A new study has shown promising results for the use of cocoa flavanols in preventing heart disease.
The study, called the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), was led by Howard Sesso and JoAnn Manson of Brigham and Women’s Hospital.
The study tested a cocoa flavanol supplement and a multivitamin in the prevention of cardiovascular disease and cancer.
While either supplement strongly reduced the primary outcome of total cardiovascular events, the team found people who received the cocoa flavanol supplement had a 27% lower rate of heart disease death.
Cocoa flavanols are compounds found in several plant-based foods, including cocoa, tea, grapes, and berries.
Previous smaller, short-term trials have found cardiovascular benefits for cocoa flavanols on blood pressure and blood vessel dilation.
The study offered the first opportunity to study whether a cocoa flavanol supplement might also lead to longer-term reductions in clinical cardiovascular events.
The study involved more than 21,000 participants who were randomized to take daily capsules that contained 500 mg of cocoa flavanols, a multivitamin tablet, neither, or both.
The primary heart outcome for the cocoa flavanol intervention was a composite of total cardiovascular events, including heart attacks, stroke, coronary revascularization, cardiovascular death, carotid artery disease, peripheral artery surgery, and unstable angina.
The study found that cocoa flavanols reduced total cardiovascular events by 10%, but this was not statistically significant.
However, several secondary analyses provided broader support for the potential benefit of cocoa flavanols on cardiovascular events.
Those receiving the cocoa flavanol supplement had a significant 27% reduction in death from cardiovascular disease.
When the study team took adherence to study pills into account, they saw a stronger, 15% reduction in total cardiovascular events and a 39% reduction in death from cardiovascular disease.
A composite endpoint of major cardiovascular events (heart attacks, strokes, and cardiovascular deaths) was also significantly reduced.
A daily multivitamin had no significant effect on total or individual cardiovascular events. There were no safety concerns for either cocoa flavanols or a multivitamin.
The study concluded after about 3.6 years, which was likely too short to detect whether the supplements could have affected cancer risk.
Although a daily multivitamin improved levels of several nutritional biomarkers, it had no significant effect on total invasive cancer. Cocoa flavanols also had no significant effect on total invasive cancer.
The authors note that their promising results on cocoa flavanols and cardiovascular events warrant cautious interpretation and underscore the need for additional research.
While the study suggests intriguing signals for cardiovascular protection with cocoa flavanols, any health benefits due to taking these supplements will need confirmation in a future trial.
The researchers recommend eating a healthy, balanced diet rich in natural food sources of flavanols as the best way to protect against heart disease.
How to prevent heart disease
There are several lifestyle changes that can help prevent heart disease:
Eating a healthy diet: Include more fruits, vegetables, whole grains, lean proteins, and healthy fats in your diet. Reduce your intake of saturated and trans fats, salt, and sugar.
Exercising regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
Maintaining a healthy weight: Being overweight or obese increases your risk of heart disease.
Managing stress: High levels of stress can contribute to heart disease. Find healthy ways to manage stress, such as exercise, meditation, or spending time with loved ones.
Quitting smoking: Smoking damages the lining of your blood vessels, making them more susceptible to plaque buildup.
Limiting alcohol intake: Drinking too much alcohol can raise your blood pressure and increase your risk of heart disease.
Getting enough sleep: Poor sleep can contribute to high blood pressure, obesity, and other risk factors for heart disease.
It’s important to talk to your doctor about your individual risk factors for heart disease and how to manage them. They may recommend medication, such as cholesterol-lowering drugs, if necessary.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more information about health, please see recent studies about a surprising cause of abnormal heart rhythm, and results showing magnet in common popular devices may harm your heart health.
The study was published in The American Journal of Clinical Nutrition.
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