Hazelnut and cocoa spread improves flow-mediated dilatation in smokers

The role of cocoa flavanols in modulating peripheral and cerebral microvascular function in healthy individuals and populations at-risk of cardiovascular disease: a systematic review

BACKGROUND

Cocoa flavanols (CFs) are polyphenolic molecules with proposed cardioprotective effects. Whilst extensive evidence supports their ability to ameliorate vasodilator responses within conduit vessels, their actions in the microvasculature are less clear. This systematic review of the literature aimed to determine whether CF interventions lead to improvements in microvascular vasodilator responses in healthy populations and those with increased cardiovascular disease risk.

METHODS

Database searches were conducted up to September 2023 using Medline, Embase, Pubmed and Web of Science Core Collection to identify randomised, placebo-controlled, human studies investigating the effect of CF interventions on the microvasculature (at rest and vasodilator responses). All studies were assessed for risk of-bias according to Cochrane Collaboration recommendations for randomised-controlled trials, data were extracted from studies and findings collated by vote-counting.

RESULTS

Searches identified 511 unique articles for screening, of which 19 were selected for data extraction. Vasodilator responses were enhanced in 85.7% (80.4-91.0%, p = 0.013) of all acute studies (n = 13), and in 81.8% (74.1-89.4%, p = 0.065) of studies in healthy subgroups (n = 11). Importantly, this effect was apparent in all studies with 'low risk of bias' (n = 8, p = 0.008). In contrast, there was no effect of acute CF interventions at rest. For chronic studies (n = 7), the effect of CFs was less clear, with a significant benefit reported at rest only, in all young, healthy subgroups (n = 7, p = 0.016), but no evidence of improvements in vasodilator responses.

CONCLUSIONS

CFs have the potential to improve microvascular function, particularly in healthy individuals, with benefits appearing more pronounced following acute CF supplementation. Despite this, interpretations are limited by the small number of comparable studies identified and the heterogeneity of populations studied. Overall, the effects of CFs on the microvasculature seem to be less consistent than previous evidence in the macrovasculature, suggesting that the microvessels may be less susceptible to the effect of CFs than conduit arteries.

REGISTRATION

The PROSPERO registration number for this review is CRD42023483814.

The Effect of Including Sea Buckthorn Berry By-Products on White Chocolate Quality and Bioactive Characteristics under a Circular Economy Context

The by-products of the extraction of sea buckthorn (Hippophae rhamnoides L.) concentrated juice may represent a functional food ingredient for white chocolate production, as a rich source of bioactive compounds. The effects of six treatments derived from the factorial combination of two types of by-products (with oil or without oil) and three different concentrations (5%, 10%, and 15%), were assessed on rheological, quality, colour, antioxidant, and mineral properties of chocolate. The 15% addition of full powder led to the highest values of max firmness, total shear energy, shear energy, cohesiveness, gummosity, dry matter, and ABTS, compared to the untreated control, but the two highest concentrations of the oil-deprived powder resulted in the protein content increasing. The full powder addition always raised fat levels. Both the 'L' and 'a' colour component as well as total carotenoids, β-carotene, lycopene, and vitamin C increased with the rise of H. rhamnoides powder addition, compared to the untreated control. The opposite trend was shown by the 'b' colour component and pH, whereas polyphenols and antioxidant activity attained higher values with the oil-deprived powder. The content of potassium decreased upon the 15% addition of the Hippophae rhamnoides by-product powder, compared to the untreated control, whereas calcium and magnesium increased. The 15% H. rhamnoides full powder elicited the augmentation of phosphorus content in chocolate, compared to the untreated control, contrary to the effect of the oil-deprived powder on P and Zn. The employment of SBB by-products highlights the great potential for manufacturing innovative functional foods with high nutritional value, such as chocolate.

Chocolate enriched by extra virgin olive oil improves endothelial function and oxidative stress in patients with diabetes

OBJECTIVE

Endothelial dysfunction and oxidative stress are among the most relevant mechanisms underlying the atherosclerotic process in patients with type 2 diabetes mellitus (T2 DM). Extra virgin olive oil (EVOO) reduces postprandial glycemia with a mechanism counteracting oxidative stress-mediated incretin down-regulation in healthy subjects and in patients with impaired fasting glucose. The aim of this study was to evaluate if the intake of chocolate enriched by EVOO had positive effects on endothelial function and oxidative stress in patients with T2 DM.

