Cocoa flavanols improve peakVO2 and exercise capacity in a randomized double blinded clinical trial in healthy elderly people.

2023
Food & function 14(16)
- Michael Gröne
- Dragos Andrei Duse
- Nicolas Kramser
- Niklas Ophoff
- Hendrik Schweers
- Fabian Voß
- Christine Quast
- Roberto Sansone
- Christian Heiss
- Christian Jung
- Malte Kelm
- Ralf Erkens

PubMed: 37526943
DOI: 10.1039/d3fo01737k

Study Design

Type: Randomized Controlled Trial (RCT)
Population: 68 healthy elderly people (55-79 years, 28 female)
Methods: randomized, double-masked, placebo-controlled, parallel-group dietary intervention trial; 500 mg of CF or a nutrient-matched control capsule twice a day for 30 days
Blinding: Double-blind
Duration: 30 days
Funding: Unclear

Rigorous Journal

Background: Loss of functional capacity is one of the hallmarks in cardiovascular aging. Cocoa flavanols (CF) exert favorable effects on endothelial function, blood pressure, and inflammation. These cardiovascular health markers worsen with increasing age and limit functional exercise capacity. Aim: To investigate the effect of CF on cardiorespiratory-fitness in healthy elderly people. Methods: In a randomized, double-masked, placebo-controlled, parallel-group dietary intervention trial, 68 healthy elderly people (55-79 years, 28 female) received either 500 mg of CF or a nutrient-matched control capsule twice a day for 30 days. Primary endpoint was defined as peak oxygen consumption (VO₂) in a cardiopulmonary exercise test (CPET). Secondary endpoints were oxygen pulse (VO₂ per heart rate (HR)), resting blood pressure (BP), and resting vascular function. Results: After 30 days of CF intake peakVO₂ increased by 190 ml min^-1 (95% CI 1-371 ml min^-1) and peakVO₂ per kg by 2.5 ml (min kg)^-1 (95% CI 0.30-4.2 ml (min kg)^-1). O₂-pulse increased by 1.7 ml (95% CI 0.29-3.2 ml) and max exercise capacity by 9.6 W (95% CI 2.1-17.7 W). CF decreased resting systolic and diastolic BP by 5.4 mmHg (95% CI -10.7 to -0.1 mmHg) and 2.9 mmHg (95% CI -5.5 to -0.4 mmHg), respectively. Flow-mediated vasodilation (FMD) increased by an absolute 1.3% (95% CI 0.76-1.79%) in the CF group. Indexes of pulmonary function were not affected. No changes for primary and secondary endpoints were detected in control. Conclusion: CF substantially improve markers of cardiorespiratory fitness in healthy elderly humans highlighting their potential to preserve cardiovascular health with increasing age.

Research Insights

Cocoa→Improved Exercise Capacity
O2-pulse increased by 1.7 ml (95% CI 0.29-3.2 ml) and max exercise capacity by 9.6 W (95% CI 2.1-17.7 W).
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Cocoa→Improved Flow-Mediated Vasodilation
Flow-mediated vasodilation (FMD) increased by an absolute 1.3% (95% CI 0.76-1.79%) in the CF group.
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Cocoa→Improved Oxygen Pulse
O2-pulse increased by 1.7 ml (95% CI 0.29-3.2 ml) and max exercise capacity by 9.6 W (95% CI 2.1-17.7 W).
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Cocoa→Improved Peak Oxygen Consumption
After 30 days of CF intake peakVO2 increased by 190 ml min-1 (95% CI 1-371 ml min-1) and peakVO2 per kg by 2.5 ml (min kg)-1 (95% CI 0.30-4.2 ml (min kg)-1).
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Cocoa→Improved Pulmonary Function
Indexes of pulmonary function were not affected.
Effect
Neutral
Effect size
Small
Dose
500 mg twice daily
Cocoa→Reduced Diastolic Blood Pressure
CF decreased resting systolic and diastolic BP by 5.4 mmHg (95% CI -10.7 to -0.1 mmHg) and 2.9 mmHg (95% CI -5.5 to -0.4 mmHg), respectively.
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Cocoa→Reduced Systolic Blood Pressure
CF decreased resting systolic and diastolic BP by 5.4 mmHg (95% CI -10.7 to -0.1 mmHg) and 2.9 mmHg (95% CI -5.5 to -0.4 mmHg), respectively.
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily