Dietary cocoa improves health of obese mice; likely has implications for humans

April 14, 2021

Science Daily/Penn State

Supplementation of cocoa powder in the diet of high-fat-fed mice with liver disease markedly reduced the severity of their condition, according to a new study by Penn State researchers, who suggest the results have implications for people.

Cocoa powder, a popular food ingredient most commonly used in the production of chocolate, is rich in fiber, iron and phytochemicals reported to have positive health benefits, including antioxidant polyphenols and methylxanthines, noted study leader Joshua Lambert, professor of food science in the College of Agricultural Sciences.

"While it is typically considered an indulgence food because of its high sugar and fat content, epidemiological and human-intervention studies have suggested that chocolate consumption is associated with reduced risk of cardio-metabolic diseases including stroke, coronary heart disease and Type 2 diabetes," Lambert said. "So, it made sense to investigate whether cocoa consumption had an effect on non-alcohol-related fatty liver disease, which is commonly associated with human obesity."

This study has several strengths, Lambert explained. It used a commercially available cocoa product at a "physiologically achievable dose" -- meaning its equivalent could be duplicated by humans. "Doing the calculations, for people it works out to about 10 tablespoons of cocoa powder a day," he said. "Or, if you follow the directions on the Hershey's box of cocoa powder, that's about five cups of hot cocoa a day."

The high-fat-fed mouse is a well-established, diet-induced model of obesity, Lambert added. By waiting until mice were already obese before beginning cocoa treatment, researchers were able to test the protective effects of cocoa in a model that better simulates the current public health situation related to non-alcohol-related fatty liver disease.

That's important, Lambert pointed out, because a significant proportion of the world's population has preexisting obesity and non-alcohol-related fatty liver disease. "Given the high proportion of people in the United States and other parts of the world with obesity, there is a need to develop potentially effective dietary interventions rather than just preventive agents," he said.

For this study, researchers examined changes in fatty liver disease, markers of oxidative stress, antioxidant response and cell damage in high-fat-fed obese mice treated with a diet supplemented with 80 mg cocoa powder per gram of food -- roughly a pinch per quarter teaspoon -- for eight weeks.

In findings recently published in the Journal of Nutritional Biochemistry, the researchers reported that cocoa-treated mice gained weight at a 21% lower rate and had smaller spleen weights -- indicating less inflammation -- than the high-fat-fed control mice. At the end of the study, mice fed the cocoa-powder-supplemented diet had 28% less fat in their livers than the control mice. Cocoa-treated mice also had 56% lower levels of oxidative stress and 75% lower levels of DNA damage in the liver compared to high-fat-fed control mice.

The mechanisms by which cocoa imparts health benefits are not well understood, but previous studies in Lambert's lab showed that extracts from cocoa and some of the chemicals in cocoa powder can inhibit the enzymes that are responsible for digesting dietary fat and carbohydrate.

The result, he proposes, is that when mice get cocoa as part of their diet, these compounds in the cocoa powder prevent the digestion of dietary fat. When it can't be absorbed, the fat passes through their digestive systems. A similar process may occur with cocoa in humans, he hypothesizes.

In view of this new information about cocoa powder, Lambert is not recommending that obese people -- or anyone -- simply add five cups of hot cocoa to their daily routine and change nothing else in their diet. But he does advise, based on what he has learned in this study, to consider substituting cocoa for other foods, particularly high-calorie snack foods.

"This exchange is potentially beneficial, especially in combination with a healthy overall diet and increased physical activity," he said. "If you go to the gym and work out, and your reward is you go home and have a cup of cocoa, that may be something that helps get you off the couch and moving around."

Also involved in the research were Mingyao Sun, Yeyi Gu and Shannon Glisan, former graduate students in the Department of Food Science.

https://www.sciencedaily.com/releases/2021/04/210414154933.htm

Cocoa may help curb fatigue typically associated with multiple sclerosis (MS)

May offer easy, safe approach to persistent symptom, if confirmed in larger studies, suggest researchers

March 4, 2019

Science Daily/BMJ

Cocoa may help curb the fatigue that is typically associated with multiple sclerosis (MS), suggest the results of a small feasibility trial, published online in the Journal of Neurology Neurosurgery & Psychiatry.

Cocoa, like dark chocolate, is rich in flavonoids -- substances found abundantly in fruit and vegetables and associated with anti-inflammatory properties.

If the findings are confirmed in larger studies, it may offer a simple dietary approach to a persistent and hard to treat symptom, which affects nine out of 10 people with MS, suggest the researchers.

The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic, and psychological factors. None of the currently available approaches offers long term relief, say the researchers.

Previous research suggests that dark chocolate, containing between 70 and 85 per cent cocoa solids, is associated with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome (ME).

This prompted the researchers to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.

They randomly assigned 40 adults recently diagnosed with the relapsing remitting form of MS and fatigue to drink a cup of either high flavonoid cocoa powder mixed with heated rice milk (19) or a low flavonoid version (21) every day for six weeks.

Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.

Fatigue and fatigability-the speed with which mental and physical fatigue set in-were formally assessed before the start, at the mid-point, and at the end of the trial.

And participants also subjectively rated their fatigue on a scale of 1 to 10, at 10.00, 15.00, and 20.00 hours each day, and monitored their activity with a pedometer.

After six weeks there was a small improvement in fatigue in 11 of those drinking high flavonoid cocoa compared with eight of those drinking the low flavonoid version.

And there was a moderate effect on fatigability, with those drinking high flavonoid cocoa able to cover more distance during the 6 minute walk test.

Those drinking the high flavonoid version showed a 45 per cent improvement in subjectively assessed fatigue and an 80 per cent improvement in walking speed.

Although not objectively measured, pain symptoms also improved more in the high flavonoid group.

"Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management, by improving fatigue and walking endurance," write the researchers.

Given the anti-inflammatory properties of flavonoids, they could be used alongside other approaches, such as exercise, drug treatment, and physiotherapy, to treat fatigue, they suggest.

"The use of dietary approaches to reduce fatigue and associated factors in people with MS may be an easy, safe, and cost-effective way to have an impact on quality of life and independence, allowing people to feel more in control of their condition.

"A full evaluation, including wider geography, longer follow up and cost effectiveness is now indicated," they conclude.

In a linked editorial, Dr Paolo Ragonese, University of Palermo, points out that the treatment and management of MS related fatigue "still represents a challenge...because its mechanisms are multifactorial."

And diets rich in flavonoids are linked to longer life and a lower risk of cardiovascular disease as well as positive changes to the volume and diversity of gut bacteria (the microbiome), he points out.

"Although [this] study is an exploratory trial, it adds further interesting suggestions to the possible positive effects of flavonoid intake on the management of fatigue in patients with MS," he concludes.

https://www.sciencedaily.com/releases/2019/03/190304195240.htm