The Health Effects of Chocolate and Cocoa: A Systematic Review

Characterization of dark chocolates based on polyphenolic profiles and antioxidant activity

Dark chocolates were characterized according to geographical origin, cocoa variety, and cocoa content using the methylxanthine and polyphenolic composition and antioxidant activity as the data. The main study objective was to uncover sample patterns and identify possible markers of quality, variety, or origin to deal with authentication or fraud detection issues. In the study, a set of 26 dark chocolates from different varieties (e.g., Criollo, Forastero, and Trinitario) harvested in Africa, America, and Asia was analyzed. The optimized sample treatment consisted of defatting the chocolate (1 g of sample with 5 mL of cyclohexane for 15 min, three times) and then extracting the analytes by sonication with methanol/water 60:40 (v:v) for 15 min. The filtered extracts were analyzed by reversed-phase high-performance liquid chromatography with UV and spectrophotometric methods (Folin-Ciocalteu, ferric reducing antioxidant power, and aluminum methods) to determine individual phenolics and overall indexes of antioxidant and flavonoid content. Results from this chocolate set indicated that American samples are richer than African counterparts in alkaloids and phenolics (e.g., 1.7 vs. 1.1 mg g-1 caffeine and 14.5 vs. 12.5 mg g-1 total flavanols, respectively). Regarding cocoa varieties, Criollo cocoa was richer in bioactive compounds and antioxidant capacity (e.g., 16, 15, and 12 mg g-1 total flavanols for Criollo, Forastero, and Trinitario, respectively). These results indicate that the analytes resulted in potential descriptors of varietal or geographical attributes.

Integration of network-based approaches for assessing variations in metabolic profiles of alkalized and non-alkalized commercial cocoa powders

Cocoa can undergo an alkalization process to enhance its color and solubility. It reduces astringency and alters its composition, particularly in the phenolic compound content, which is related to cocoa health benefits. This study aimed to investigate the impact of alkalization on the composition of seven commercial cocoa powders. A liquid chromatography-based metabolomic approach was employed to assess the metabolic differences between alkalized and non-alkalized cocoa powders. Supervised orthogonal partial least squares discriminant analysis (OPLS-DA) was used to identify the most discriminating variables between groups. A feature-based molecular network (FBMN) was used to explore the chemical space. Three hundred forty-seven metabolites were obtained as the most discriminant, among which 60 were tentatively annotated. Phenolic compounds, lysophosphatidylethanolamines, amino acids, and their derivatives were significantly reduced in alkalized cocoas. In contrast, fatty acids and their derivatives significantly increased with alkalization. Despite the variability among commercial cocoas, chemometrics allowed the elucidation of alterations induced specifically by alkalization in their composition.

Topical Antioxidant Cocoa Polyphenol Skin Penetration

BACKGROUND

Cocoa powder derived from the Theobroma cacao plant is rich in polyphenols, such as catechin and epicatechin. These polyphenols are strong antioxidants when consumed orally; however, their ability to enter the stratum corneum following the topical application has never been demonstrated.

OBJECTIVE

The objective of this study was to demonstrate the deposition of catechin and epicatechin in the stratum corneum following the topical application of 6% aqueous cocoa powder 1 and 2 h after application.

METHODS

Five healthy female subjects aged 25-60 years were enrolled. A 6% aqueous cocoa powder solution was prepared and applied to two randomized designated spots on the left forearm. 2 cc of the solution was applied under a ¼-inch gauze square covered with plastic wrap and held in place with a Coban dressing. The 15 d-squame 7/8-inch circular tape strips were applied to the predetermined area on the forearm 1 h and 2 h after application of the 6% cocoa powder solution. The tape strips were immediately placed in a -80°C freezer for storage until extraction in preparation for LC-MS evaluation for catechin and epicatechin levels.

RESULTS

More catechin and epicatechin were detected at 2 h than 1 h for both compounds, although the difference was not statistically significant. Higher epicatechin levels than catechin levels were detected from the cocoa powder at both time points. This is consistent with published data from food-grade cocoa powder.

