The sweet side of dark chocolate for chronic kidney disease patients

Protect the Kidneys and Save the Heart Using the Concept of Food as Medicine

Chronic kidney disease is a significant risk factor for cardiovascular disease. In addition to traditional risk factors, such as hypertension, dyslipidemia, diabetes and smoking, patients with chronic kidney disease have a uremic phenotype marked by premature aging, mitochondrial dysfunction, persistent low-grade inflammation, gut dysbiosis and oxidative stress. These complications contribute to abnormal vascular and myocardial remodeling processes, resulting in accelerated vascular calcification, cellular and organ senescence and a high risk of cardiovascular disease. Nonpharmacological strategies, such as increasing physical activity and a healthy diet, may slow the progression of kidney disease and consequently protect the heart. Thus, a deep promotion and advocacy of nutritional guidance based on scientific data is needed. This narrative review discusses how nutritional interventions may delay progressive organ damage in the kidney-heart axis.

Computational and experimental pharmacology to decode the efficacy of Theobroma cacao L. against doxorubicin-induced organ toxicity in EAC-mediated solid tumor-induced mice

Background and objective: Doxorubicin is extensively utilized chemotherapeutic drug, and it causes damage to the heart, liver, and kidneys through oxidative stress. Theobroma cacao L (cocoa) is reported to possess protective effects against several chemical-induced organ damages and also acts as an anticancer agent. The study aimed to determine whether the administration of cocoa bean extract reduces doxorubicin-induced organ damage in mice with Ehrlich ascites carcinoma (EAC) without compromising doxorubicin efficacy. Methodology: Multiple in vitro methods such as cell proliferation, colony formation, chemo-sensitivity, and scratch assay were carried out on cancer as well as normal cell lines to document the effect of cocoa extract (COE) on cellular physiology, followed by in vivo mouse survival analysis, and the organ-protective effect of COE on DOX-treated animals with EAC-induced solid tumors was then investigated. In silico studies were conducted on cocoa compounds with lipoxygenase and xanthine oxidase to provide possible molecular explanations for the experimental observations. Results: In vitro studies revealed potent selective cytotoxicity of COE on cancer cells compared to normal. Interestingly, COE enhanced DOX potency when used in combination. The in vivo results revealed reduction in EAC and DOX-induced toxicities in mice treated with COE, which also improved the mouse survival time; percentage of lifespan; antioxidant defense system; renal, hepatic, and cardiac function biomarkers; and also oxidative stress markers. COE reduced DOX-induced histopathological alterations. Through molecular docking and MD simulations, we observed chlorogenic acid and 8'8 methylenebiscatechin, present in cocoa, to have the highest binding affinity with lipoxygenase and xanthine oxidase, which lends support to their potential in ameliorating oxidative stress. Conclusion: The COE reduced DOX-induced organ damage in the EAC-induced tumor model and exhibited powerful anticancer and antioxidant effects. Therefore, COE might be useful as an adjuvant nutritional supplement in cancer therapy.

The Effects of Gamma-Aminobuytric Acid (GABA) Enrichment on Nutritional, Physical, Shelf-Life, and Sensorial Properties of Dark Chocolate

Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Gamma-aminobutyric acid (GABA) has potential in regulating hypertension. Cocoa beans are rich in GABA, but GABA is being destroyed during roasting of cocoa beans and chocolate production. This study aimed to develop GABA-enriched dark chocolate by partially replacing sugar syrup with pure GABA powder at concentrations of 0.05 (F1), 0.10 (F2), and 0.15% (F3). The chocolate samples were incorporated with GABA after the heating and melting process of cocoa butter to maintain the viability and functionality of the GABA in the final product. The effects of GABA enrichment on the quality of chocolate in terms of nutritional, physical, shelf-life, and sensorial properties were studied. The inclusion of 0.15% GABA significantly increased the GABA content and angiotensin-converting-enzyme (ACE) inhibitory effect of chocolate. The nutritional compositions of the control and GABA-enriched chocolates were almost similar. The addition of GABA significantly increased the hardness but did not affect the apparent viscosity and melting properties of chocolate. Accelerated shelf-life test results showed that all the chocolates stored at 20 and 30 °C were microbiologically safe for consumption for at least 21 days. Among the GABA-enriched chocolates, panellists preferred F2 the most followed by F3 and F1, owing to the glossiness and sweetness of F2. F3 with the highest GABA content (21.09 mg/100 g) and ACE inhibitory effect (79.54%) was identified as the best GABA-enriched dark chocolate.

Cinnamon: an aromatic condiment applicable to chronic kidney disease

Cinnamon, a member of the Lauraceae family, has been widely used as a spice and traditional herbal medicine for centuries and has shown beneficial effects in cardiovascular disease, obesity, and diabetes. However, its effectiveness as a therapeutic intervention for chronic kidney disease (CKD) remains unproven. The bioactive compounds within cinnamon, such as cinnamaldehyde, cinnamic acid, and cinnamate, can mitigate oxidative stress, inflammation, hyperglycemia, gut dysbiosis, and dyslipidemia, which are common complications in patients with CKD. In this narrative review, we assess the mechanisms by which cinnamon may alleviate complications observed in CKD and the possible role of this spice as an additional nutritional strategy for this patient group.

