. However, the annual consumption of chocolate in Japan is only about 2 kg, which is about one fifth as large as the top three countries. In this research we consider a strategy to fill this gap of one fifth. In this research, attention was paid to students (university students/graduate students), and in this research, chocolate products of a confectionery company A, which provided data for analysis, we aim to increase in the sales volume consumed by students five-fold. Using the WEB quantitative survey conducted in June 2013 (raw data), we analyzed the two points of students’ ‘good image for chocolate’ and ‘information source for chocolate’, by using the correspondence analysis method. The analysis of the ‘good image for chocolate’ is plotted near the university students, in respect to the college student, and the category ‘easy to carry ∙ suitable for distribution’ is plotted in the vicinity and ‘a substitute for meal’ was plotted in the vicinity of the category of graduate students. In addition, the analysis result of ‘information source for chocolate’ shows that categories such as ‘Reputation’, ‘SNS’, ‘video sites’ are plotted in the vicinity of ‘college students’ and near ‘graduate students’ are ‘Advertisement’, ‘Radio CMs’ plotted. From the above results, we set up three hypotheses; place importance on friendship compared to other occupations, graduate students live such a busy student life that they save meal time, and students tend to dislike physical advertisements which are conveyed with letters, that is, they prefer digital information and auditory information. Based on the above analysis results and hypothesis, we developed a product of tablet type chocolate (10 capsules) referring to ‘a Bottle type package of a breath-care product of A company’, and appointed YouTubers as a video advertisement medium. The amount of contents of the product advertised is 27.4 g, and if one package can be consumed, per day, the goal of increasing the annual consumption by five-fold can be achieved. Moreover, by advertising on YouTube, it is possible to reduce advertising expenses, and that you can draw interest of students through the effect of YouTubers popular among students. If we provide rental service of tablet type chocolate replacement servers and increase the number of variations of bottle type chocolate, as an increasing sales promotion plan, we can promote the habit of eating chocolate every day without ending the proposed product with a temporary trend. Since it is a problem that there is an idea which incurs expenses in the promotion plan, we need to carry out the sales promotion plan step by step. Then, even if the sales target is not reached, the deficit can be minimized by stopping the product development. In this way, we aim to increase the Japanese chocolate consumption by 5 times from a long-term perspective.
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The aging process is associated with the gradual decline of several cognitive functions, and working memory is particularly affected. Although the majority of older adults experience a deterioration of their working memory, some individuals maintain their working memory in older age, and some suffer an extreme deterioration of their working memory. The purpose of the present study was to identify, among a total of 120 potential predictors, those that significantly contributed to these two extreme outcomes in working memory. A sample of 588 healthy adults was examined with the n-back task in the spatial and verbal domains using a 2-back level of difficulty. Individuals were classified as working memory maintainers or decliners if their discrimination level in the two domains was superior to the 80th percentile or inferior to the 20th percentile, respectively. Logistic regression identified eight and six significant predictors of working memory maintenance and decline, respectively. High vocabulary scores and smoking more were significant predictors of working memory maintenance; however, in the opposite direction, these same variables predicted working memory decline. Several consumption habits that influenced cerebrovascular function were found in both models. Psychological traits and everyday activities were present in both models. We identified specific predictors that contribute to extremely high or low working memory performance in older age.
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Evidence has implicated oxidative stress (OS) and inflammation as drivers of neurodegenerative pathologies. We previously reported on the beneficial effects of (−)-epicatechin (Epi) treatment on aging-induced OS and its capacity to restore modulators of mitochondrial biogenesis in the prefrontal cortex of 26-month-old male mice. In the present study using the same mouse model of aging, we examined the capacity of Epi to mitigate hippocampus OS, inflammation, hyperphosphorylation of tau protein, soluble β-amyloid protein levels, cell survival, memory, anxiety-like behavior levels and systemic inflammation. Mice were subjected to 4 weeks of Epi treatment (1 mg kg⁻¹ day⁻¹) and samples of the hippocampus were obtained. Assessments of the OS markers, protein carbonyls, and malondialdehyde levels demonstrated their significant increase (∼3 fold) with aging that were partially suppressed by Epi. The protein levels of the glial fibrillary acidic protein, inflammatory factor 1 (Iba1), pro-inflammatory cytokines, interleukins (IL-1β, IL-3, 5, 6 and 15), cyclooxygenase 2, tumor necrosis factor α, nuclear factor-activated B cells and interferon γ increase with aging and were also significantly decreased with Epi treatment. However, anti-inflammatory cytokines, IL-1ra, IL-10 and 11 decrease with aging and were restored with Epi. Epi also reversed the aging effects on the hyperphosphorylation of tau, increased soluble β-amyloid levels (∼2 fold), cellular death (as per caspase 3 and 9 activity), and reduced nerve growth factor and triggering receptor expressed on myeloid cells 2 levels. Measures of anxiety like-behavior and memory demonstrated improvements with Epi treatment. Indicators of systemic inflammation increase with aging and Epi was capable of decreasing blood inflammatory markers. Altogether, the results show a significant capacity of Epi to mitigate hippocampus OS and inflammation leading to improved brain function.
