Postgraduate Thesis: A systematic review on the role of chocolate in the prevention of cardiovascular diseases

File Download

FullText.pdf

Supplementary

Citations:
- Scopus:
- Web of Science:
- PubMed Central:
Item Statistics (The Hub)
Appears in Collections:
- Community Medicine: Theses
- HKU Theses Online

Title	A systematic review on the role of chocolate in the prevention of cardiovascular diseases
Authors	Chow, Wai-sum. 周瑋琛.
Issue Date	2011
Publisher	The University of Hong Kong (Pokfulam, Hong Kong)
Abstract	Background: Research studies in recent years suggested possible role of dark chocolate in preventing cardiovascular diseases due to its high flavonal and procyanidins contents. Whether there is clear clinical benefit and the mechanisms mediating such benefits is controversial. Objective: This systematic review aims to comprehensively examine the current clinical evidence regarding effectiveness and the possible mechanisms of chocolate in reducing the risk and / or surrogate markers of cardiovascular diseases. Methods: Comprehensive electronic literature search was performed using Ovid, Medline and Cochrane database. Only English language literatures published during year 1950 - 2010 were reviewed. All intervention studies and observational studies of adult human subjects taking white or dark chocolate in relation to outcomes of cardiovascular risk were included. All review articles and meta-analysis were also included. Clinical diagnosis of cardiovascular disease and surrogate markers including blood pressure, vascular endothelial function as measured by flowed mediated vasodilation, and blood biomarkers such as lipid profile were studied as outcome variables. Results: The review outlines recent observational and interventional studies and meta-analysis to give an overview of the topic. For observational studies, a cohort studies and two case control studies were found. The observational studies showed that dark chocolate consumption was inversely associated with blood pressure, cardiovascular mortality and C-reactive protein. All interventional studies searched showed that dark chocolate increased FMD and improved platelet function. However, the effects of cocoa on intermediate outcomes such as blood pressure, antioxidant capacity and inflammatory marker changes were inconsistent among interventional studies. Three interventional studies indicated that there was a dose-dependent improvement in immediate outcome variables after 1 month or even 2 hours acute consumption of dark chocolate with procyanidins or cocoa drink with flavonol. However, publication bias and potential conflict of interests may be a potentially important factor in interpreting study results in the current literature. Conclusions: There are some clinical and scientific evidences that consumption of dark chocolate produces positive cardiovascular benefits. A small amount of dark chocolate may be good for the heart. However, gaps in our knowledge such as a lack of long-term RCT in clinical outcomes must be filled in before recommending habitual dark chocolate consumption for reduction of cardiovascular risk.
Degree	Master of Public Health
Subject	Cardiovascular system - Diseases - Prevention. Chocolate - Health aspects.
Dept/Program	Community Medicine

DC Field	Value
dc.contributor.author	Chow, Wai-sum.
dc.contributor.author	周瑋琛.
dc.date.hkucongregation	2012
dc.date.issued	2011
dc.description.abstract	Background: Research studies in recent years suggested possible role of dark chocolate in preventing cardiovascular diseases due to its high flavonal and procyanidins contents. Whether there is clear clinical benefit and the mechanisms mediating such benefits is controversial. Objective: This systematic review aims to comprehensively examine the current clinical evidence regarding effectiveness and the possible mechanisms of chocolate in reducing the risk and / or surrogate markers of cardiovascular diseases. Methods: Comprehensive electronic literature search was performed using Ovid, Medline and Cochrane database. Only English language literatures published during year 1950 - 2010 were reviewed. All intervention studies and observational studies of adult human subjects taking white or dark chocolate in relation to outcomes of cardiovascular risk were included. All review articles and meta-analysis were also included. Clinical diagnosis of cardiovascular disease and surrogate markers including blood pressure, vascular endothelial function as measured by flowed mediated vasodilation, and blood biomarkers such as lipid profile were studied as outcome variables. Results: The review outlines recent observational and interventional studies and meta-analysis to give an overview of the topic. For observational studies, a cohort studies and two case control studies were found. The observational studies showed that dark chocolate consumption was inversely associated with blood pressure, cardiovascular mortality and C-reactive protein. All interventional studies searched showed that dark chocolate increased FMD and improved platelet function. However, the effects of cocoa on intermediate outcomes such as blood pressure, antioxidant capacity and inflammatory marker changes were inconsistent among interventional studies. Three interventional studies indicated that there was a dose-dependent improvement in immediate outcome variables after 1 month or even 2 hours acute consumption of dark chocolate with procyanidins or cocoa drink with flavonol. However, publication bias and potential conflict of interests may be a potentially important factor in interpreting study results in the current literature. Conclusions: There are some clinical and scientific evidences that consumption of dark chocolate produces positive cardiovascular benefits. A small amount of dark chocolate may be good for the heart. However, gaps in our knowledge such as a lack of long-term RCT in clinical outcomes must be filled in before recommending habitual dark chocolate consumption for reduction of cardiovascular risk.
dc.description.nature	published_or_final_version
dc.description.thesisdiscipline	Community Medicine
dc.description.thesislevel	master's
dc.description.thesisname	Master of Public Health
dc.identifier.hkul	b4756019
dc.language	eng
dc.publisher	The University of Hong Kong (Pokfulam, Hong Kong)
dc.relation.ispartof	HKU Theses Online (HKUTO)
dc.rights	The author retains all proprietary rights, (such as patent rights) and the right to use in future works.
dc.rights	Creative Commons: Attribution 3.0 Hong Kong License
dc.source.uri	http://hub.hku.hk/bib/B47560198
dc.subject.lcsh	Cardiovascular system - Diseases - Prevention.
dc.subject.lcsh	Chocolate - Health aspects.
dc.title	A systematic review on the role of chocolate in the prevention of cardiovascular diseases
dc.type	PG_Thesis

