Effects of Cocoa Consumption on Cardiometabolic Risk Markers: Meta-Analysis of Randomized Controlled Trials

Abstract

Background: We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and blood pressure levels in adults, with and without comorbidities. Methods: The databases used were MEDLINE (PubMed), EMBASE, Web of Science, Cochrane, LILACS, and SciELO. The eligible studies were randomized clinical trials (RCTs) involving adults undergoing cocoa consumption (cocoa extract or ≥70% cocoa dark chocolate) for ≥4 weeks that evaluated at least one of the following markers: body weight, body mass index (BMI), waist/abdominal circumference, total cholesterol, LDL-c, triglycerides, HDL-c, blood glucose, glycated hemoglobin (HbA1c), and systolic and diastolic blood pressure (SBP/DBP). Results: Thirty-one studies were included, totaling 1986 participants. Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c. Yet, there was a reduction in total cholesterol (−8.35 mg/dL, 95% CI −14.01; −2.69 mg/dL), LDL-c (−9.47 mg/dL, 95% CI −13.75; −5.20 mg/dL), fasting blood glucose (−4.91 mg/dL, 95% CI −8.29; −1.52 mg/dL), SBP (−2.52 mmHg, 95% CI −4.17; −0.88 mmHg), and DBP (−1.58 mmHg, 95% CI −2.54; −0.62 mmHg). Conclusions: The consumption of cocoa showed protective effects on major cardiometabolic risk markers that have a clinical impact in terms of cardiovascular risk reduction.

Keywords

• cocoa
• polyphenols
• obesity
• dyslipidemia
• fasting glucose
• blood pressure