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J Gerontol A Biol Sci Med Sci. 2019 May 6. pii: glz107. doi: 10.1093/gerona/glz107. [Epub ahead of print]

High flavonoid cocoa supplement ameliorates plasma oxidative stress and inflammation levels while improving mobility and quality of life in older subjects: a double blind randomized clinical trial.

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Seccion de Estudios de Posgrado e Investigacion, Escuela Superior de Medicina, Instituto Politecnico Nacional, Mexico.
Escuela Nacional de Ciencias Biologicas, Instituto Politecnico Nacional, Mexico.
Department of Medicine, School of Medicine, University of California, San Diego, La Jolla California.
Research Scientist VA San Diego Healthcare System, SD, CA.



The age-related decline in mass, strength and performance of skeletal muscle is associated with loss of independence, falls risk, disability, institutionalization and death.


To determine whether a cocoa supplement enriched in flavonoids can improve plasma markers of oxidative stress and inflammation, physical performance and frailty in middle and older age subjects, we conducted a two-phase, randomized, double blind, clinical trial. The initial study included 60 subjects (55-70 year-old) allocated into placebo (P), highly alkalinized (no-flavonoid; NF) or flavonoid rich natural cocoa (F) beverage groups. The follow-up study included 74 older subjects (65-90 year-old) randomly distributed into NF or F groups. Subjects were instructed to consume the beverages once/day for up to 12-weeks. A comprehensive (aging relevant) set of endpoints were assessed which included mean change in blood plasma metabolic and oxidative stress indicators, in physical performance tests and quality of life (QoL).


In the initial study, the F group showed improved glycemia, triglyceridemia (TG), c-HDL, c-LDL, the TG/HDL index, and oxidative markers. Performance on the Up & Go test, skeletal muscle index, and QoL also improved. In the follow-up study, F treatment was associated with significant improvements in metabolic, oxidative stress and inflammatory endpoints and positive effects on physical performance, frailty indicators and QoL (F vs. NF group).


Regular flavonoids consumption positively impact blood oxidative stress and inflammation endpoints, cardiometabolic risk markers, physical performance and QoL. The sum of such effects may help to mitigate the extent of frailty development in the elderly.Trial Registration: Identifier: NCT03585868.


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