METHODS

In this study we enrolled and randomly assigned 25 consecutive patients with T2 DM to receive 40 g of EVOO-enriched chocolate or 40 g of control chocolate spread. Participants were assessed at baseline and 2 h after chocolate intake. Endothelial function was assessed by arterial brachial flow-mediated dilation (FMD); oxidative stress was evaluated by the measurement of serum nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-2 (Nox2) levels, nitric oxide availability, and serum hydrogen peroxide breakdown activity (HBA).

RESULTS

We observed a significant increase of FMD, nitric oxide (NO) availability, and HBA in the EVOO-enriched chocolate group (P < 0.001). Conversely, soluble Nox2-derived peptide (sNox2-dp) levels significantly decreased (P < 0.001). No significant change was observed in the control chocolate group. To assess the relation of EVOO-enriched chocolate to endothelial function and oxidative stress, a general linear model (GLM) analysis was performed; a significant difference for treatments was found with respect to FMD, NO availability, HBA, and sNox-dp.

CONCLUSIONS

Administration of 40 g of EVOO-enriched chocolate is associated with increased endothelial function and reduction of oxidative stress in patients with T2 DM. Future studies are needed to analyze the effect of chronic assumption of EVOO-enriched chocolate on vascular function, oxidative stress, and cardiovascular complications in patients with T2 DM.

Physico-chemical and sensory acceptability of no added sugar chocolate spreads fortified with multiple micronutrients

Vitamin D and magnesium-calcium carbonate nanoparticles were used to fortify a newly developed healthy chocolate spread formulated with inulin and maltitol as sugar replacers and alternative to palm oil to reduce the concentration of saturated fatty acid. These samples were compared with well-known commercially available chocolate spreads in terms of rheology, polyphenols content and in vitro digestion, sensory attributes and willingness to buy. The fortified chocolate spreads showed comparable if not better acceptability than the current products on the market and over 80% of the participants were inclined to buy and 66% prepared to spend 10 to 15% more money on the product enriched with the three micronutrients. The results also demonstrate that the incorporation of nanoparticles could affect the rheological and physio-chemical properties of the formulations and an appropriate ratio between the fat phase and particles seems an important factor to consider.

Impact of cocoa flavanols on human health

Cocoa is a source of flavanols, and these phenolic compounds exert beneficial effects on health and aging, and reduce the risk of suffering chronic diseases (cardiovascular diseases, metabolic disorders, cancer). An increasing body of evidence has emerged to suggest that cocoa flavanols potentially are important chemopreventive natural agents. This review summarizes human studies from the past two decades, providing data related to the effects derived from cocoa intake on health and disease. Most human studies have reported beneficial effects of cocoa consumption on health and chronic diseases; however, outcomes are not unequivocal. Review of human studies enable to identify different mechanisms of action for cocoa, although they are not fully understood at present. In addition, it remains unclear whether cocoa consumption should be recommended to healthy subjects or to patients and what is the appropriate dosage or duration of cocoa consumption. Elucidation of information regarding these crucial issues could lead to cocoa use as an approach for decreasing the risk of certain chronic diseases, as well as improving health and quality of life.

Role of Polyphenols and Carotenoids in Endothelial Dysfunction: An Overview from Classic to Innovative Biomarkers

Nowadays, the dramatically increased prevalence of metabolic diseases, such as obesity and diabetes mellitus and their related complications, including endothelial dysfunction and cardiovascular disease, represents one of the leading causes of death worldwide. Dietary nutrients together with healthy lifestyles have a crucial role in the endothelium health-promoting effects. From a growing body of evidence, active natural compounds from food, including polyphenols and carotenoids, have attracted particular attention as a complementary therapy on atherosclerosis and cardiovascular disease, as well as preventive approaches through the attenuation of inflammation and oxidative stress. They mainly act as radical scavengers by promoting a variety of biological mechanisms, such as improvements in endothelial function, blood pressure, platelet activity, and insulin sensitivity, and by modulating various known biomarkers. The present review highlights the role of polyphenols and carotenoids in early endothelial dysfunction with attention to their beneficial effect in modulating both classical and recent technologically generated emerging biomarkers. These, alone or in combination, can play an important role in the prediction, diagnosis, and evolution of cardiovascular disease. However, a main challenge is to speed up early and prompt new interventions in order to prevent or slow down disease progression, even with an adequate intake of bioactive compounds. Hence, there is an urgent need of new more validated, appropriate, and reliable diagnostic and therapeutic biomarkers useful to diagnose endothelial dysfunction at an earlier stage.

