The Potential of Cocoa Extract in Reducing Inflammation
Recent research investigates whether cocoa extract supplements, which are rich in cocoa flavanols, can decrease inflammation and subsequently prevent age-related chronic diseases. A study from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) conducted by investigators from Mass General Brigham examined changes in five age-related markers of inflammation among participants who ingested daily cocoa supplements over an extended period. The findings revealed a decrease in high-sensitivity C-reactive protein (hsCRP) levels—an inflammatory marker associated with an increased risk of cardiovascular disease—among those taking the cocoa extract. This suggests that cocoa extract may possess anti-inflammatory properties that contribute to its heart-protective effects. These results are published in Age and Ageing.
Understanding Inflammaging and Cocoa Extract
Nutritional interventions have gained popularity for their potential to mitigate the effects of “inflammaging,” a term describing age-related chronic inflammation. Previous smaller studies have indicated that cocoa extract can reduce inflammatory biomarkers, thanks to flavanols—bioactive compounds present in not only cocoa beans but also in various plant-based foods such as berries, grapes, and tea. The COSMOS trial was initiated to bridge the knowledge gap between these previous studies and human applications, focusing on the influence of cocoa extract on cardiovascular health and its connection to inflammaging.
The COSMOS Trial: A Comprehensive Investigation
From 2014 to 2020, the COSMOS trial, a large-scale randomized double-blind placebo-controlled clinical study, was conducted at Brigham and Women’s Hospital, involving 21,442 participants aged 60 years and older. The trial found that cocoa extract supplementation resulted in a 27% reduction in mortality due to cardiovascular disease.
Biomarkers of Inflammation Analyzed in the Study
In this recent study, researchers collected and analyzed blood samples from 598 COSMOS participants to measure various biomarkers of inflammation, including three pro-inflammatory proteins (hsCRP, IL-6, and TNF-α), one anti-inflammatory protein (IL-10), and one immune-mediating protein (IFN-γ). Changes in these biomarkers were measured at baseline, as well as at one and two years of follow-up. The results indicated an annual decrease of 8.4% in hsCRP levels compared to placebo, while the other biomarkers demonstrated relative stability or modest increases.
Implications for Future Research
“Interestingly, an increase in interferon-γ, an immune-related cytokine, was also noted, prompting new questions for future research,” stated senior author Yanbin Dong, MD/PhD, Director of the Georgia Prevention Institute. “While cocoa extract cannot replace a healthy lifestyle, these results underscore its potential role in modulating inflammation as we age.”
The observed decrease in hsCRP may elucidate the cardio-protective effects noted in earlier findings from the COSMOS trial, where participants experienced a reduction in deaths from cardiovascular disease. Researchers highlighted the need for further studies to investigate changes in other biomarkers of inflammation, including a minor reduction in IL-6 seen in female participants, which requires additional exploration. Ongoing evaluations of the COSMOS trial aim to determine whether cocoa extract and multivitamin regimens can mitigate more severe inflammaging and other aging-related health outcomes.
The Importance of Plant-Based Foods
“This study emphasizes the significance of plant-based foods, particularly cocoa products rich in flavanols, for cardiovascular health,” added Howard Sesso, ScD, MPH, associate director of the Division of Preventive Medicine at Brigham and Women’s Hospital. “It reinforces the value of a diverse and colorful plant-based diet, particularly regarding inflammation.”
Key Health Takeaway
The ongoing research into cocoa extract highlights its potential to reduce inflammation and may bolster cardiovascular health, suggesting that incorporating plant-based foods rich in flavanols might be beneficial for healthy aging.
Authorship: In addition to Sesso, Mass General Brigham authors include Sidong Li, Rikuta Hamaya, Allison Clar, Pamela M. Rist, and JoAnn E. Manson. Authors from Augusta University include Haidong Zhu and Ying Huang.
Disclosures: Manson and Sesso received grants from Mars Edge for study support and the donation of study materials. Sesso also reported receiving additional funding and honoraria from various organizations. No other authors disclosed conflicts of interest.
Funding: This research was funded by the National Institutes of Health (HL157665) and supported by Mars Edge and Pfizer Consumer Healthcare. Neither company was involved in the trial’s design, conduct, data analysis, or manuscript preparation.