SUMMARY

It is detected that 6% aqueous cocoa powder delivers the antioxidants catechin and epicatechin to the stratum corneum 1 h and 2 h after topical application.

Chocolate Ganaches: Formulation, Processing and Stability in View of the New Production Trends

This review aims at the current trends in chocolate ganache production and recipe formulation. Ganache is a blend of chocolate, sugars, dairy, and other ingredients commonly used to fill pralines, pastries, etc. In spite of ganache's popularity in the food industry, a comprehensive review focused on the application of functional substances and ganache processing has not been discussed in the scientific literature. This review addresses the new ways of applying special ingredients, such as vegetable fats and seeds, flavor infusions, oleogels, hemp products, etc., which can be added to the ganache matrix to achieve desirable properties. In particular, the application of sterols and sterol esters as functional substances of oleogels seems to be a very promising method, enhancing the ganache fat profile. The elevated caloric content that is characteristic of ganache can be substantially attenuated through the application of hydrocolloids and/or fruit-based components, thereby offering the potential for caloric reduction without compromising on taste. The various alterations to ganache formulations by the application of natural substances offer a large base for the development of novel ganache variants and relevant food products.

A multi-year heavy metal analysis of 72 dark chocolate and cocoa products in the USA

Introduction

Contamination of cocoa containing products, such as dark chocolate, with heavy metals including lead, cadmium and arsenic has been reported in the US. However, a formal exploration into the significance of this contamination, nor multi-year trends in the degree or scope remain unresolved.

Methods

From 2014 to 2022, 72 consumer cocoa-containing products were purchased and analyzed for heavy metal contamination with lead (Pb), cadmium (Cd), and arsenic (As) in 4 distinct cohorts (2014, 2016, 2019, 2022). The thresholds used to assess heavy metal contamination were set to Prop 65 maximum allowable dose levels (MADLs) of 0.5 mcg/day, 4.1 mcg/day, 10 mcg/day for Pb, Cd, and As, respectively.

Results and discussion

Our analysis reports that 43, 35, and 0% of the products tested exceed Prop 65 MADLs for heavy metal concentrations, respectively, of Pb, Cd, and As, while 97.2% (70 of 72) fall below US FDA IRL limits established for Pb. Median concentrations of each metal tested were lower than even the conservative Prop 65 MADLs, indicating a potentially large effect of product outliers. This indicates that heavy metal contamination-in more than half of products tested-may not pose any appreciable risk for the average person when consumed as a single serving; however, consuming some of the products tested, or more than one serving per day in combination with non-cocoa derived sources heavy metals, may add up to exposure that would exceed the Prop 65 MADLs. Notably, "organic" products were significantly more likely to demonstrate higher levels of both Cd and Pb.

The Relationship between Chocolate Consumption and the Severity of Acne Lesions-A Crossover Study

The aim of this study was to assess the relationship between the daily consumption of 50 g of chocolate with 85% cocoa content and the severity of acne lesions.

METHODS

The study involved 92 participants with acne who were divided into two groups, A (n = 51) and B (n = 41). In the first week, both groups had to follow an anti-inflammatory diet (AID), then for the next 4 weeks, group A continued on with the AID, and group B followed an AID with chocolate. After this time, group B started a 4-week AID without chocolate, and group A started a 4-week AID with chocolate. The severity of acne lesions was assessed using the Investigator's Static Global Assessment scale, where zero points indicated no lesions and five points indicated severe acne.

RESULTS

As a result of the consumption of 50 g of chocolate, a statistically significant intensification of acne lesions was observed in both groups. After 4 weeks of following the chocolate diet, the severity of acne lesions increased from 2.5 ± 0.7 to 3.4 ± 0.8 points (p < 0.0001) in group A, and from 2.4 ± 0.7 to 3.5 ± 0.6 points (p < 0.0001) in group B. Overall, chocolate intake contributed to the exacerbation of acne lesions by one point in 65 participants, by two points in 13 participants and by three points in one participant.

