Cocoa, hazelnuts, sterols and soluble fiber cream reduces lipids and inflammation biomarkers in hypertensive patients: a randomized controlled trial

• Published in: PloS one Vol. 7; no. 2; p. e31103
• Main Authors: Solà, Rosa, Valls, Rosa M, Godàs, Gemma, Perez-Busquets, Gloria, Ribalta, Josep, Girona, Josefa, Heras, Mercedes, Cabré, Anna, Castro, Antoni, Domenech, Gema, Torres, Ferran, Masana, Lluís, Anglés, Neus, Reguant, Jordi, Ramírez, Bartolomé, Barriach, Joaquim M
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27-02-2012; Public Library of Science (PLoS)
• Subjects: Adult; Age; Aged; Antioxidants; Apolipoprotein B; Apolipoproteins; Bioindicators; Biological markers; Biology; Biomarkers; Biomarkers - metabolism; C-reactive protein; Cacao - metabolism; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - drug therapy; Cholesterol; Clinical trials; Cocoa; Corylus - metabolism; Cream; Diet; Dietary fiber; Double-Blind Method; Endothelium; Fatty acids; Female; Food; Food intake; Hazelnuts; Heart attacks; Humans; Hypercholesterolemia; Hypertension; Hypertension - drug therapy; Inflammation; Inflammation - drug therapy; Insulin resistance; Kinases; Lipids; Lipids - blood; Low density lipoprotein; Low density lipoproteins; Low fat diet; Male; Medicine; Middle Aged; Mortality; Nutrient deficiency; Nuts; Oils & fats; Phytosterols; Polyphenols; Proteins; Randomization; Research Design; Sample Size; Statistical analysis; Sterols; Sterols - chemistry; Vascular endothelial growth factor; Women; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0031103

Cocoa, mixed with other food ingredients, intake can have beneficial effects on cardiovascular disease (CVD) biomarkers. We compared the effects of 4 cocoa cream products on some of these biomarkers.
In this multi-centered, randomized, controlled, double-blind, parallel trial, volunteers (n = 113; age range: 43-65 years) who were pre-hypertensive, stage-1 hypertensive and hypercholesterolemic received one of 4 cocoa cream products (13 g/unit; 1 g cocoa/unit, 6 units/d; 465 Kcal/d) added to a low saturated fat diet for 4 weeks. The groups were: A) (n = 28), cocoa cream considered as control; B) (n = 28), cocoa+hazelnut cream (30 g/d hazelnuts); C) (n = 30), cocoa+hazelnuts+phytosterols (2 g/d); and D) (n = 27), cocoa+hazelnuts+phytosterols+soluble fiber (20 g/d) the patented "LMN product". Primary outcome measures were BP, LDL-c, apolipoprotein B-100 (Apo B), ApoB/ApoA ratio, oxidized LDL (oxLDL) and high-sensitive C-reactive protein (hsCRP) determined at baseline and post-cocoa cream product intake. Statistical analysis used was ANCOVA or mixed models (in case of repeated measurements), with baseline observation included as a covariate. After 4 weeks, compared to product A, product C reduced LDL-c by 11.2%, Apo B by 8.1% and ApoB/ApoA ratio by 7.8% (P = 0.01). LMN decreased LDL-c by 9.2%, Apo B-100 by 8.5%, ApoB/ApoA ratio by 10.5%, hsCRP by 33.4% and oxLDL by 5.9% (P = 0.01). Surprisingly, even "control" product A reduced systolic BP (-7.89 mmHg; 95%CI: -11.45 to -4.3) and diastolic BP (-5.54 mmHg; 95%CI: -7.79 to -3.29). The BP reductions were similar with the other 3 products. Limitations of the study are that the trial period was relatively short and that a better "BP control" product would have been preferable.
The creams (particularly the LMN) have anti-inflammatory and antioxidant effects in addition to lowering LDL-c, Apo B and ApoB/ApoA ratio. Thus, the soluble fiber effects amplified with sterols (as contained in the cocoa creams) provide new dietary therapeutic perspectives.
Clinicaltrials.gov NCT00511420.