Suzana Almoosawi

The effect of polyphenol-rich dark chocolate on fasting capillary whole blood glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjects

Numerous studies indicate that polyphenol-rich chocolate reduces fasting blood glucose, blood pressure (BP) and total cholesterol in healthy individuals and hypertensives with or without glucose intolerance. The aim of the present study was to investigate the effect of two doses of polyphenol-rich dark chocolate (DC) on fasting capillary whole blood glucose, total cholesterol and BP and to examine whether improvements in these parameters are associated with changes in adrenocorticoid excretion in overweight and obese individuals. The study used a randomised, single-blind, cross-over design where fourteen overweight and obese subjects were randomised to either take 20 g DC with 500 mg polyphenols then 20 g DC with 1000 mg polyphenols or vice-versa. Participants followed each diet for 2 weeks separated by a 1-week washout period. It was observed that the 500 mg polyphenol dose was equally effective in reducing fasting blood glucose levels, systolic BP (SBP) and diastolic BP (DBP) as the 1000 mg polyphenol dose suggesting that a saturation effect might occur with increasing dose of polyphenols. There was also a trend towards a reduction in urinary free cortisone levels with both groups although it did not reach statistical significance. No changes in anthropometrical measurements were seen. We suggest that more research is required to investigate the mechanism(s) by which polyphenol-rich foods influence health.

Cocoa and Human Health: From Head to Foot—A Review

The cocoa, as part of the wonderful nature, provides the mankind a wide variety of valuable food products and health benefits. The most known and universally relished product derived from this fruit is chocolate, an amazing and unique food for the human nutrition with records of consumption of similar products dating to 1000 years BC. In fact, the cocoa is a complex food that includes over 300 different components. This review is designed to inform scientists, technicians, academicians, farmers, and interested communities of numerous studies that have been conducted worldwide to investigate the properties of various cocoa constituents, their relations to human health, and their potential role in the prevention and treatment of many medical conditions. The general population, for example in Brazil, despite being one of the major producers of cocoa, is poorly informed of the significant and beneficial properties of cocoa. The present review covers important topics linking cocoa to human health and show the state of the art of effect of cocoa in different systems that comprise the human body. The paper is organized based on the main human organ system and includes: cardiovascular/circulatory, neurological/nervous, oral health, endocrine, lymphatic and immunological, respiratory, reproductive, and dermatological systems. Scientific findings tend to confirm the historic designation of cocoa as “food of the Gods.”

Intake of polyphenol-rich pomegranate pure juice influences urinary glucocorticoids, blood pressure and homeostasis model assessment of insulin resistance in human volunteers.

Pomegranate juice (PJ; also known as pomegreat pure juice) provides a rich and varied source of polyphenolic compounds that may offer cardioprotective, anti-atherogenic and antihypertensive effects. The aim of this study was to investigate the effect of PJ consumption on glucocorticoids levels, blood pressure (BP) and insulin resistance in volunteers at high CVD risk. Subjects (twelve males and sixteen females) participated in a randomised, placebo-controlled cross-over study (BMI: 26·77 (sd 3·36) kg/m2; mean age: 50·4 (sd 6·1) years). Volunteers were assessed at baseline, and at weeks 2 and 4 for anthropometry, BP and pulse wave velocity. Cortisol and cortisone levels in urine and saliva were determined by specific ELISA methods, and the cortisol/cortisone ratio was calculated. Fasting blood samples were obtained to assess plasma lipids, glucose, insulin and insulin resistance (homeostasis model assessment of insulin resistance). Volunteers consumed 500 ml of PJ or 500 ml of a placebo drink containing a similar amount of energy. Cortisol urinary output was reduced but not significant. However, cortisol/cortisone ratios in urine (P = 0·009) and saliva (P = 0·024) were significantly decreased. Systolic BP decreased from 136·4 (sd 6·3) to 128·9 (sd 5·1) mmHg (P = 0·034), and diastolic BP from 80·3 (sd 4·29) to 75·5 (sd 5·17) mmHg (P = 0·031) after 4 weeks of fruit juice consumption. Pulse wave velocity decreased from 7·5 (sd 0·86) to 7·44 (sd 0·94) m/s (P = 0·035). There was also a significant reduction in fasting plasma insulin from 9·36 (sd 5·8) to 7·53 (sd 4·12) mIU/l (P = 0·025) and of homeostasis model assessment of insulin resistance (from 2·216 (sd 1·43) to 1·82 (sd 1·12), P = 0·028). No significant changes were seen in the placebo arm of the study. These results suggest that PJ consumption can alleviate key cardiovascular risk factors in overweight and obese subjects that might be due to a reduction in both systolic and diastolic BP, possibly through the inhibition of 11β-hydroxysteroid dehydrogenase type 1 enzyme activity as evidenced by the reduction in the cortisol/cortisone ratio. The reduction in insulin resistance might have therapeutic benefits for patients with non-insulin-dependent diabetes, obesity and the metabolic syndrome.

