OBJECTIVES: Our goal was to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabetic patients. BACKGROUND: Even in fully medicated diabetic patients, overall prognosis is unfavorable due to deteriorated cardiovascular function. Based on epidemiological data, diets rich in flavanols are associated with a reduced cardiovascular risk. METHODS: In a feasibility study with 10 diabetic patients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability after an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75, 371, and 963 mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabetic patients were assessed after a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321 mg flavanols per dose) or a nutrient-matched control (25 mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Primary and secondary outcome measures included changes in FMD and plasma flavanol metabolites, respectively. RESULTS: A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2 h: from 3.7 +/- 0.2% to 5.5 +/- 0.4%, p < 0.001). A 30-day, thrice-daily consumption of flavanol-containing cocoa increased baseline FMD by 30% (p < 0.0001), while acute increases of FMD upon ingestion of flavanol-containing cocoa continued to be manifest throughout the study. Treatment was well tolerated without evidence of tachyphylaxia. Endothelium-independent responses, blood pressure, heart rate, and glycemic control were unaffected. CONCLUSIONS: Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease.
RCT Entities:
OBJECTIVES: Our goal was to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabeticpatients. BACKGROUND: Even in fully medicated diabeticpatients, overall prognosis is unfavorable due to deteriorated cardiovascular function. Based on epidemiological data, diets rich in flavanols are associated with a reduced cardiovascular risk. METHODS: In a feasibility study with 10 diabeticpatients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability after an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75, 371, and 963 mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabeticpatients were assessed after a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321 mg flavanols per dose) or a nutrient-matched control (25 mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Primary and secondary outcome measures included changes in FMD and plasma flavanol metabolites, respectively. RESULTS: A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2 h: from 3.7 +/- 0.2% to 5.5 +/- 0.4%, p < 0.001). A 30-day, thrice-daily consumption of flavanol-containing cocoa increased baseline FMD by 30% (p < 0.0001), while acute increases of FMD upon ingestion of flavanol-containing cocoa continued to be manifest throughout the study. Treatment was well tolerated without evidence of tachyphylaxia. Endothelium-independent responses, blood pressure, heart rate, and glycemic control were unaffected. CONCLUSIONS: Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease.
Authors: Mary M McDermott; Michael H Criqui; Kathryn Domanchuk; Luigi Ferrucci; Jack M Guralnik; Melina R Kibbe; Kate Kosmac; Christopher M Kramer; Christiaan Leeuwenburgh; Lingyu Li; Donald Lloyd-Jones; Charlotte A Peterson; Tamar S Polonsky; James H Stein; Robert Sufit; Linda Van Horn; Francisco Villarreal; Dongxue Zhang; Lihui Zhao; Lu Tian Journal: Circ Res Date: 2020-02-14 Impact factor: 17.367
Authors: Katrina Go Yamazaki; Pam R Taub; Maraliz Barraza-Hidalgo; Maria M Rivas; Alexander C Zambon; Guillermo Ceballos; Francisco J Villarreal Journal: J Am Coll Cardiol Date: 2010-06-22 Impact factor: 24.094
Authors: Sonia F Shenoy; Alexandra G Kazaks; Roberta R Holt; Hsin Ju Chen; Barbara L Winters; Chor San Khoo; Walker S C Poston; C Keith Haddock; Rebecca S Reeves; John P Foreyt; M Eric Gershwin; Carl L Keen Journal: Nutr J Date: 2010-09-17 Impact factor: 3.271
Authors: Sonia F Shenoy; Walker Sc Poston; Rebecca S Reeves; Alexandra G Kazaks; Roberta R Holt; Carl L Keen; Hsin Ju Chen; C Keith Haddock; Barbara L Winters; Chor San H Khoo; John P Foreyt Journal: Nutr J Date: 2010-02-23 Impact factor: 3.271