Study Title: Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial
Citation: Manson et al., 2022 · American Journal of Clinical Nutrition
What the Study Found: In a large randomized trial, cocoa flavanol supplementation (containing high levels of (−)-epicatechin) significantly reduced total cardiovascular events compared with placebo. It lowered the composite endpoint of myocardial infarction, stroke, and cardiovascular death. The effect was independent of the multivitamin arm of the study.
What this means in real life: Cardiovascular events often begin with mitochondrial dysfunction in the vascular wall and heart muscle, leading to oxidative damage and inflammation. This landmark trial demonstrates that consistent (−)-epicatechin/flavanol intake can meaningfully lower the risk of major heart events. Mitochondrial support through flavanols is therefore a practical, evidence-based strategy for protecting long-term cardiovascular energy and resilience.
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