Brain-impaired elderly subjects appear to most benefit from cocoa flavanols: Review

Flavanol-rich chocolate is well known for its beneficial effect on the brain, but a review by Italian researchers point towards its neuroprotective effects in vulnerable populations over time.

Research looking into the effects of cocoa flavanol ingestion ranging from 5 days to 3 months in the elderly found notable effects to attention, processing speed, working memory and verbal fluency.

Older adults, whose memories have started to decline, or who have other mild cognitive impairments appeared to benefit most from ingesting this food for a prolonged period.

 “If you look at the underlying mechanism, the cocoa flavanols have beneficial effects for cardiovascular health and can increase cerebral blood volume in the dentate gyrus of the hippocampus,” according to lead authors Valentina Socci and Michele Ferrara from the University of L'Aquila in Italy.

“This structure is particularly affected by aging and therefore the potential source of age-related memory decline in humans."

The biological effects of flavonoids and their potential as nutraceuticals is not a new discovery with firms such as confectionary giants Barry Callebaut supplying the cocoa ingredient for inclusion in chocolate-based food products.

In March of last year, Belgian firm Vandenbulcke introduced ChoVita, the first chocolate brand in Europe that makes a cocoa flavanol health claim that it is “good for your blood flow.”

The brand uses Barry Callebaut's Acticoa chocolat, which uses special processing techniques to preserve cocoa flavanol content.

Likewise, Mars’s own flavanol-containing capsule CocoaVia, is now available in the UK and Ireland having previously been sold in the US.

“Unexpected” and “promising”

The review takes into account close to 50 randomised controlled trials detailing the effects of acute and chronic administration of cocoa flavanols on different cognitive domains.

Whilst the majority of the studies focused on middle aged subjects, findings from elderly adults were “unexpected” and “promising,” according to the authors.

Daily consumption of a flavanol-rich cocoa drink looked to have positively affected cognition, leading to improvements in performance in older adults with early memory decline, according to one study and in cognitively intact elderly subjects in another study.

The team noted the cognitive beneficial effects’ link to improvements in blood pressure and insulin resistance, suggesting a role of endothelial function and glucose sensitivity in controlling cognitive function.

The long-term cognitive protection of cocoa was also noted in populations at risk with a 30-day evaluation of cocoa intake in elderly subjects with vascular risk factors.

While improvements in “cognitive flexibility” were noted, no significant effects were observed in those with intact cerebrovascular functions.

“Beneficial cognitive effects of regular flavanols intake, particularly in patients at risk, are presumably mediated by direct neuroprotective actions as well as improvements in cerebrovascular and metabolic functions,” the study concluded.

“Furthermore, acute administration of cocoa flavanols could result in immediate cognitive-enhancing effect, sustaining performance particularly in cognitively demanding conditions, including fatigue and sleep loss.”

EFSA ruling 

The European Food and Safety Authority (EFSA) set the minimum recommended daily consumption for health benefits at 200 milligrams (mg) back in 2013.

They ruled that dark chocolate, cocoa extracts and cocoa-based beverages with 200 mg of cocoa flavanols contribute to normal blood circulation by helping to maintain the elasticity of blood vessels.

However, research uncovered last year believed that 100 mg of the specific flavanol epicatechin was required to achieve this health benefit and that 200 mg of total flavanols only contains 46 mg of epicatechin.

Source: Frontiers in Nutrition

Published online ahead of print: doi.org/10.3389/fnut.2017.00019

“Enhancing Human Cognition with Cocoa Flavonoids.”

Authors: Valentina Socci, Daniela Tempesta,  Giovambattista Desideri,  Luigi De Gennaro and Michele Ferrara.