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Original Article

Dark Chocolate Effect on Platelet Activity, C-Reactive Protein and Lipid Profile: A Pilot Study

Miruais S. Hamed, MD, Steven Gambert, MD, Kevin P. Bliden, BS, Oscar Bailon, MD, Singla Anand, MD, Mark J. Antonino, BS, Fatema Hamed, BS, Udaya S. Tantry, PhD, Paul A. Gurbel, MD
Volume: 101 Issue: 12 December, 2008

Abstract:

Background: Dark chocolate (DC) is one of the richest sources of flavonoids. Since DC has been demonstrated to have beneficial effects on the cardiovascular system, our study examined its effect on platelet reactivity, inflammation, and lipid levels in healthy subjects.


Methods: In 28 healthy volunteers, we analyzed the effect of one week of DC (providing 700 mg of flavonoids/day). The primary outcome was to determine the effects of DC consumption on platelet activity measured by flow cytometry (adenosine diphosphate [ADP]- and arachidonic acid [AA]-induced total and activated glycoprotein (GP) IIb/IIIa as well as P-selectin expression). In addition to this, we measured the effect of DC on high-sensitivity C-reactive protein (hsCRP), high-density lipid cholesterol (HDL) and low-density lipid cholesterol (LDL) levels.


Results: Following seven days of regular DC ingestion, LDL fell by 6% (120 ± 38 vs 112 ± 37 mg/dL, P < 0.018) and HDL rose by 9% (66 ± 23 vs 72 ± 26 mg/dL, P < 0.0019). ADP- and AA-induced activated GPIIb/IIIa expression was reduced by DC [27.3 ± 27.8 vs 17.4 ± 20.5 mean fluorescence intensity (MFI), P < 0.006; and 9.2 ± 6.5 vs. 6.1 ± 2.2 MFI, P < 0.005, respectively]. DC reduced hsCRP levels in women (1.8 ± 2.1 vs. 1.4 ± 1.7 mg/dL, P < 0.04).


Conclusions: One week of DC ingestion improved lipid profiles and decreased platelet reactivity within the total group while reducing inflammation only in women. Regular dark chocolate ingestion may have cardioprotective properties. Further long-term research is warranted to evaluate the effect of flavonoids on cardiovascular health and to determine whether DC's beneficial effects are related to flavonoids or some yet unknown component. This research is based on a larger study which was presented at the American Heart Association Scientific Sessions 2007.

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References:

1. Richelle M, Tavazzi I, Offord E. Comparison of the antioxidant activity of commonly consumed polyphenolic beverages (coffee, cocoa, and tea) prepared per cup serving. J Agric Food Chem2001;49:3438–3442.
 
2. Rein D, Lotito S, Holt RR, et al. Epicatechin in human plasma: in vivo determination and effect of chocolate consumption on plasma oxidation status. J Nutr 2000;130(8S suppl):2109S–2114S.
 
3. Mutoh M, Takahashi M, Fukuda K. Suppression by flavonoids of cyclooxygenase-2 promoter dependant transcriptional activity in colon cancer cells: structure-activity relationship. Jpn J Cancer Res2000;91:686–691.
 
4. Rosenkranz S, Knirel D, Dietrich H, et al. Inhibition of the PDGF receptor by red wine flavonoids provides a molecular explanation for the “French paradox.” FASEB J 2002;16:1958–1960.
 
5. Taubert D, Roesen R, Schoemig E. Effect of cocoa and tea intake on blood pressure, meta-analysis.Arch Int Med 2007;167:626–634.
 
6. Taubert D, Roesen R, Lehmann C, et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA 2007;298:49–60.
 
7. Polagruto JA, Wang-Polagruto JF, Braun MM, et al. Cocoa flavanol-enriched snack bars containing phytosterols effectively lower total and low-density lipoprotein cholesterol levels. J Am Diet Assoc2006;106:1804–1813.
 
8. Fisher ND, Hughes M, Gerhard-HermanM, et al. Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans. J Hypertens 2003;21:2281–2286.
 
9. Heiss C, Dejam A, Kleinbongard P, et al. Vascular effects of cocoa rich in flavan-3-ols. JAMA2003;290:1030–1031.
 
10. Holt R, Schramm DD, Keen CL, et al. Chocolate consumption and platelet function. JAMA2002;287:2212–2213.
 
11. Innes AJ, Kennedy G, McLaren M, et al. Dark chocolate inhibits platelet aggregation in healthy volunteers. Platelets 2003;14:325–327.
 