Polyphenol-Rich Dark Chocolate in Treatment of Diabetes Mellitus Risk Factors

Type 2 diabetes is generally characterized by hyperglycemia, insulin resistance (reduced insulin sensitivity), and obesity, which is associated with not only diabetes but also hyperlipidemia and hypertension. Evidence from the past 10 years demonstrates that moderate intake of dark chocolate may exert protective effects against the development of type 2 diabetes risk factors; however, large-scale clinical trials are required. Several mechanisms have been proposed to explain the chocolate’s positive effects, not only on insulin sensitivity and vascular endothelial function but also its metabolic (fat and carbohydrate), antihypertensive, antithrombotic, and anti-inflammatory effects. Polyphenol-rich chocolate may potentially be used as a nutraceutical medication to help treat diabetes, strokes, and vascular dementia; thus, future studies should provide information on polyphenol content and the flavanol plasma levels achieved.

Polyphenol-rich dark chocolate: effect on fasting capillary glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjects

Excess cortisol is associated with various variables of the metabolic syndrome including hypertension, insulin resistance and dyslipidaemia. This relationship is likely to be mediated via cortisol’s ability to regulate NO bioavailability. Since increased NO bioavailability is considered the main mechanism by which polyphenols improve glucose, blood pressure and lipid homeostasis, the present study aimed to investigate the effect of two doses of polyphenol-rich dark chocolate on fasting capillary glucose (FG), total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP) and urinary free cortisol (F), cortisone (E) and cortisone:cortisol (E:F) in a group of overweight and obese subjects. The study used a single-blind randomised cross-over design wherein fourteen subjects (eight males, six females; age 36 (SD 11) years; BMI 28 (SD 2.5) kg/m) consumed 20 g dark chocolate containing 500 mg or 1000 mg polyphenols for 2 weeks, separated by a 1-week washout period. This 20g portion corresponds to half a portion of habitual chocolate intake and provides similar concentrations of polyphenols as used in previous studies on healthy and hypertensive volunteers that have reported significant reductions in blood pressure following consumption of dark chocolate . Capillary FG and TC levels were measured using a calibrated Accutrend GC system (Roche Diagnostics, Burgess Hill, West Sussex, UK). Blood pressure was measured using an automated A&D Medical UA-767 BP monitor (A&D Medical, San Jose, CA, USA). Subjects also completed three 3 d diet and physical activity diaries at baseline and during each intervention. Compliance was measured by direct interviewing, returning of empty chocolate foils and assessment of diet diaries. Repeated-measures ANOVA revealed a significant reduction in capillary FG levels, SBP and DBP following both treatments. No significant differences were observed between dark chocolate containing 500 mg and 1000 mg polyphenols, suggesting that both doses were equally effective in improving these variables (P>0.05). No changes in anthropometrical measurements, capillary TC and urinary free glucocorticoids levels were observed.