CONCLUSIONS

The obtained results suggest that daily consumption of 50 g of chocolate with 85% cocoa content, even with an anti-inflammatory diet, may intensify acne lesions in this study group. However, it remains unclear which chocolate components may lead to the exacerbation of acne.

Research on Application of Japanese Quince (Chaenomeles L.) and Pork Collagen in Dark Chocolate-Benefits in Prevention of Inflammation In Vitro Model

In the present study, the effect of the addition of quince and collagen type I and III to dessert chocolate on its functional properties was determined. The study evaluated the antioxidant potential of the tested formulations using the FRAP method and the linoleic acid oxidation test and beta-carotene bleaching test. The tested samples were also evaluated for inhibitory activity against enzymes important in preventive health (inflammation and neurodegenerative disorders) namely: AChE, BChE, GR, GPx, COX, and SOD. The addition of quince and collagen to the chocolate samples resulted in higher activity compared to the control sample, as indicated by the FRAP test. The experiment highlighted the impact of including quince fruit on the antioxidant activity of the chocolate samples. Interestingly, merely increasing the quince fruit amount did not consistently enhance antioxidant potential. Specifically, chocolate samples with a lower proportion of quince fruit (2 g/100 g) exhibited greater antioxidant activity when supplemented with collagen I. Conversely, in samples with higher quince percentages (3 g and 4 g), those enriched with collagen III showed higher antioxidant activity. Similar correlations were observed in the linoleic acid oxidation test. Notably, samples containing 3 g and 4 g of quince and type III collagen demonstrated statistically similar highest antioxidant properties. Regardless of the collagen type used, there was no observed increase in activity towards the tested enzymes for samples with the lowest percentage of quince fruit. Both collagen types exhibited the highest activity in the inhibition assay against acetylcholinesterase and butyrylcholinesterase when combined with 3 g and 4 g of quince. Overall, the experimental incorporation of both fruit and collagen enhanced the chocolates' activity. Similarly to the antioxidant activity findings, chocolates with lower quince fruit quantities showed increased activity when supplemented with collagen III, while those with higher quince content (3 g and 4 g) displayed higher activity with collagen I. Bitter chocolate by itself is an attractive food product, rich in many bioactive compounds. However, enriching it with other attractive raw materials can make its properties and taste even more attractive.

Genome-wide identification, characterization, and expression analysis of the small auxin-up RNA gene family during zygotic and somatic embryo maturation of the cacao tree (Theobroma cacao)

Small auxin-up RNA (SAUR) proteins were known as a large family that supposedly participated in various biological processes in higher plant species. However, the SAUR family has been still not explored in cacao (Theobroma cacao L.), one of the most important industrial trees. The present work, as an in silico study, revealed comprehensive aspects of the structure, phylogeny, and expression of TcSAUR gene family in cacao. A total of 90 members of the TcSAUR gene family have been identified and annotated in the cacao genome. According to the physic-chemical features analysis, all TcSAUR proteins exhibited slightly similar characteristics. Phylogenetic analysis showed that these TcSAUR proteins could be categorized into seven distinct groups, with 10 sub-groups. Our results suggested that tandemly duplication events, segmental duplication events, and whole genome duplication events might be important in the growth of the TcSAUR gene family in cacao. By re-analyzing the available transcriptome databases, we found that a number of TcSAUR genes were exclusively expressed during the zygotic embryogenesis and somatic embryogenesis. Taken together, our study will be valuable to further functional characterizations of candidate TcSAUR genes for the genetic engineering of cacao.