<?xml encoding="utf-8" version="1.0"?><item><contributor.author>Chow, Wai-sum.</contributor.author><contributor.author>&#21608;&#29771;&#29723;.</contributor.author><date.issued>2011</date.issued><description.abstract>&#65279;Background: Research studies in recent years suggested possible role of dark chocolate in preventing cardiovascular diseases due to its high flavonal and procyanidins contents. Whether there is clear clinical benefit and the mechanisms mediating such benefits is controversial. 

Objective: This systematic review aims to comprehensively examine the current clinical evidence regarding effectiveness and the possible mechanisms of chocolate in reducing the risk and / or surrogate markers of cardiovascular diseases. 

Methods: Comprehensive electronic literature search was performed using Ovid, Medline and Cochrane database.  Only English language literatures published during year 1950 - 2010 were reviewed. All intervention studies and observational studies of adult human subjects taking white or dark chocolate in relation to outcomes of cardiovascular risk were included. All review articles

and meta-analysis were also included. Clinical diagnosis of cardiovascular disease and surrogate markers including blood pressure, vascular endothelial function as measured by flowed mediated vasodilation, and blood biomarkers such as lipid profile were studied as outcome variables.

Results: The review outlines recent observational and interventional studies and meta-analysis to give an overview of the topic.  For observational studies, a cohort studies and two case control studies were found. The observational studies showed that dark chocolate consumption was inversely associated with blood pressure, cardiovascular mortality and C-reactive protein. All interventional studies searched showed that dark chocolate increased FMD and improved platelet function. However, the effects of cocoa on intermediate outcomes such as blood pressure, antioxidant capacity and inflammatory marker changes were inconsistent among interventional studies. Three interventional studies indicated that there was a dose-dependent improvement in immediate outcome variables after 1 month or even 2 hours acute consumption of dark chocolate with procyanidins or cocoa drink with flavonol. However, publication bias and potential conflict of interests may be a potentially important factor in interpreting study results in the current literature. 

Conclusions: There are some clinical and scientific evidences that consumption of dark chocolate produces positive cardiovascular benefits. A small amount of dark chocolate may be good for the heart. However, gaps in our knowledge such as a lack of long-term RCT in clinical outcomes must be filled in before recommending habitual dark chocolate consumption for reduction of cardiovascular risk.</description.abstract><language>eng</language><publisher>The University of Hong Kong (Pokfulam, Hong Kong)</publisher><relation.ispartof>HKU Theses Online (HKUTO)</relation.ispartof><rights>The author retains all proprietary rights, (such as patent rights) and the right to use in future works.</rights><rights>Creative Commons: Attribution 3.0 Hong Kong License</rights><source.uri>http://hub.hku.hk/bib/B47560198</source.uri><subject.lcsh>Cardiovascular system - Diseases - Prevention.</subject.lcsh><subject.lcsh>Chocolate - Health aspects.</subject.lcsh><title>A systematic review on the role of chocolate in the prevention of cardiovascular diseases</title><type>PG_Thesis</type><identifier.hkul>b4756019</identifier.hkul><description.thesisname>Master of Public Health</description.thesisname><description.thesislevel>master&apos;s</description.thesislevel><description.thesisdiscipline>Community Medicine</description.thesisdiscipline><description.nature>published_or_final_version</description.nature><date.hkucongregation>2012</date.hkucongregation><bitstream.url>http://hub.hku.hk/bitstream/10722/174429/1/FullText.pdf</bitstream.url></item>