Oleuropein-enriched chocolate by extra virgin olive oil blunts hyperglycaemia in diabetic patients: Results from a one-time 2-hour post-prandial cross over study

BACKGROUND & AIMS

Oleuropein, a component of extra virgin olive oil (EVOO), reduces post-prandial glycemia with a mechanism counteracting oxidative stress-mediated incretin down-regulation. In this study we evaluated if the intake of an oleuropein-enriched chocolate could have positive effects on glycaemia and insulin levels in patients with type 2 diabetes mellitus (T2DM) and healthy subjects (HS).

METHODS

Twenty-five consecutive T2DM patients and 20 HS were recruited. Participants were randomized to receive 40 g oleuropein-enriched chocolate by EVOO or 40 g control chocolate spread in a cross-over design. Serum glucose, insulin, glucagon-like peptide-1 (GLP1), and dipeptidyl-peptidase-4 (DPP4) were measured before and 2 h after chocolate intake.

RESULTS

In T2DM, the pairwise comparisons showed that intake of oleuropein-enriched chocolate was associated with a significantly less increase of blood glucose compared to control; GLM analysis showed a significant difference for treatments with respect to glucose (p = 0.04), GLP1 (p < 0.001) and DPP-4 activity (p = 0.01). In HS, the pairwise comparisons showed that, after oleuropein-enriched chocolate intake, blood glucose concentration and DPP4 activity did not change; conversely a significant increase was observed for insulin and GLP1. After control chocolate intake, a significant increase for blood glucose, insulin levels and DPP4 activity were observed while GLP1 did not change.

CONCLUSION

The study shows that using EVOO as source of oleuropein administration of 40 g oleuropein-enriched chocolate is associated with a modest increase or no change of glycemia in T2DM and HS respectively, via an incretin-mediated mechanism.

A Micromethod for Polyphenol High-Throughput Screening Saves 90 Percent Reagents and Sample Volume

There is ample evidence that polyphenols are important natural substances with pronounced antioxidative properties. This study aimed to develop a fast and reliable method to determine total polyphenol content (TPC) in foodstuffs and human samples. The microtitration format offers the advantage of low sample volumes in the microlitre range, facilitating high-throughput screening with 40 samples simultaneously. We accordingly adjusted the so-called Folin–Ciocalteu method to a microtitre format (polyphenols microtitre—PPm) with 90% reduction of reagents. The assay was standardized with gallic acid in the range between 0.1 and 3 mM, using a 20 µL sample volume. The intra-assay coefficient of variation (CV) was less than 5%, and inter-assay CV was in the range of 10%. Wavelength was measured at 766 nm after two hours of incubation. This micromethod correlates significantly with both the classical Folin–Ciocalteu method and High-Performance Thin-Layer Chromatography (HPTLC) (r² = 0.9829). We further observed a significant correlation between PPm and total antioxidants (r² = 0.918). The highest polyphenol concentrations were obtained for red, blue, and black fruits, vegetables, and juices. Extracts of red grapes could be harvested almost sugar free and might serve as a basis for polyphenol supplementation. Beer, flour, and bread contained polyphenol concentrations sufficient to meet the minimal daily requirement. We conclude that PPm is a sensitive and reliable method that detects polyphenols even in samples diluted 10-fold. The literature strongly recommends further investigations on the effects of polyphenol uptake on human and animal health.

The effect of cocoa consumption on markers of oxidative stress: A systematic review and meta-analysis of interventional studies

A number of studies have examined the beneficial effects of cocoa consumption on markers of oxidative stress in different population, however, the findings have been inconclusive. Herein, we systematically reviewed available interventional studies to elucidate the overall impact of cocoa consumption on markers of oxidative stress among adult population. PubMed, Cochrane's library, Science Direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until March 2019 for relevant studies. The Jadad scale was used to assess the quality of each study. A total of 48 studies out of 1402 met the inclusion criteria and were included in our systematic review and 16 of them were entered in meta-analysis. The pooled estimate from the random-effect model showed cocoa consumption significantly reduced malondialdehyde (SMD: -0.71; 95 % CI, -1.41 to -0.01; P = 0.048) and 8-iso-prostaglandin F2α (WMD: -43.76; 95 % CI, -76.25 to -11.28; P = 0.008) but not the other markers of oxidative stress. Our findings support the concept that cocoa consumption plays an important role in the human metabolic pathway through reducing the oxidative stress. In order to draw a firm link between cocoa and oxidative stress, more clinical trials with adequate sample size and sufficient follow-up periods are warranted.