D-allose, a typical rare sugar: properties, applications, and biosynthetic advances and challenges

D-allose, a C-3 epimer of D-glucose and an aldose-ketose isomer of D-allulose, exhibits 80% of sucrose's sweetness while being remarkably low in calories and nontoxic, making it an appealing sucrose substitute. Its diverse physiological functions, particularly potent anticancer and antitumor effects, render it a promising candidate for clinical treatment, garnering sustained attention. However, its limited availability in natural sources and the challenges associated with chemical synthesis necessitate exploring biosynthetic strategies to enhance production. This overview encapsulates recent advancements in D-allose's physicochemical properties, physiological functions, applications, and biosynthesis. It also briefly discusses the crucial role of understanding aldoketose isomerase structure and optimizing its performance in D-allose synthesis. Furthermore, it delves into the challenges and future perspectives in D-allose bioproduction. Early efforts focused on identifying and characterizing enzymes responsible for D-allose production, followed by detailed crystal structure analysis to improve performance through molecular modification. Strategies such as enzyme immobilization and implementing multi-enzyme cascade reactions, utilizing more cost-effective feedstocks, were explored. Despite progress, challenges remain, including the lack of efficient high-throughput screening methods for enzyme modification, the need for food-grade expression systems, the establishment of ordered substrate channels in multi-enzyme cascade reactions, and the development of downstream separation and purification processes.

Impact of Diet and Nutrition in Patients with Acne Vulgaris

Acne vulgaris is a widespread a chronic inflammatory dermatosis that affects millions of people around the world, which has a significant influence on patients' standard of living. The progression of this dermatosis results in the appearance of inflammatory and non-inflammatory changes, and, in severe cases, disfiguring scars and hyperpigmentation. The aetiopathogenesis of acne is complex. It involves a complex interaction of many different factors, both endo- and exogenous in their effect on the hair and sebaceous unit. Genetic predisposition, hormones, the skin and gut microbiome, psychological stress, air pollutants, aggressive facial products, and certain medications are cited as factors influencing acne formation. The link between nutrition and acne is extensively debated for many years and is still relatively controversial. Diet is commonly recognised to have a direct relationship with certain biochemical markers and the transcription of genes related to sebaceous gland function, and the proliferation of bacteria and inflammation that encourage the progression of the disease. In this review, the authors take a closer look at the existing scientific reports on the involvement of nutrition in the development of acne vulgaris.

Clovamide and Its Derivatives-Bioactive Components of Theobroma cacao and Other Plants in the Context of Human Health

Clovamide (N-caffeoyl-L-3,4-dihydroxyphenylalanine, N-caffeoyldopamine, N-caffeoyl-L-DOPA) is a derivative of caffeic acid, belonging to phenolamides (hydroxycinnamic acid amides). Despite a growing interest in the biological activity of natural polyphenolic substances, studies on the properties of clovamide and related compounds, their significance as bioactive components of the diet, as well as their effects on human health are a relatively new research trend. On the other hand, in vitro and in vivo evidence indicates the considerable potential of these substances in the context of maintaining human health or using them as pharmacophores. The name "clovamide" directly derives from red clover (Trifolium pratense L.), being the first identified source of this compound. In the human diet, clovamides are mainly present in chocolate and other cocoa-containing products. Furthermore, their occurrence in some medicinal plants has also been confirmed. The literature reports deal with the antioxidant, anti-inflammatory, neuroprotective, antiplatelet/antithrombotic and anticancer properties of clovamide-type compounds. This narrative review summarizes the available data on the biological activity of clovamides and their potential health-supporting properties, including prospects for the use of these compounds for therapeutic purposes.

Effects of (-)-epicatechin on hepatic triglyceride metabolism

(-)-Epicatechin (EC) consumption is associated with an improvement of hyperlipemia and other metabolic changes linked to obesity and western-style diets. This work investigated the effects of EC on triglyceride (TG) metabolism both in vivo, where mice were supplemented with EC (2 and 20 mg EC per kg body weight), and in vitro, when human HepG2 hepatocytes were incubated in the presence of EC and the main EC metabolites found in human plasma. Increased hepatic TG levels were only observed after 24 weeks supplementation with EC (20 mg per kg body weight), with a preserved liver structure and absence of inflammation or oxidative stress. EC caused increased expression of diacylglycerol acyltransferases (DGAT2), key enzymes in TG synthesis, and the upregulation of PPARα, which promotes free fatty acid (FFA) oxidation. On the other hand, incubation of HepG2 cells in the presence of high concentrations of EC (1-10 μM) did not affect TG deposition nor DGAT2 expression. In summary, in mouse liver, EC upregulated mechanisms that can neutralize the potential toxicity of FFA, i.e. TG synthesis and FFA β-oxidation. Results in mouse liver and HepG2 cells stress the safety of EC in terms of TG metabolism and development of hepatopathies in doses within the limits given by a rational time and dose for human consumption.

