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Abstract
Randomized controlled trials indicate that flavanol-rich cocoa intake may improve postprandial glucose and lipid metabolism in patients with type 2 diabetes (T2D), based on studies with meals that impose a strong metabolic load. Hence, the aim of the present study was to investigate whether flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal may beneficially affect glucose, lipid metabolism, and blood pressure (BP) in patients with T2D. Twelve adults with T2D, overweight/obesity, and hypertension ingested capsules with 2.5 g of flavanol-rich cocoa or microcrystalline cellulose with a diabetic-suitable breakfast in a randomized, placebo-controlled, double-blind crossover study. BP was measured and blood samples were taken before, 2 and 4 h after breakfast and capsule intake. Cocoa treatment did not affect glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, and BP. For glucose, insulin and HOMA-IR, only effects by time were observed after both treatments. Thus, 2.5 g of flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal does not seem to affect postprandial glucose and lipid metabolism and BP in stably-treated diabetics. Nevertheless, future studies with close-meshed investigations are desirable, providing realistic amounts of cocoa together with realistic meals rich in carbohydrates to subjects with T2D or metabolic syndrome, which do not afford pharmacological treatment.
Highlights
The prevalence of type 2 diabetes (T2D) is increasing globally [1]
2.5 g of flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal does not seem to affect postprandial glucose and lipid metabolism and blood pressure (BP) in stably-treated diabetics
Postprandial hyperglycemia is often accompanied by postprandial hypertriglyceridemia, which acts as a further risk factor for cardiovascular disease (CVD)
Summary
The prevalence of type 2 diabetes (T2D) is increasing globally [1]. In patients with T2D, postprandial hyperglycemia has shown to raise the incidence of cardiovascular disease (CVD)and all-cause mortality [2,3]. A decrease in insulin resistance [8], triglycerides [8], low density lipoprotein-cholesterol (LDL-cholesterol) [9], and blood pressure (BP) [8], as well as an increase in insulin sensitivity and high density lipoprotein-cholesterol (HDL-cholesterol) [8] could be observed in meta-analyses of randomized controlled trials (RCTs) after regular cocoa treatment. These effects were even more substantial in morbid subjects than in healthy ones without any comorbidities [8]
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