Abstract
Epicatechin is a monomeric flavanol found in food sources such as tea, apples, berries and cocoa. A number of large-scale epidemiological studies have demonstrated an association between the consumption of these foods and cognitive function, as well as improved blood flow. The aim of this review is to summarise the evidence from intervention studies to clarify the effect of epicatechin on cognition and to consider the role of increased cerebral blood flow as a mechanism for any effects. The effects of epicatechin as consumed in cocoa are, therefore, reviewed here as this represents the only dietary source where it is purported to be the major active component. Our main findings are that a) the positive modulation of tasks that involve memory, executive function and processing speed in older adults; b) the cognitive benefits are more often shown in studies containing more than 50 mg epicatechin/day; and c) all studies with a duration of 28 days or longer in populations >50 years old demonstrate a cognitive improvement. However, as highlighted by this review, it is not currently possible to attribute effects solely to epicatechin without consideration of synergies. In order to overcome this issue, further studies examining the cognitive effects of epicatechin in isolation are required. The role of cerebral blood flow also requires further investigation through simultaneous measurement alongside cognitive function.
Highlights
Flavanols are a subclass of the bioactive compounds, flavonoids, which can be further sub-divided into monomeric flavan-3-ols and their oligomeric/polymeric counterparts, procyanidins
It is difficult to make definitive conclusions regarding the impact of the consumption of epicatechin on cognition due to a paucity of data
Evidence is emerging which suggests a positive modulation of tasks that involve memory, executive function and processing speed in older adults following cocoa flavanol (CF) interventions where the major active component is purported to be (−)-epicatechin [22,25–27]
Summary
Flavanols are a subclass of the bioactive compounds, flavonoids, which can be further sub-divided into monomeric flavan-3-ols and their oligomeric/polymeric counterparts, procyanidins. Epicatechin (see Figure 1), along with catechin, is a monomeric flavan-3-ol, which is abundant in food sources such as tea, apples, berries, and cocoa. A number of large-scale epidemiological studies have demonstrated a link between the consumption of these epicatechin-rich foods and cognitive function. The Paquid longitudinal study demonstrated that the relative risk of dementia was significantly lower for those in the two highest tertiles of flavonoid consumption, compared to those in the lowest tertile when followed up 5 years later [1]. An inverse relationship between intake and cognitive decline over the 10-year follow up was demonstrated, whereby those in the highest two quartiles of flavonoid intake had less cognitive decline than those in the lowest quartile [2]. In a cross-sectional study of 1003 community-dwelling Japanese adults aged 70 years and above, Kuriyama et al [3]
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