In Vitro and In Vivo Evaluation of Dark Chocolate as Age-appropriate Oral Matrix

Swallowing difficulties encountered by geriatric patients who undergo polypharmacy represent a significant challenge that hampers patient compliance and therapeutic management. As an appealing and sensory-pleasing, chocolate-based formulations have emerged as a potential alternative oral dosage form suitable for both the elderly and paediatric populations. However, the extent to which the incorporation of drugs into a chocolate matrix affects their oral availability remains unclear. Therefore, the objective of this investigation was to explore the in vitro and in vivo performance of an ibuprofen-based chocolate dosage form. A matrix based on dark chocolate and the model drug was prepared at two distinct temperatures: 50 and 80 °C. In vitro release studies revealed that ibuprofen formulated through co-melting at 80 °C exhibited a statistically significant slower drug release (p < 0.05) compared to formulations prepared at 50 °C in both FaSSGF (fasted-state simulated gastric fluid) and lipolysis media. The enzymatic degradation of chocolate in the presence of lipase accelerated in vitro ibuprofen release from chocolate matrices. To delve deeper into the bioavailability of ibuprofen within the chocolate formulations, we conducted an in vivo assessment, comparing the pharmacokinetic profiles of ibuprofen in its conventional suspension form with our chocolate-based dosage forms. A notable drop (p < 0.05) in the maximum serum concentration of ibuprofen when incorporated into co-melted or solid-suspension chocolate matrices. However, no significant differences in plasma exposure were observed between the two formulations. These findings shed a light on the potential of chocolate to extend of ibuprofen when integrated into various chocolate matrices, showcasing the potential held by these innovative formulations.

Proximate Composition and Bioactive Compounds of Cocoa Bean Shells as a By-Product from Cocoa Industries in Indonesia

Cocoa bean shell (CBS) is a by-product from cocoa processing which is abundant in Indonesia, one of the largest cocoa-producing countries. It has a great potential for being processed into food ingredients due to its comparable composition to cocoa nibs. The present study was conducted to identify the proximate composition and bioactive compounds in CBS produced at several cocoa industries in Indonesia utilizing different cocoa varieties (Criollo and Forastero) and processing techniques (fermented, non-fermented, pulp washing, and drying), which remain unknown. The results showed that the CBS derived from roasted Criollo cocoa pods in the Kendeng Lembu cocoa industry had ash and protein content of about 8.21% and 18.79%, respectively, which was higher than other industries. Additionally, the concentration of bioactive substances was higher here than it was elsewhere. This included total phenolic (136.2 mg GAE g-1) and theobromine (22.50 mg g-1). The lowest ash and protein concentration found in CBS was from Forastero cocoa pods, non-fermented like Sulawesi cocoa. These values were 6.48% and 15.70%, respectively. The concentration of theobromine (15.40 mg g-1) was also lower compared to other industries.

Authentication of Cocoa Products Based on Profiling and Fingerprinting Approaches: Assessment of Geographical, Varietal, Agricultural and Processing Features

Cocoa and its derivative products, especially chocolate, are highly appreciated by consumers for their exceptional organoleptic qualities, thus being often considered delicacies. They are also regarded as superfoods due to their nutritional and health properties. Cocoa is susceptible to adulteration to obtain illicit economic benefits, so strategies capable of authenticating its attributes are needed. Features such as cocoa variety, origin, fair trade, and organic production are increasingly important in our society, so they need to be guaranteed. Most of the methods dealing with food authentication rely on profiling and fingerprinting approaches. The compositional profiles of natural components -such as polyphenols, biogenic amines, amino acids, volatile organic compounds, and fatty acids- are the source of information to address these issues. As for fingerprinting, analytical techniques, such as chromatography, infrared, Raman, and mass spectrometry, generate rich fingerprints containing dozens of features to be used for discrimination purposes. In the two cases, the data generated are complex, so chemometric methods are usually applied to extract the underlying information. In this review, we present the state of the art of cocoa and chocolate authentication, highlighting the pros and cons of the different approaches. Besides, the relevance of the proposed methods in quality control and the novel trends for sample analysis are also discussed.