12. Manach C, Scalbert A, Morand C, et al. Polyphenols: food sources and bioavailability. Am J Clin Nutr 2004;79:727–747.
 
13. Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3:369–376.
 
14. Son DJ, Cho MR, Jin YR, et al. Antiplatelet effect of green tea catechins: a possible mechanism through arachidonic acid pathway. Prostaglandins Leukot Essent Fatty Acids 2004;71:25–31.
 
15. Tejero I, Gonzalez-Garcia N, Gonzalez-Lafont A, et al. Tunneling in green tea: understanding the antioxidant activity of catechol-containing compounds. A variational transition-state theory study. J Am Chem Soc 2007;129:5846–5854.
 
16. Wan Y, Vinson JA, Etherton TD, et al. Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans. Am J Clin Nutr 2001;74:596–602.
 
17. Mursu, J, Voutilainen S, Nurmi T, et al. Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. Free Radic Biol Med 2004;37:1351–1359.
 
18. Raederstorff DG, Schlachter MF, Elste V, et al. Effect of EGCG on lipid absorption and plasma lipid levels in rats. J Nutr Biochem 2003;14:326–332.
 
19. Ridker PM. Cardiology Patient Page. C-reactive protein, a simple test to help predict risk of heart attack and stroke. Circulation 2003;108:e81–e85.
 
20. Arima H, Kubo M, Yonemoto K, et al. High-sensitivity C-reactive protein and coronary heart disease in a general population of Japanese: the Hisayama study. Arterioscler Thromb Vasc Biol 2008;28:1385–1391.
 
21. Shlipak MG, Ix JH, Bibbins-Domingo K, et al. Biomarkers to predict recurrent cardiovascular disease: the Heart and Soul Study. Am J Med 2008:121:50–57.
 
22. Ryu OH, Lee J, Lee KW, et al. Effects of green tea consumption on inflammation, insulin resistance and pulse wave velocity in type 2 diabetes patients. Diabetes Res Clin Pract 2006;71:356–358.
 
23. Naruszewicz M, Laniewska I, Milo B, et al. Combination therapy of statin with flavonoids rich extract from chokeberry fruits enhanced reduction in cardiovascular risk markers in patients after myocardial infraction (MI). Atherosclerosis 2007;194:e179–e184.
 
24. Gurbel PA, Bliden KP, Samara W, et al. Clopidogrel effect on platelet reactivity in patients with stent thrombosis: results of the CREST study. J Am Coll Cardiol 2005;46:1827–1832.
 
25. Gurbel PA, Kereiakes DJ, Dalesandro MR, et al. Role of soluble and platelet-bound P-selectin in discriminating cardiac from noncardiac chest pain at presentation in the emergency department. Am Heart J 2000;139(2 pt 1):320–328.
 
26. Holt RR, Actis-Goretta L, Momma TY, et al. Dietary flavanols and platelet reactivity. J Cardiovasc Pharmacol 2006:47(suppl 2):S187–S196; discussion S206–S209.
 
27. Hall WL, Vafeiadou K, Hallund J, et al. Soy-isoflavone-enriched foods and inflammatory biomarkers of cardiovascular disease risk in postmenopausal women: interactions with genotype and equol production, Am J Clin Nutr 2005;82:1260–1268; quiz 1365–1366.
 
28. Hanson LN, Engelman HM, Alekel DL, et al. Effects of soy isoflavones and phytate on homocysteine, C-reactive protein, and iron status in postmenopausal women. Am J Clin Nutr2006;84:774–780.
 
29. Richelle M, Tavazzi I, Enslen M, et al. Plasma kinetics in man of epicatechin from black chocolate.Eur J Clin Nutr 1999:53:22–26.
 
30. Rein D, Lotito S, Holt RR, et al. Epicatechin in human plasma: in vivo determination and effect of chocolate consumption on plasma oxidation status. J Nutr 2000;130(8S suppl):9S–14S.
 
31. Baba S, Osakabe N, Yasuda A, et al. Bioavailability of (−)-epicatechin upon intake of chocolate and cocoa in human volunteers. Free Radic Res 2000:33:635–641.
 

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