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Cognitive decline can occur with normal ageing and in age‐related brain disorders, such as mild cognitive impairment and dementia, including Alzheimer's disease, with limited pharmacological therapies available. Other approaches to reduce cognitive decline are urgently needed, and so the role of dietary interventions or nutraceuticals has received much attention in this respect. In this review, we examine the evidence for dietary plants and their chemical constituents as nutraceuticals, relevant to both cognitive decline in normal ageing and in dementia. Pharmacological (in vitro and in vivo), clinical and epidemiological evidence is assessed for both frequently consumed plants and their dietary forms, including tea, coffee, cocoa (chocolate), red wine, grapes, citrus and other fruits; in addition to plants used less frequently in certain diets, and that cross the blurred boundaries between foods, nutraceuticals and medicinal plants. For the latter, turmeric, saffron, sage, rosemary and lemon balm are examples of those discussed.
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Objectives The aim of this research was to evaluate the effects of adding 10 g of cocoa-rich chocolate (99%) to the habitual diet on cognitive performance in postmenopausal women. Methods Following a randomised controlled parallel clinical trial, a total of 140 postmenopausal women aged 50–64 were recruited. The intervention group (n = 73) consumed daily 10 g of chocolate (99% cocoa) in addition to their usual food intake for 6 months, whereas the control group (n = 67) did not receive any intervention. Attention and executive functions, verbal memory, working memory, phonological fluency, category fluency and clinical variables were assessed at baseline and 6 months. Results Trail Making Test B execution time showed a decreased of −12.08 s (95% CI: −23.99, −0.18; p = 0.047) in the intervention group compared to the control group, after adjusting for age, educational level, time elapsed from the beginning of menopause and daily energy consumption (Cohen’s d = −0.343). Attention, immediate or delayed verbal memory, phonological or category fluency, and working memory remained unchanged. Conclusions The consumption of cocoa-rich (99%) chocolate in addition to the habitual diet could be related to a slight improvement in cognitive performance regarding cognitive flexibility and processing speed in postmenopausal women, with no changes in the rest of the cognitive performance variables evaluated.Trial registration: This clinical trial has been registered at clinicaltrials.gov as NCT03492983.
Chapter
Bioactive compounds found naturally in fruits, vegetables, and other plant sources, are essential for human health due to their beneficial properties, acting as an antioxidant and for the prevention and amelioration of cardiovascular and metabolic diseases. However, these compounds are unstable when in contact with adverse conditions (e.g., high temperatures, light, presence of oxygen), and mostly exhibit low bioavailability, which makes their handling and application in food products more challenging. Probiotics are also prone to degradation and their incorporation into food products is not straightforward. They are live microorganisms that exhibit health benefits when ingested in adequate amounts which means they have to survive adverse conditions during food processing, storage, and digestion to exert their effects in vivo. An alternative to minimize the degradation and enable the broad application of bioactive compounds and probiotic cells is through nano/microencapsulation. This chapter aims to briefly review the main nano/microencapsulation techniques applied to oil/fat-based systems (e.g., emulsion having oil as a continuous phase) and characterization methods and to summarize recent studies on the incorporation of these systems in fat-based products, such as chocolate, cheese, among others. An overview of the challenges and future trends of these types of products is also provided.