Cocoa flavanols protect cognitive function, cerebral oxygenation, and mental fatigue during severe hypoxia

We tested the hypothesis that ingestion of cocoa flavanols would improve cognition during acute hypoxia equivalent to 5,500 m altitude (partial pressure of end-tidal oxygen = 45 mmHg). Using placebo-controlled double-blind trials, 12 participants ingested 15 mg·kg-1 of cocoa flavanols 90 min before completing cognitive tasks during normoxia and either poikilocapnic or isocapnic hypoxia (partial pressure of end-tidal carbon dioxide uncontrolled or maintained at the baseline value, respectively). Cerebral oxygenation was measured using functional near-infrared spectroscopy. Overall cognition was impaired by poikilocapnic hypoxia (main effect of hypoxia, P = 0.008). Cocoa flavanols improved a measure of overall cognitive performance by 4% compared with placebo (effect of flavanols, P = 0.033) during hypoxia, indicating a change in performance from "low average" to "average." The hypoxia-induced decrease in cerebral oxygenation was two-fold greater with placebo than with cocoa flavanols (effect of flavanols, P = 0.005). Subjective fatigue was increased by 900% with placebo compared with flavanols during poikilocapnic hypoxia (effect of flavanols, P = 0.004). Overall cognition was impaired by isocapnic hypoxia (effect of hypoxia, P = 0.001) but was not improved by cocoa flavanols (mean improvement = 1%; effect of flavanols, P = 0.72). Reaction time was impaired by 8% with flavanols during normoxia and further impaired by 11% during isocapnic hypoxia (effect of flavanols, P = 0.01). Our findings are the first to show that flavanol-mediated improvements in cognition and mood during normoxia persist during severe oxygen deprivation, conferring a neuroprotective effect.NEW & NOTEWORTHY We show for the first time that cocoa flavanols exert a neuroprotective effect during severe hypoxia. Following acute cocoa flavanol ingestion, we observed improvements in cognition, cerebral oxygenation, and subjective fatigue during normoxia and severe poikilocapnic hypoxia. Cocoa flavanols did not improve cognition during severe isocapnic hypoxia, suggesting a possible interaction with carbon dioxide.

The Effect of Bioactive Aliment Compounds and Micronutrients on Non-Alcoholic Fatty Liver Disease

In the current review, we focused on identifying aliment compounds and micronutrients, as well as addressed promising bioactive nutrients that may interfere with NAFLD advance and ultimately affect this disease progress. In this regard, we targeted: 1. Potential bioactive nutrients that may interfere with NAFLD, specifically dark chocolate, cocoa butter, and peanut butter which may be involved in decreasing cholesterol concentrations. 2. The role of sweeteners used in coffee and other frequent beverages; in this sense, stevia has proven to be adequate for improving carbohydrate metabolism, liver steatosis, and liver fibrosis. 3. Additional compounds were shown to exert a beneficial action on NAFLD, namely glutathione, soy lecithin, silymarin, Aquamin, and cannabinoids which were shown to lower the serum concentration of triglycerides. 4. The effects of micronutrients, especially vitamins, on NAFLD. Even if most studies demonstrate the beneficial role of vitamins in this pathology, there are exceptions. 5. We provide information regarding the modulation of the activity of some enzymes related to NAFLD and their effect on this disease. We conclude that NAFLD can be prevented or improved by different factors through their involvement in the signaling, genetic, and biochemical pathways that underlie NAFLD. Therefore, exposing this vast knowledge to the public is particularly important.

