New Study Shows Cocoa Flavanols could Significantly Reduce Heart Disease
Last year, a landmark study known as the COSMOS Trial (COcoa Supplement and Multivitamin Outcomes Study) was published. This is by far the largest and longest trial looking at polyphenols (naturally occurring nutrients found in plants that have shown many health benefits) and their properties in relation to cardiovascular disease and cancer prevention. While results from previous trials have suggested positive health benefits from taking cocoa flavanol (subclass of polyphenols) supplements, there has never been as much evidence as there is now that the COSMOS trial has published its findings.
What is the COSMOS Trial & Why is it Important?
A double-blind, placebo-controlled and randomized trial, COSMOS tested a cocoa extract supplement and a multivitamin supplement’s effects on cardiovascular health and cancer risk. With a total of 21,442 participants (12,666 women aged 65+ and 8,776 men aged 60+), the study spanned an average of 3.6 years.
COSMOS was led by researchers at Harvard Medical’s Brigham and Women’s Hospital. This research was conducted because previous clinical trials showed that polyphenols, especially cocoa flavanols, could be beneficial to cardiovascular health. The trial was able to take this research further and understand the health effects of cocoa flavanols at the population level. Another major goal of COSMOS was to test the effect of the interventions on slowing cognitive decline and aging-related conditions.
Why Study the Health Benefits of Cocoa Flavanols?
Flavanols are a specific group of flavonoids that are found in all sorts of foods. Cocoa flavanols are the naturally occurring group of flavonoids that are contained in cocoa beans. These specific flavanols are likely to be lost as cocoa is harvested, and especially during the chocolate making process. So, while all cocoa beans start off rich in cocoa flavanols, most finished cocoa products are not.
Different kinds of chocolate contain very different levels of cocoa–this ranges from milk chocolate, which has the lowest cocoa content, to craft chocolate made of 100 percent ground cocoa beans. While craft chocolate or a high percentage dark chocolate will contain some cocoa flavanols, the levels will be highly variable.
This is because cocoa flavanols are often destroyed by a number of steps in conventional cocoa processing, like fermentation, drying, roasting, and in some cases, alkalization. As a result, the percentage of cocoa in chocolate products isn't a reliable indicator of their flavanol content.
The Landmark Findings of the COSMOS Trial
Now everyone can read the results of the trial published in The American Journal of Clinical Nutrition. There are full reports available on cocoa extract findings and multivitamin findings but we will distill some of the key points here:
A 10% reduction in total count of all cardiovascular events from heart attacks and strokes to cardiovascular surgeries. (This percentage is not considered statistically significant.)
16% reduction in the total number of major cardiovascular events including strokes, heart attacks and deaths. (This percentage is considered statistically significant.)
27% reduction in cardiovascular death. (This percentage is considered statistically significant.)
“Pause for a second,” Mars Edge VP of R&D, Scientific and Regulatory Affairs Catherine Kwik-Uribe told FoodNavigator. “That's not only a statistically significant number, that's quite meaningful. If it could be translated across a population, that would be a lot fewer deaths attributable to cardiovascular disease.”
Those results could also be downplaying the significance of the flavanols because when researchers looked at the data without reporting participants that didn’t take the supplements in accordance with the protocol, they found:
A statistically significant 15% percent reduction in the number of all total cardiovascular events.
A statistically significant 39% reduction in cardiovascular death.
A statistically significant 24% reduction in the total number of major cardiovascular events.
Kwik-Uribe describes this as “breath-taking” because of the potential impact on public health for older adults. “The idea that you can have a positive impact on cardiovascular health after so many decades of life is pretty exciting for the field of nutrition and is pretty exciting for the field of flavanols as well.”
FDA Announces Qualified Health Claim
Earlier this year, the FDA announced that it does not intend to object to the use of certain qualified health claims regarding the relationship between the consumption of cocoa flavanols in high flavanol cocoa powder and a reduced risk of cardiovascular disease.
The authorized qualified health claim for cocoa flavanols states: "Consuming 200 mg or more of cocoa flavanols per day as part of a diet low in saturated fat and cholesterol may reduce the risk of cardiovascular disease." This claim provides evidence-based information about the potential cardiovascular benefits of consuming cocoa flavanols. However, it's important to note that the qualified health claim is not a guarantee of a health benefit. The claim is based on scientific evidence, but individual results may vary depending on factors such as overall diet and lifestyle.
Does This Mean Chocolate Is Healthy For You?
Unfortunately, this does not mean eating mass amounts of chocolate will prevent cardiovascular disease. Quite the opposite: chocolate is processed with fats and sugars, therefore upping your consumption of chocolate will also up your amount of those ingredients. Also, as stated before, the chocolate making process basically strips all beneficial flavanols from the cocoa beans, that’s why cocoa supplements were used in the COSMOS trial.
What Now?
Kwik-Uribe looks at COSMOS as the opening of a new chapter for research and opportunities regarding flavanols and health. The strong correlation between cocoa flavanol intake and the reduction of cardiovascular disease is groundbreaking - there will no doubt be much innovation for the delivery of these flavonols, whether in supplement form, powders or maybe even in a healthier version of chocolate. COSMOS has opened the door to harnessing the power of cocoa flavanol extracts and the world should keep an eye out for more groundbreaking studies in the cocoa flavanol space.
Where Do We Come In?
At California Cultured we are using cellular agriculture to replicate and sustain a line of cocoa cells not only to create cell cultured chocolate but to amplify and harness the power of cocoa flavanols. While cocoa flavanols are often broken down and lost when the cocoa plant is harvested, we find ourselves at an advantage in working with cocoa cells. Not only are we able to keep all of the powerful flavanols intact, we are also able to boost the levels of flavonoid content to significant dosage than what would naturally occur in the plant. As we learn more and more about the health benefits of cocoa flavanols, we think it’s important to focus our research and development on bringing out these compounds in high concentration and at a fast rate through our cell culture technology.