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Epicatechin (EC), a flavonoid present in various foods including cocoa, dark chocolate, berries, and tea, was recently reported to promote general health and survival of old mice fed a standard chow diet. This is considered a novel discovery in the field of identifying natural compounds to extend lifespan, given that presumably popular anti-aging natural agents including resveratrol, green tea extract, and curcumin had failed in extending the lifespan of standard chow-diet-fed mice. However, the anti-aging mechanism of EC is not fully understood, thus impeding the potential application of this natural compound in improving healthy lifespan in humans. In this review, we first summarized the main dietary sources that contains significant amount of EC and recent research regarding the absorption, metabolism and distribution of EC in humans and rodents. The review is then focused on the anti-aging effects of EC in cultured cells, animals and humans with the possible physiological, cellular and molecular mechanisms underlying its lifespan-extending effects.
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Введение. Ишемическая болезнь сердца является одной из основных причин развития хронической сердечной недостаточности. Хроническая сердечная недостаточность является независимым фактором риска развития изменений головного мозга, когнитивной дисфункции и нарушений психоэмоциональной сферы у пациентов с ишемической болезнью сердца. Наряду с медикаментозной терапией у данных пациентов активно изучается возможность немедикаментозных способов коррекции нарушений в работе центральной нервной системы. В ряде ранее проведенных исследований было отмечено положительное влияние компонентов какао на показатели когнитивной сферы (память, внимание, скорость реакции) и на психоэмоциональный статус, однако именно среди пациентов с хронической сердечной недостаточностью ишемического генеза клинических испытаний для оценки воздействия потребления шоколада проведено ограниченное количество.Цель. В пилотном исследовании изучить влияние приема горького и молочного шоколада на показатели психоэмоционального статуса и когнитивные функции у пациентов с хронической сердечной недостаточностью ишемического генеза.Материалы и методы. Пациенты до 65 лет, у которых была выявлена и подтверждена хроническая сердечная недостаточность II–III функциональных классов ишемического генеза, случайным образом распределялись в группы, принимавшие ежедневно по 20 граммов горького или молочного шоколада (20 и 22 пациента соответственно), и в группу контроля (23 пациента). Оценка психоэмоционального статуса на визите скрининга и заключительном визите через 12 недель проводилась посредством теста Макса Люшера, госпитальной шкалы тревоги и депрессии HADS. Когнитивный статус оценивался с помощью субтестов Векслера 5 и 7 и корректурной пробы Бурдона. Для контроля безопасности использовались электрокардиография, общий и биохимический анализ крови, включая глюкозу крови натощак.Результаты. Только в группе пациентов, получавших горький шоколад, через 12 недель произошло статистически достоверное улучшение показателей субтестов Векслера 5 и 7 и увеличение скорости выполнения корректурной пробы Бурдона.Пациенты, принимавшие как горький, так и молочный шоколад, при выполнении теста Люшера, достоверно чаще стали выбирать основные цвета на первую позицию, а не основные – на последнюю, что свидетельствует об улучшении их эмоционального состояния. В группе пациентов, принимавших горький шоколад, достоверно чаще первым был выбран зеленый цвет, что может отражать увеличение волевого компонента и стрессоустойчивости. В группе пациентов, употреблявших молочный шоколад, отмечалась лишь тенденция в выборе зеленого цвета на 1-ю позицию. В контрольной группе выбор цветов у части пациентов повторял результаты скринингового теста либо наблюдалась тенденция к изменению цветовых предпочтений в сторону темных и ахроматических цветов.Согласно госпитальной шкале HADS уровни тревоги и депрессии достоверно не изменились, вне зависимости от приема шоколада.Заключение. Горький шоколад, очевидно, положительно влияет на когнитивные функции у пациентов с нетяжелой хронической сердечной недостаточностью ишемического генеза. Употребление горького и молочного шоколада у пациентов с хронической сердечной недостаточностью может улучшать их эмоциональный статус. Introduction. Coronary heart disease is one of the main causes of chronic heart failure. Chronic heart failure is an independent risk factor of development of brain changes, cognitive dysfunction, and psychoemotional disorders in patients with coronary heart disease. Along with drug therapy, in these patients, the possibility of non-drug methods of correcting disorders of the central nervous system is actively studied. A number of previous studies have shown a positive effect of cocoa components on cognitive indicators (memory, attention, speed