The Impact of Nutrient Intake and Metabolic Wastes during Pregnancy on Offspring Hypertension: Challenges and Future Opportunities

Hypertension can have its origin in early life. During pregnancy, many metabolic alterations occur in the mother that have a crucial role in fetal development. In response to maternal insults, fetal programming may occur after metabolic disturbance, resulting in programmed hypertension later in life. Maternal dietary nutrients act as metabolic substrates for various metabolic processes via nutrient-sensing signals. Different nutrient-sensing pathways that detect levels of sugars, amino acids, lipids and energy are integrated during pregnancy, while disturbed nutrient-sensing signals have a role in the developmental programming of hypertension. Metabolism-modulated metabolites and nutrient-sensing signals are promising targets for new drug discovery due to their pathogenic link to hypertension programming. Hence, in this review, we pay particular attention to the maternal nutritional insults and metabolic wastes affecting fetal programming. We then discuss the role of nutrient-sensing signals linking the disturbed metabolism to hypertension programming. This review also summarizes current evidence to give directions for future studies regarding how to prevent hypertension via reprogramming strategies, such as nutritional intervention, targeting nutrient-sensing signals, and reduction of metabolic wastes. Better prevention for hypertension may be possible with the help of novel early-life interventions that target altered metabolism.

Mexican Ancestral Foods (Theobroma cacao, Opuntia ficus indica, Persea americana and Phaseolus vulgaris) Supplementation on Anthropometric, Lipid and Glycemic Control Variables in Obese Patients: A Systematic Review and Meta-Analysis

Diet containing Mexican ancestral foods such as cocoa, nopal, avocado, and common bean have been individually reported to have beneficial effects on obesity and comorbidities. Methods: A systematic review and meta-analysis on the effect of Mexican ancestral foods on the anthropometric, lipid, and glycemic control variables in obese patients was performed following PRISMA guidelines. Data were analyzed using a random-effects model. Results: We selected 4664 articles from an initial search, of which only fifteen studies satisfied the inclusion criteria. Data for 1670 participants were analyzed: 843 in the intervention group and 827 in the control group. A significant reduction in body mass index (mean difference: −0.80 (−1.31 to −0.30)) (95% confidence interval), p = 0.002, heterogeneity I2 = 92% was showed after the ingestion of cocoa, nopal, avocado, or common bean. The mean difference for body weight was −0.57 (−1.93 to 0.79), waist of circumference: −0.16 (−2.54 to −2.21), total cholesterol: −5.04 (−11.5 to 1.08), triglycerides: −10.11 (−27.87 to 7.64), fasting glucose: −0.81 (−5.81 to 4.19), and insulin: −0.15 (−0.80 to 0.50). Mexican ancestral food supplementation seems to improve anthropometric, lipid, and glycemic control variables in obesity; however, more randomized controlled trials are needed to have further decisive evidence about dosage and method of supplementation and to increase the sample size.

Dark chocolate (70% cocoa) attenuates the inflammatory marker TNF-α in patients on hemodialysis

BACKGROUND

Inflammation and oxidative stress lead to a high risk of cardiovascular disease in patients with chronic kidney disease (CKD). Food rich in polyphenols such as dark chocolate may be an effective strategy to mitigate inflammation and delay CKD complications, outwith sensorial pleasure promotion. The aim of this study was to evaluate the effects of dark chocolate on inflammation and oxidative stress markers in patients with CKD on hemodialysis (HD).

METHODS

A clinical trial was carried out with 59 patients who were allocated into the chocolate group [40g of dark chocolate (70% cocoa) offered during HD sessions, 3×/week] or the control group with any intervention for two months. Plasma levels of the inflammatory cytokines TNF-α and IL-6 were evaluated by the ELISA method. Thiobarbituric acid reactive substances such as malondialdehyde (MDA) and LDLox levels were evaluated as lipid peroxidation markers. Routine biochemical parameters were analysed using commercial BioClin® kits.

