Cocoa flavanols may use gut microbiota pathway to ease metabolic syndrome: Review

By Will Chu

- Last updated on GMT

Cocoa is generally regarded as the most concentrated dietary source of flavanols with the strongest antioxidant potential. (©
Cocoa is generally regarded as the most concentrated dietary source of flavanols with the strongest antioxidant potential. (©

Related tags Metabolic syndrome Nutrition

Consuming cocoa flavanols may interact with the gut microbiota as a way of preventing metabolic syndrome or easing the condition’s symptoms, a review has concluded.

While flavanols from a variety of dietary sources appear promising, cocoa flavanols represent an emerging approach for intervention in metabolic syndrome. Flavanols are compounds found in a variety of plant-based foods and beverages, including tea, apples, grapes, cocoa and nuts.

Cocoa is generally regarded as the most concentrated dietary source of flavanols with the strongest antioxidant potential. Cocoa extracts or products with added cocoa extracts are usually ingested in supplement form.

Microbiome magic

The gut microbiome's protective role in metabolic diseases such as diabetes is only just being discovered. (©

New findings published in the Journal of Nutritional Biochemistry, ​suggest the flavanol composition of cocoa allows an advantageous interaction with molecules, improving metabolic syndrome. These interactions likely occur primarily in the gastrointestinal tract, where native cocoa flavanol concentration is high.

The researchers thought flavanols reduced toxin absorption through improvement of gut barrier function via interactions with the gut microbiota. In a number of associated animal studies, one​ reported changes in gut microbiome while another​ reported attenuated endotoxin levels.

“Microbial metabolites of flavanols should be considered as potential contributors to the health effects of these compounds observed following oral administration,”​ the researchers noted.

“They are extensively produced and comparatively more bioavailable than the native compounds themselves.”

Metabolic syndrome refers to a number of conditions that increase an individual’s risk of developing cardiovascular disease and type 2 diabetes. Conditions that fall under the umbrella term include abdominal obesity, insulin resistance, glucose intolerance and low-grade chronic inflammation.

Diabetes in Europe 

According to the International Diabetes Federation (IDF) more than 55 million people in Europe have been diagnosed with diabetes. By 2030 this total will rise to 64 million people. The IDF says Europe has the highest number of children with type 1 diabetes.

In 2008, The European Global Cardiometabolic Risk Profile in Patients with Hypertension Disease (GOOD) survey investigated the cardiometabolic risk profile in adult patients with hypertension across 289 locations in four European regions.

In Central Europe 44% of the participants had type 2 diabetes compared with 33% in the Atlantic European Mainland and 26% in the Northwest and the Mediterranean regions.

The study revealed metabolic syndrome affected 68% of Central Europe, 60% of the Atlantic European Mainland, 52% of the Mediterranean regions and 50% of Northwest Europe.

Fasting blood glucose, total cholesterol and triglyceride levels were all highest in Central Europe compared with the other three regions.

“Cocoa flavanols appear to alleviate metabolic syndrome, and specifically derangements in glucose homeostasis, by several intermediate mechanisms,”​ the researchers said.

“One potential mechanism is the chronic cocoa consumption, leading to beneficial changes in the gut microbiota, resulting in improved gut barrier function, reduced circulating endotoxin, and uninhibited insulin signalling mechanisms.”

While promising, the researchers noted in vivo studies were needed to isolate and assess individual primary and intermediate mechanisms of action.

Source: The Journal of Nutritional Biochemistry

Published online ahead of print:

“Mechanisms by which Cocoa Flavanols Improve Metabolic Syndrome and Related Disorders”

Authors: Karen M. Strata, Thomas J. Rowley IV, Andrew T. Smithson, Jeffery S. Tessem, Matthew W. Hulver, Dongmin Liu, Brenda M. Davy, Kevin P. Davy, Andrew P. Neilson

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