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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.

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.

The application of metabolomics in nutritional research may be a useful tool to analyse and predict the response to a dietary intervention. The aim of this study was to examine metabolic changes in serum samples following exposure to an energy-restricted diet (-15% of daily energy requirements) over a period of 8weeks in overweight and obese older adults (n=22) using a gas chromatography/mass spectrometry (GC/MS) metabolomic approach. After 8weeks, there were significant reductions in weight (7%) and metabolic improvement (glucose and lipid profiles). Metabolomic analysis found that total saturated fatty acids (SFAs), including palmitic acid (C16:0) and stearic acid (C18:0) and monounsaturated fatty acids (MUFAs), were significantly decreased after the 8-week intervention. Furthermore, palmitoleic acid (C16:1) was found to be a negative predictor of change in body fat loss. Both the total omega-6 and omega-3 polyunsaturated fatty acids (PUFAs) significantly decreased, although the overall total amounts of PUFAs did not. The branched chain amino acid (BCAA) isoleucine significantly decreased in the serum samples after the intervention. In conclusion, this study demonstrated that the weight loss intervention based on a hypocaloric diet identified changes in the metabolic profiles of serum in overweight and obese older adults, with a reduction in anthropometric and biochemical parameters also found.