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J Am Soc Hypertens. 2009 Mar-Apr;3(2):105-12. doi: 10.1016/j.jash.2008.11.001. Epub 2009 Feb 20.

Flavanols, the Kuna, cocoa consumption, and nitric oxide.

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Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.


The Kuna Indians, who reside in an archipelago on the Caribbean Coast of Panama, have very low blood pressure (BP) levels, live longer than other Panamanians, and have a reduced frequency of myocardial infarction, stroke, diabetes mellitus, and cancer-at least on their death certificates. One outstanding feature of their diet includes a very high intake of flavanol-rich cocoa. Flavonoids in cocoa activate nitric oxide synthesis in healthy humans. The possibility that the high flavanol intake protects the Kuna against high BP, ischemic heart disease, stroke, diabetes mellitus, and cancer is sufficiently intriguing and sufficiently important that large, randomized controlled clinical trials should be pursued.

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