Could Cocoa Supplements Reduce Age-Related Inflammation?
Older adults taking cocoa extract supplements appeared to improve their heart health in a recent trial. But the research comes with some caveats.
Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.
Data from nearly 600 older adults found that participants who took this kind of supplement had significantly lower levels of an inflammation biomarker tied to age-related heart disease — suggesting cocoa has anti-inflammatory properties that may translate into heart-protective benefits, researchers say.
In a large initial investigation called COSMOS (the Cocoa Supplement and Multivitamin Outcomes Study), researchers randomly assigned more than 20,000 adults to receive either 500 milligrams (mg) of cocoa extract or a placebo (a dummy pill).
The study was supported in part by the supplement manufacturer Mars Edge and the pharmaceutical company Pfizer; each contributed materials and funding but weren’t involved in the trial design or analysis.
For the current study, the team looked at a subset of data from nearly 600 older adults to see whether the cocoa supplements would have any effect on five age-related biomarkers of inflammation.
They found that a marker tied to greater heart disease risk — called high-sensitivity C-reactive protein, or hsCRP — significantly decreased in participants who took a daily cocoa extract supplement.
The findings suggest cocoa supplements may encourage a decrease in “inflammaging,” or inflammation linked to aging, says the corresponding study author Howard Sesso, ScD, MPH, an associate director of preventive medicine and an associate epidemiologist at Brigham and Women’s Hospital in Boston.
Unfortunately, it’s not easy to get that much flavanol from standard chocolate or cocoa products on the market, Dr. Sesso says, because processing cocoa beans strips much of their flavanol content.
“Cocoa flavanol content is not found on food labels, but cocoa powder may be more likely to have modest amounts,” he says. “There are some cocoa extract supplements on the market, but they are not mainstream, so I would recommend initially focusing on flavanols as part of a broad plant-based healthy diet.”
People with a known allergy to cocoa shouldn’t take cocoa extract supplements. They also wouldn’t be appropriate for someone who is particularly sensitive to caffeine, because cocoa contains modest amounts of the similar mild stimulant called theobromine, Sesso explains.
The study design offers strengths in that it pulls from the COSMOS trial, which was large-scale, randomized, and double-blind — meaning the participants didn’t know which supplement they were taking. But as the researchers underscore, the findings were limited to older adults who remained healthy during the trial, and did not investigate changes in inflammation markers that might have led to heart disease.
Overall, there’s not enough conclusive evidence yet to determine exactly how cocoa extract products affect heart health, and there’s more investigation to be done, says Douglas Vaughan, MD, a professor of medicine in cardiology and the director of the Potocsnak Longevity Institute, which focuses on studying the biological changes associated with aging, at the Northwestern University Feinberg School of Medicine in Chicago.
“The research looks at biomarkers mostly related to inflammation, so that’s a limitation,” Dr. Vaughan says. “You can’t draw conclusions that this has an effect on aging, as they didn’t actually measure changes in aging of the vascular or other organ systems that might be reflective of a change in biological age, so it’s a limited perspective.”
The study suggests that a nutritious and flavanol-rich diet may support the heart and healthy aging.
“It is most important to focus on a healthy dietary pattern first, along with other known lifestyle and clinical risk factors for cardiovascular disease,” says Sesso. “We already have many tools to help prevent cardiovascular disease. No single food is most important; cocoa flavanols should be part of a broader healthy pattern of diet and other lifestyle factors.”
At the Human Longevity Lab at Northwestern, Vaughan says recommendations for extending lifespan and healthspan focus on evidence-based strategies: “One, exercise regularly. Two, get your weight to an optimal level, whatever that takes. And three, try to reduce stress in your life.”
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