of reaction) and on psychoemotional status. However, in patients with chronic heart failure of ischemic origin, there is a limited number of clinical trials conducted to assess the impact of chocolate consumption.Purpose. To examine the effect of dark and milk chocolate on the indicators of psychoemotional status and cognitive function in patients with chronic heart failure of ischemic origin (in the pilot study).Materials and methods. Patients under the age of 65, who were diagnosed with and confirmed chronic heart failure of the II-III functional classes of ischemic genesis were randomly distributed to the groups, taking 20 grams of bitter or milk chocolate daily (20 and 22 patients, respectively), and to the control group (23 patients). Patients in the first group received 20 grams of bitter chocolate daily for 12 weeks, and the second group received 20 grams of milk chocolate. Analysis of the psycho- emotional status at the screening visit and the final visit in 12 weeks was carried out using the Max Luscher test, the hospital anxiety and depression scale HADS. Cognitive status was assessed using the Wechsler subtests 5 and 7 and the Bourdon proof test. For safety monitoring, electrocardiogram, general and biochemical blood tests were used, including fasting blood glucose.Results. Only in the group of patients, who received dark chocolate, in 12 weeks, a statistically significant improvement of the Wechsler subtests 5 and 7 and the increase of the speed of the Bourdon proofreading test occurred.Patients who received both bitter and milk chocolate were significantly more likely to choose primary colors in the first position in the Luscher test, and non-primary – in the last, which indicates an improvement of the emotional background. Among patients, who took dark chocolate, green was chosen the first significantly more often, which may reflect the increase of the volitionalcomponent and stress resistance. In those who took milk chocolate, there was only the tendency in choosing green color in the 1st position. In the control group, the choice of colors in some patients repeated the results of the screening test, or there was a tendency to change color preferences towards dark and achromatic colors.According to the hospital scale HADS, anxiety and depression did not change significantly, regardless of chocolate intake.Conclusion. The use of bitter and milk chocolate in patients with heart failure can improve their emotional status; dark chocolate has a positive effect on cognitive function in patients with heart failure of ischemic origin.
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Recent evidence has indicated that flavanol consumption may have many health benefits in humans, including improved cognitive activities. The aim was to evaluate the effect of flavanol consumption on cognitive performance in cognitively intact elderly subjects. This was a double-blind, controlled, parallel-arm study conducted in 90 elderly individuals without clinical evidence of cognitive dysfunction who were randomly assigned to consume daily for 8 wk a drink containing 993 mg [high flavanol (HF)], 520 mg [intermediate flavanol (IF)], or 48 mg [low flavanol (LF)] cocoa flavanols (CFs). Cognitive function was assessed at baseline and after 8 wk by using the Mini-Mental State Examination (MMSE), the Trail Making Test (TMT) A and B, and the Verbal Fluency Test (VFT). The changes in MMSE score in response to the 3 different treatments were not different. In contrast, there was a positive impact of the intervention on specific aspects of cognitive function. Mean changes (±SEs) in the time required to complete the TMT A and B after consumption of the HF (-8.6 ± 0.4 and -16.5 ± 0.8 s, respectively) and IF (-6.7 ± 0.5 and -14.2 ± 0.5 s, respectively) drinks significantly (P < 0.0001) differed from that after consumption of the LF drinks (-0.8 ± 1.6 and -1.1 ± 0.7 s, respectively). Similarly, VFT scores significantly improved among all treatment groups, but the magnitude of improvement in the VFT score was significantly (P < 0.0001) greater in the HF group (7.7 ± 1.1 words/60 s) than in the IF (3.6 ± 1.2 words/60 s) and LF (1.3 ± 0.5 words/60 s) groups. Significantly different improvements in insulin resistance (P < 0.0001), blood pressure (P < 0.0001), and lipid peroxidation (P = 0.001) were also observed for the HF and IF groups in comparison with the LF group. Changes in insulin resistance explained ∼17% of changes in composite z score (partial r(2) = 0.1703, P < 0.0001). This dietary intervention study provides evidence that regular CF consumption can reduce some measures of age-related cognitive dysfunction, possibly through an improvement in insulin sensitivity. These data suggest that the habitual intake of flavanols can support healthy cognitive function with age. This trial was registered at www.controlled-trials.com as ISRCTN68970511. © 2015 American Society for Nutrition.
