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Obesity is associated to a variety of metabolic disorders and psychological disturbances. The improvement of dietary habits and the promotion of physical activity are the principal strategies to combat obesity. Currently, antioxidants are thoroughly being investigated. Cocoa is one of the richest sources of antioxidants, principally flavanols, with healthy properties to prevent cardiovascular disease, endothelial dysfunctions and oxidative stress. In this context, the principal aim of this investigation was to assess if the daily consumption of 1.4 g of cocoa extract (645 mg of polyphenols with 415 mg of flavanols) within ready‐to‐eat meals and consumed under an energy restricted diet (‐15% E) during 4 weeks, could have beneficial effects on the nutritional and the cardiometabolic status, as well as on depression and anxiety symptoms of middle‐aged overweight/obese subjects. In this sense, the specific objectives were: 1) to analyse the effect of the dietary intervention on general nutrition and metabolism; 2) to assess the effects of cocoa extract consumption on anthropometrics and body composition, blood pressure, routine blood biochemical determinations and biomarkers related to oxidative status, endothelial function and inflammation; 3) to investigate the acute effects of cocoa consumption on blood pressure and blood biochemical markers (0, 60, 120 and 180 min), before and after 4 weeks of daily cocoa consumption; 4) to analyse the effect of cocoa intake within ready‐to‐eat meals on depressive and anxiety symptoms, as well as on the peripheral dopaminergic activity; 5) to evaluate plasma and urinary metabolomic profile in order to assess the presence of cocoa derived metabolites. For that purpose, a 4 week, double‐blind, randomised, placebo‐controlled parallel intervention with a simultaneous postprandial sub‐study was carried out. Fifty subjects were recruited, 25 in each group. The intervention consisted on the daily intake of ready‐to‐eat meals supplemented with 1.4 g of cocoa extract and integrated within a 15% energy restricted diet. At the endpoint, 24 subjects completed the study in the control group and 23 subjects in the cocoa group. This investigation showed that an energy restriction of 15% resulted in beneficial outcomes reducing anthropometric and body composition variables, cardiometabolic markers, inflammatory and oxidative markers, and contributed to the reduction of depressive symptoms. Concerning the inclusion of 1.4 g of cocoa extract, a significantly higher reduction of oxidised low‐density lipoprotein‐cholesterol levels was found in cocoa consumers. However, no difference was demonstrated in the oxidative DNA damage between both groups. Interestingly, the daily consumption of the cocoa extract during 4 weeks revealed a higher reduction of the postprandial systolic blood pressure response compared to the control group, suggesting an adaptive effect over time. On the other hand, the consumption of cocoa extract during 4 weeks did not induce a direct effect on Beck Depression Inventory. However, pHVA, which reflects dopaminergic activity in the brain, showed a greater increase in cocoa consumers compared to the control group. In cocoa group, pHVA was negatively associated with the reduction of depressive symptoms, suggesting the implication of cocoa on psychological behaviour. Finally, the higher presence of cocoa derived metabolites in plasma and urine on cocoa consumers suggested the adequate adherence of the volunteers, as well as the bioavailability of cocoa compounds within the meals.

