Effects of Acute Cocoa Supplementation on Postprandial Apolipoproteins, Lipoprotein Subclasses, and Inflammatory Biomarkers in Adults with Type 2 Diabetes after a High-Fat Meal.

Dustin W. Davis,Arpita Basu,Anthony Salazar,Timothy J. Lyons,Rickelle Tallent,James W. Navalta

doi:10.3390/nu12071902

Dustin W. Davis, Arpita Basu + Show 4 more

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https://doi.org/10.3390/nu12071902

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Abstract

Dyslipidemia and inflammation exacerbate postprandial metabolic stress in people with diabetes. Acute dietary supplementation with polyphenols shows promise in improving postprandial metabolic stress in type 2 diabetes (T2D). Cocoa is a rich source of dietary polyphenols with demonstrated cardioprotective effects in adults without diabetes. To date, the acute effects of cocoa on postprandial lipids and inflammation have received little attention in the presence of T2D. This report expands on our earlier observation that polyphenol-rich cocoa, given as a beverage with a fast-food-style, high-fat breakfast, increased postprandial high-density lipoprotein-cholesterol (HDL-C) in adults with T2D. We now test whether polyphenol-rich cocoa modulated postprandial apolipoproteins (Apo-A1, B), non-esterified fatty acids, nuclear magnetic resonance (NMR)-derived lipoprotein subclass profiles, and select biomarkers of inflammation following the same dietary challenge. We found that cocoa decreased NMR-derived concentrations of total very low-density lipoprotein and chylomicron particles and increased the concentration of total HDL particles over the 6-hour postprandial phase. Serum interleukin-18 was decreased by cocoa vs. placebo. Thus, polyphenol-rich cocoa may alleviate postprandial dyslipidemia and inflammation following a high-fat dietary challenge in adults with T2D. The study was registered at clinicaltrials.gov as NCT01886989.

Highlights

In the United States (U.S.), 88 million adults (34.5%) have prediabetes, and another 34 million (13.0%) have type 2 diabetes (T2D) [1,2]
Epicatechin is the predominant flavonoid in cocoa, but others are present, including flavan-3-ols, anthocyanins, and flavones that are associated with improvements in lipemia [23], an important target in slowing the progression of atherosclerotic cardiovascular disease (CVD) in T2D [28]
We examined the acute effects of polyphenol-rich cocoa on postprandial lipemia: the supplement was consumed with a single fast-food-style HF meal

Summary

Introduction

In the United States (U.S.), 88 million adults (34.5%) have prediabetes, and another 34 million (13.0%) have type 2 diabetes (T2D) [1,2]. T2D is the seventh leading cause of mortality, contributing to over a quarter-million U.S deaths in 2017 alone [1]. The burgeoning prevalence causes considerable financial strain. Indirect and direct expenses for treating the disease surpassed $300 million in 2017, an increase of $70 million from 2012 [1]. The health and financial burdens are projected to grow over the four decades alongside the number of older adults, who are disproportionately affected by. The population of U.S adults aged ≥ 65 years (T2D prevalence of 26.8% [1]) is expected to grow

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