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Objectives: Few studies have examined whether cognitive function predicts dietary intake. The majority of research has focused on how diet can influence cognitive performance or risk for cognitive impairment in later life. The aim of this study was to examine prospective relationships between cognitive performance and dietary intake in participants of the Maine-Syracuse Longitudinal Study. Design: A prospective study with neuropsychological testing at baseline and nutritional assessments measured a mean of 18 years later. Setting: Community-dwelling individuals residing in central New York state. Participants: 333 participants free of dementia and stroke. Measurements: The Wechsler Adult Intelligence Scale (WAIS) was assessed at baseline and dietary intake was measured using the Nutrition and Health Questionnaire. Results: Higher WAIS Scores at baseline were prospectively associated with higher intakes of vegetables, meats, nuts and legumes, and fish, but inversely associated with consumption of total grains and carbonated soft drinks. After adjustment for sample selection, socioeconomic indicators, lifestyle factors (smoking and physical activity), and cardiovascular risk factors, the relations between higher cognitive performance and greater consumption of vegetables, meat, and fish, and lower consumption of grains remained significant. Conclusion: These data suggest that cognition early in life may influence dietary choices later in life. http://www.jpreventionalzheimer.com/current-issue.html
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Validation of Food frequency questionnaire (FFQ) is particularly important element, as incorrect information may lead to false associations between dietary factors and diseases. The aim of the study was to evaluate the validity of the FFQ used in NESCAV (Nutrition, Environment and Cardiovascular Health) study, by comparing the estimated intakes of fruits and vegetables and of several micro-nutrients with corresponding nutritional biomarkers. Relative validity was assessed in a sample of 922 subjects (452 men and 470 women). Comparisons between FFQ-estimates and their corresponding biomarkers were performed through correlation and cross classification into quintiles by using both crude and energy-adjusted FFQ-estimates. Correlations adjusted for confounders were also computed. All analyses were performed separately for men and women. Concerning micro-nutrients, significant correlations were found for vitamin B9, D, E, B12 beta-carotene and iodine in both men and women. Energy-adjustment led to an increase of all correlations cited previously. However, after excluding supplement users, correlations for vitamin D were not significant anymore. Concerning fruits and vegetables, all correlations were significant. Vegetables alone and fruits and vegetables correlated better in men (r around 0.2) than in women (r around 0.1). In men, correlation was also better for vegetables alone and fruits and vegetables than fruits alone. These data demonstrate that this FFQ is a reasonable tool to assess intakes of fruits and vegetables and of several micro-nutrients. We conclude that our FFQ is suitable to be used in NESCAV study, although protein and vitamin D estimates should be interpreted with caution.
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This review explores the possibility that central actions of flavanol-rich cocoa-derived products are of benefit in the prevention and treatment of mood disorders. Flavanol-rich cocao-derived products have been studied in both neuromolecular and psychological tests. Neuromolecular effects of flavanols in cocoa-derived products include antioxidant, vasodilatory, anticoagulant, and antiinflammatory properties that may serve to counteract depressive brain disorders. Psychological studies in humans have described links between intake of flavanol-rich cocoa-derived products such as dark chocolate and improved mood, while behavioral studies in laboratory animals have reported antidepressant effects of flavanols. It is therefore likely that flavanol-rich cocoa-derived products such as dark chocolate may have beneficial effects as add-on items together with traditional antidepressant regimes.
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Habitual chocolate intake was recently found to be associated with lower body weight in three cross-sectional epidemiological studies. Our objective was to assess whether these cross-sectional results hold up in a more rigorous prospective analysis. We used data from the Atherosclerosis Risk in Communities cohort. Usual dietary intake was assessed by questionnaire at baseline (1987-98), and after six years. Participants reported usual chocolate intake as the frequency of eating a 1-oz (∼28 g) serving. Body weight and height were measured at the two visits. Missing data were replaced by multiple imputation. Linear mixed-effects models were used to evaluate cross-sectional and prospective associations between chocolate intake and adiposity. Data were from 15,732 and 12,830 participants at the first and second visit, respectively. More frequent chocolate consumption was associated with a significantly greater prospective weight gain over time, in a dose-response manner. For instance, compared to participants who ate a chocolate serving less often than monthly, those who ate it 1-4 times a month and at least weekly experienced an increase in Body Mass Index (kg/m2) of 0.26 (95% CI 0.08, 0.44) and 0.39 (0.23, 0.55), respectively, during the six-year study period. In cross-sectional analyses the frequency of chocolate consumption was inversely associated with body weight. This inverse association was attenuated after excluding participants with preexisting obesity-related illness. Compared to participants without such illness, those with it had higher BMI and reported less frequent chocolate intake, lower caloric intake, and diets richer in fruits and vegetables. They tended to make these dietary changes after becoming ill. Our prospective analysis found that a chocolate habit was associated with long-term weight gain, in a dose-response manner. Our cross-sectional finding that chocolate intake was associated with lower body weight did not apply to participants without preexisting serious illness.