Abstract Background: Cardiometabolic profile is usually altered in obesity. Interestingly, the consumption of flavanolrich foods might be protective against those metabolic alterations. Objective: To evaluate the postprandial cardiometabolic effects after the acute consumption of cocoa extract before and after 4 weeks of its daily intake. Furthermore, the bioavailability of cocoa extract was investigated. Design: Twenty-four overweight/obese middle-aged subjects participated in a 4-week intervention study. Half of the volunteers consumed a test meal enriched with 1.4 g of cocoa extract (415 mg flavanols), while the rest of the volunteers consumed the same meal without the cocoa extract (control group). Glucose and lipid profile, as well as blood pressure and cocoa metabolites in plasma, were assessed before and at 60, 120, and 180 min post-consumption, at the beginning of the study (Postprandial 1) and after following a 4-week 15% energy-restricted diet including meals containing or not containing the cocoa extract (Postprandial 2). Results: In the Postprandial 1 test, the area under the curve (AUC) of systolic blood pressure (SBP) was significantly higher in the cocoa group compared with the control group (p 0.007), showing significant differences after 120 min of intake. However, no differences between groups were observed at Postprandial 2. Interestingly, the reduction of postprandial AUC of SBP (AUC_Postprandial 2-AUC_Postprandial 1) was higher in the cocoa group (p 0.016). Furthermore, cocoa-derived metabolites were detected in plasma of the cocoa group, while the absence or significantly lower amounts of metabolites were found in the control group. Conclusions: The daily consumption of cocoa extract within an energy-restricted diet for 4 weeks resulted in a greater reduction of postprandial AUC of SBP compared with the effect of energy-restricted diet alone and independently of body weight loss. These results suggest the role of cocoa flavanols on postprandial blood pressure homeostasis.

Background and aims Cocoa flavanols are recognised by their favourable antioxidant and vascular effects. This study investigates the influence on health of the daily consumption of ready-to-eat meals supplemented with cocoa extract within a hypocaloric diet, on middle-aged overweight/obese subjects. Methods and results Fifty healthy male and female middle-aged volunteers [57.26 ± 5.24 years and body mass index (BMI) 30.59 ± 2.33 kg/m2] were recruited to participate in a 4 week randomised, parallel and double-blind study. After following 3 days on a low-polyphenol diet, 25 volunteers received meals supplemented with 1.4 g of cocoa extract (645.3 mg of polyphenols) and the other 25 participants received control meals, within a 15% energy restriction diet. On the 4th week of intervention individuals in both dietary groups improved (p < 0.05) anthropometric, body composition, blood pressure and blood biochemical measurements. Oxidised LDL cholesterol (oxLDL), showed a higher reduction (p = 0.030) in the cocoa group. Moreover, myeloperoxidase (MPO) levels decreased only in the cocoa supplemented group (p = 0.007). Intercellular Adhesion Molecule-1 (sICAM-1) decreased significantly in both groups, while Vascular Cell Adhesion Molecule-1 (sVCAM-1) did not present differences after the 4 weeks of intervention. Interestingly, cocoa intake showed a different effect by gender, presenting more beneficial effects in men. Conclusions The consumption of cocoa extract as part of ready-to-eat meals and within a hypocaloric diet improved oxidative status (oxLDL) in middle-aged subjects, being most remarkable in males.

PURPOSE: Dietary food composition influences postprandial glucose homeostasis. Thus, the objective was to investigate the effects of an acute intake of three different types of strawberry jam, differing in carbohydrate and antioxidants content, on postprandial glucose metabolism, lipid profile, antioxidant status, and satiety. METHODS: Sixteen healthy adults participated in a randomized, crossover, double-blind study with three arms, receiving 60 g of three different strawberry jams. Blood samples were collected at fasting and at 30, 60, 90, and 120 min after its intake. Blood analyses were performed with validated procedures and satiety was estimated with visual analogue scale (VAS). RESULTS: Blood glucose concentrations were maintained at normal values and without peaks within the 2 h after consumption of low-sugar jams. However, blood glucose and insulin were significantly higher at 30 and 60 min after high-sugar (HS) jam intake versus both low-sugar jams. Furthermore, HS jam produced more satisfaction at short time, but decreased as soon as blood glucose concentration began to decrease. Moreover, HS ingestion produced lower free fatty acid levels (p < 0.05) throughout the trial with respect both the low-sugar jams. However, no additional benefits on oxidative status (malondialdehyde, glutathione peroxidase, total antioxidant capacity, and uric acid), glucose, lipid, and satiety variables were observed due to the inclusion of an antioxidant to low-sugar jam. CONCLUSIONS: This study reinforces the idea that products without added sugars are appropriate for the management of glycemic alterations and provides further insight into the effect of natural antioxidants as a functional ingredient on oxidative status and related metabolic disturbances.