Dark chocolate: An overview of its biological activity, processing, and fortification approaches

Dark chocolate gets popularity for several decades due to its enormous health benefits. It contains several health-promoting factors (bioactive components - polyphenols, flavonoids, procyanidins, theobromines, etc, and vitamins and minerals) that positively modulate the immune system of human beings. It confers safeguards against cardiovascular diseases, certain types of cancers, and other brain-related disorders like Alzheimer's disease, Parkinson's disease, etc. Dark chocolate is considered a functional food due to its anti-diabetic, anti-inflammatory, and anti-microbial properties. It also has a well-established role in weight management and the alteration of a lipid profile to a healthy direction. But during the processing of dark chocolate, several nutrients are lost (polyphenol, flavonoids, flavan 3 ol, ascorbic acid, and thiamine). So, fortification would be an effective method of enhancing the overall nutrient content and also making the dark chocolate self-sufficient. Thus, the focus of this review study is to gather all the experimental studies done on dark chocolate fortification. Several ingredients were used for the fortification, such as fruits (mulberry, chokeberries, and elderberries), spices (cinnamon), phytosterols, peanut oil, probiotics (mainly Lactobacillus, bacillus spices), prebiotics (inulin, xanthan gum, and maltodextrin), flavonoids, flavan-3-ols, etc. Those fortifications were done to raise the total antioxidant content as well as essential fatty acid content simultaneously reducing total calorie content. Sometimes, the fortification was done to improve physical properties like viscosity, rheological propertiesand also improve overall consumer acceptance by modifying its bitter taste.

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Dark chocolate gets popularity for several decades due to its enormous health benefits.

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Dark chocolate is considered a functional food due to its health benefits.

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During the processing of dark chocolate, several nutrients are lost.

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Fortification would be an effective method of enhancing the overall nutrient content.

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This review study is to gather all the experimental studies done on dark chocolate fortification.

Effect of Theobroma cacao L. on the Efficacy and Toxicity of Doxorubicin in Mice Bearing Ehrlich Ascites Carcinoma

Background and objective: Doxorubicin is a widely used chemotherapeutic agent that causes oxidative stress leading to cardiotoxicity, hepatotoxicity, and nephrotoxicity. In contrast, Theobroma cacao L. has been recorded as an anticancer agent and found to be protective against multiple chemical-induced organ injuries, including heart, liver, and kidney injuries. The present study investigated the possible role of extracts from T. cacao beans for organ-protective effects in doxorubicin-induced toxicity in mice bearing Ehrlich ascites carcinoma (EAC). Methodology: After survival analysis in rodents, cocoa bean extract (COE) was investigated for its efficacy against EAC-induced carcinoma and its organ-protective effect against doxorubicin-treated mice with EAC-induced carcinoma. Results: Significant reductions in EAC and doxorubicin-induced alterations were observed in mice administered the COE, either alone or in combination with doxorubicin. Furthermore, COE treatment significantly increased the mouse survival time, life span percentage, and antioxidant defense system. It also significantly improved cardiac, hepatic, and renal function biomarkers and markers for oxidative stress, and it also reduced doxorubicin-induced histopathological changes. Conclusion: COE acted against doxorubicin-induced organ toxicity; potent antioxidant and anticancer activities were also reflected by the COE itself. The COE may therefore serve as an adjuvant nutraceutical in cancer chemotherapy.

Rheological, bioactive properties and sensory preferences of dark chocolates with partial incorporation of Sacha Inchi (Plukenetia volubilis L.) oil

We studied the effect of substituting partially, cocoa butter (CB) with Sacha Inchi (Plukenetia volubilis L.) oil (SIO) on rheology, bioactive properties, and sensory preferences in potentially functional chocolate. For this 70% dark chocolates were prepared and the CB was substituted with 1.5%, 3%, and 4.5% of SIO. Hardness and viscosity of the SIO-chocolates were significantly reduced compared to the control (5451 ± 658 g; 17.01 ± 0.94 Pa s, respectively). Total phenolic content remained constant while the antioxidant capacity increased up to IC₅₀ of 2.48 ± 0.10 as the content of SIO increased. The Casson yield stress and Casson plastic viscosity decreased as the amount of SIO increased. Chocolates with 4.5% SIO had a similar color, better glossiness, preferable snap attributes, and were more accepted (7.50 ± 0.08) compared to the control (p < 0.05), measured with a hedonic scale. Then, SIO can improve the bioactive properties of dark chocolates obtaining a potentially functional food with acceptable physicochemical characteristics. SIO can be considered as a new cocoa butter equivalent.