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Background Limited information is available regarding the impact of candy consumption on health. The purpose of this study was to investigate associations between typical frequency of candy consumption and body weight status and select cardiovascular risk factors among adults in the United States. Methods Using data collected in the 2003–2006 National Health and Nutrition Examination Surveys (NHANES), adults were categorized as infrequent (≤ 3 eating occasions [EO]/month), moderate (> 3 EO/month and ≤ 3.5 EO/week), or frequent (> 3.5 EO/week) candy consumers based on the combined frequency of chocolate and other candy consumption over the previous 12 months. Weight and adiposity status were analyzed using logistic regression models, and blood pressure, lipids, and insulin sensitivity were analyzed using linear regression models. Models were adjusted for age, sex and race/ethnicity, and also for additional covariates with potential associations with the outcomes. Appropriate statistical weights were used to yield results generalizable to the US population. Results Frequency of candy consumption was not associated with the risk of obesity, overweight/obesity, elevated waist circumference, elevated skinfold thickness, blood pressure, low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol, triglycerides, or insulin resistance. Increased frequency of candy consumption was associated with higher energy intakes and higher energy adjusted intakes of carbohydrates, total sugars and added sugars, total fat, saturated fatty acids and monounsaturated fatty acids (p < 0.05), and lower adjusted intakes of protein and cholesterol (p < 0.001). Conclusions Increased frequency of candy consumption among adults in the United States was not associated with objective measures of adiposity or select cardiovascular risk factors, despite associated dietary differences. Given the cross-sectional study design, however, it cannot be concluded that candy consumption does not cause obesity or untoward levels of cardiovascular risk markers. The lack of an association between frequency of candy consumption and cardiovascular risk factors could be due to reduced intake of candy among the overweight due to dieting or a health professional’s recommendations. Additionally, it is important to note that the analysis was based on frequency of candy consumption and not amount of candy consumed. Longitudinal studies are needed to confirm the lack of associations between frequency of candy consumption and cardiovascular risk factors.
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The objective of the present study was to determine the proportion of adults meeting national recommendations for food and nutrient intake and to identify the demographic, socio-economic and behavioural factors that may contribute to weaken dietary compliance. ORISCAV-LUX is a cross-sectional study that took place in Luxembourg (2007-8). A representative stratified random sample of 1352 adults aged 18-69 years participated in the nationwide cardiovascular health survey. A FFQ was used to estimate food intake. Radar charts were built to compare graphically the compliance of the participants with different key dietary guidelines on the same set of axes. The thirteen food- and nutrient-based recommendations were scored and summed to create a recommendation compliance index (range - 0·5 to 14). Ordinal logistic regression analyses were performed to determine the factors contributing to poor dietary compliance. Several food- and nutrient-based guidelines were insufficiently respected compared with others. The greatest gaps occurred in the adherence to grain and dairy product consumption guidelines, as well as to total fat and notably to SFA recommendations. Age, country of birth, economic status, smoking status and subject's awareness of the importance of balanced meals emerged as independently associated with weak dietary compliance. Obese subjects conformed more to dietary recommendations compared with normal-weight subjects. The findings underscore the need for specific nutrition education messages along with targeted interventions. Efforts should be continued to increase population awareness of the importance of a healthy lifestyle and a balanced diet.
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Evidence in support of the neuroprotective effects of flavonoids has increased significantly in recent years, although to date much of this evidence has emerged from animal rather than human studies. Nonetheless, with a view to making recommendations for future good practice, we review 15 existing human dietary intervention studies that have examined the effects of particular types of flavonoid on cognitive performance. The studies employed a total of 55 different cognitive tests covering a broad range of cognitive domains. Most studies incorporated at least one measure of executive function/working memory, with nine reporting significant improvements in performance as a function of flavonoid supplementation compared to a control group. However, some domains were overlooked completely (e.g. implicit memory, prospective memory), and for the most part there was little consistency in terms of the particular cognitive tests used making across study comparisons difficult. Furthermore, there was some confusion concerning what aspects of cognitive function particular tests were actually measuring. Overall, while initial results are encouraging, future studies need to pay careful attention when selecting cognitive measures, especially in terms of ensuring that tasks are actually sensitive enough to detect treatment effects.
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