RESULTS

Thirty-five patients completed the chocolate group (18 men, 53.0 (16) years and 31.0 (39) months on HD) and 11 in the control group (7 men, 48.0 (17.5) years and 44.0 (56.5) months on HD). Regarding the differences between the groups, the patients who received dark chocolate had reduced plasma levels of TNF-α compared to the control (p = 0.008). No significant changes were observed in the oxidative stress parameters evaluated in both groups. Routine biochemical (including phosphorus and potassium levels) and anthropometric parameters and food intake were not changed after the study period.

CONCLUSION

The intervention with dark chocolate (70% cocoa) for two months reduced the plasma levels of TNF-α in patients with CKD on HD. In addition, it is essential to emphasise that chocolate intake did not increase the plasma levels of phosphorus and potassium in these patients. This study was registered at clinicaltrials.gov as NCT04600258.

Preventive Effect of Cocoa Flavonoids via Suppression of Oxidative Stress-Induced Apoptosis in Auditory Senescent Cells

Presbycusis or Age-related hearing loss (ARHL) is a sensorineural hearing loss that affects communication, leading to depression and social isolation. Currently, there are no effective treatments against ARHL. It is known that cocoa products have high levels of polyphenol content (mainly flavonoids), that are potent anti-inflammatory and antioxidant agents with proven benefits for health. The objective is to determine the protective effect of cocoa at the cellular and molecular levels in Presbycusis. For in vitro study, we used House Ear Institute-Organ of Corti 1 (HEI-OC1), stria vascularis (SV-k1), and organ of Corti (OC-k3) cells (derived from the auditory organ of a transgenic mouse). Each cell line was divided into a control group (CTR) and an H₂O₂ group (induction of senescence by an oxygen radical). Additionally, every group of every cell line was treated with the cocoa polyphenolic extract (CPE), measuring different markers of apoptosis, viability, the activity of antioxidant enzymes, and oxidative/nitrosative stress. The data show an increase of reactive oxidative and nitrogen species (ROS and RNS, respectively) in senescent cells compared to control ones. CPE treatment effectively reduced these high levels and correlated with a significant reduction in apoptosis cells by inhibiting the mitochondrial-apoptotic pathway. Furthermore, in senescence cells, the activity of antioxidant enzymes (Superoxide dismutase, SOD; Catalase, CAT; and Glutathione peroxidase, GPx) was recovered after CPE treatment. Administration of CPE also decreased oxidative DNA damage in the auditory senescent cells. In conclusion, CPE inhibits the activation of senescence-related apoptotic signaling by decreasing oxidative stress in auditory senescent cells.

Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports?

Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.

Cardiovascular Effects of Chocolate and Wine-Narrative Review

The consumption of food for pleasure is mainly associated with adverse health effects. This review was carried out to verify recent reports on the impact of chocolate and wine consumption on cardiovascular health, with a particular focus on atherosclerosis. On one side, these products have proven adverse effects on the cardiovascular system, but on the other hand, if consumed in optimal amounts, they have cardiovascular benefits. The submitted data suggest that the beneficial doses are 30–50 g and 130/250 mL for chocolate and wine, respectively, for women and men. The accumulated evidence indicates that the active ingredients in the products under consideration in this review are phenolic compounds, characterized by anti-inflammatory, antioxidant, and antiplatelet properties. However, there are also some reports of cardioprotective properties of other compounds such as esters, amines, biogenic amines, amino acids, fatty acids, mineral ingredients, and vitamins. Our narrative review has shown that in meta-analyses of intervention studies, consumption of chocolate and wine was positively associated with the beneficial outcomes associated with the cardiovascular system. In contrast, the assessment with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) scale did not confirm this phenomenon. In addition, mechanisms of action of bioactive compounds present in chocolate and wine depend on some factors, such as age, sex, body weight, and the presence of additional medical conditions. Patients using cardiovascular drugs simultaneously with both products should be alert to the risk of pharmacologically relevant interactions during their use. Our narrative review leads to the conclusion that there is abundant evidence to prove the beneficial impact of consuming both products on cardiovascular health, however some evidence still remains controversial. Many authors of studies included in this review postulated that well-designed, longitudinal studies should be performed to determine the effects of these products and their components on atherosclerosis and other CVD (Cardiovascular Disease) disease.