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‘Cocoa can be a boost to diabetes’

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What did the media say?

The media reported that an ingredient found naturally in cocoa could help diabetics ward off the threat of heart disease

What did the research show?

German researchers said type 2 diabetes patients who routinely drank a special cocoa drink for one month showed significant improvement in blood vessel function, from severely impaired to normal.

The relatively small study tested a specially formulated, non-commercially available cocoa drink that is high in flavanols – a natural plant compound also found in tea and red wine.

It involved 41 patients with stable diabetes. Subjects were randomised to either a cocoa drink with either 321mg of flavanols or 25mg, which they received three times a day for 30 days.

Blood vessel function was tested, according to flow-mediated dilation (FMD) in the brachial artery – assessed as 5.2% for a healthy individual – at baseline, two hours after drinking the first lot of cocoa, and then again at eight days and 30 days.

At baseline, subjects had an FMD of 3.3%, which increased to 4.8% two hours after taking the high-flavanol intervention. At eight days, FMD was 4.1% before and 5.7% after taking the intervention, and at 30 days, the FMD response was 4.3% at baseline and 5.8% afterwards. FMD levels in the control group did not change significantly.

Blood pressure, heart rate and glycaemic control was unaffected, the authors said. It should be noted that the study was funded by confectionary company Mars, which provided the cocoa beverage powders used.

What did the researchers say?

‘Diets rich in flavanols reverse vascular dysfunction in diabetes, highlighting therapeutic potentials in cardiovascular disease,’ said the authors led by Malte Kelm, professor of cardiology, pulmonology and vascular medicine at University Hospital Aachen.

‘Patients with type 2 diabetes can certainly find ways to fit chocolate into a healthy lifestyle, but this study is not about chocolate, and it’s not about urging those with diabetes to eat more chocolate,’ said professor Kelm. 'This research focuses on what’s at the true heart of the discussion on “healthy chocolate” - it’s about cocoa flavanols, the naturally occurring compounds in cocoa,’ he said. ‘While more research is needed, our results demonstrate that dietary flavanols might have an important impact as part of a healthy diet in the prevention of cardiovascular complications in diabetic patients.’

What does this mean for nursing practice?

A spokesperson for Diabetes UK said: ‘Flavanols do seem to offer potential health benefits for people with diabetes but, at this stage, we don’t advise people to start drinking lots of hot chocolate as it can be high in sugar and fat.

‘More research is needed in to the long-term effects of consuming such high amounts of flavanols,’ they said.

Journal of the American College of Cardiology (2008) 51: 2141-2149

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