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Publication type: Editorial commentary. Ceballos and Villarreal (2011) discuss a separate randomized trial of acute cocoa-flavanol effects on vascular function in older adults. This article is not itself a clinical trial and should not be interpreted as direct evidence that (−)-epicatechin supplements prevent cardiovascular disease.
In this issue of the Journal of Applied Physiology, Monahan et al. (3) report on the results of a randomized, double-blind, placebo-controlled study indicating that acute cocoa ingestion dose dependently increases brachial artery flow-mediated dilation in healthy older adults. It is well known that in older individuals vascular reactivity is diminished partly due to endothelial dysfunction. Thus approaches that can restore normal endothelial reactivity if sustained over time, are likely to translate into improved cardiovascular health. The population studied (23 subjects) were of an average age of 63 yr and normotensive. The study utilized five different formulations of a low-calorie (∼100 kcal) cocoa beverage, where most of the constituents (except total polyphenol, flavan 3-ols, and procyanidins content) were held constant. As polyphenol content increased (from 330 to 1,470 mg), the concentration of suspect bioactive molecules (the flavanols catechin and epicatechin) also increased. Concentrations varied from 0 to 48 mg of catechin and 0 to 96 mg of epicatechin. In a random and blinded manner, all of the subjects were provided each of the five different formulations, thus generating responses that should be internally consistent. Beverages were only given once, thus the responses generated were of acute nature.
