Abstract
Obesity remains a major public health problem due to its increasing prevalence. Natural products have become common as adjunct therapeutic agents for treating obesity and preventing metabolic diseases. Cocoa and its products are commonly consumed worldwide. Dark chocolate, a rich source of polyphenols, has received attention lately for its beneficial role in the management of obesity; however, conflicting results are still being reported. This scoping review aims to provide a comprehensive understanding of the existing literature on the relationship and effects of cocoa and dark chocolate intake among obese adults. We searched multiple databases for research investigating the consumption of cocoa and/or dark chocolate in managing obesity among adults. This review includes epidemiological and human studies that were published in English over the last 10 years. Our review of the current literature indicates that epidemiological and human trials with obese adults have shown inconsistent results, which may be due to the different populations of subjects, and different types of cocoa products and doses used for intervention. Studies among obese adults are mainly focusing on obese individuals with comorbidities, as such more studies are needed to elucidate the role of cocoa polyphenols in weight control and preventing the risk of chronic diseases among obese individuals without comorbidities as well as healthy individuals. Careful adjustment of confounding factors would be required. The effects of cocoa and dark chocolate intake on obese adults were discussed, and further research is warranted to identify the gaps.
Highlights
Obesity has become a public health problem globally due to its alarmingly high rate and increasing prevalence, as well as the role it plays in the occurrence of many chronic diseases [1]
Six studies included in this review reported changes in glucose profiles (either fasting blood glucose (FBG), insulin level, Homeostatic Model Assessment for Insulin Resistance (HOMA-insulin resistance (IR)), or quantitative insulin sensitivity check index (QUICKI)), and these studies involved obese subjects with a risk of cardiovascular disease (CVD) or type 2 diabetes and healthy obese subjects
One study included in this review showed similar findings, where the intake of dark chocolate with a cocoa beverage improved IR but had no effect on fasting glucose [23]
Summary
Obesity has become a public health problem globally due to its alarmingly high rate and increasing prevalence, as well as the role it plays in the occurrence of many chronic diseases [1]. Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health [2]. The rate of obesity has increased globally, tripling since 1975. More than 1.9 billion adults aged 18 years and older were reported to be overweight in 2016; of these, 600 million adults were obese. The prevalence of overweight and obesity was found to be high in low- and middle-income countries, especially in urban areas [3].
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