Data from the Zutphen Elderly Study collected over 25 years indicated that men with the highest average intakes of epicatechin had a 38% lower risk of dying from coronary heart disease (CHD) than men with the lowest average intakes.
Scientists from Wageningen University also report that epicatechin intake was also significantly associated with a lower risk of dying from cardiovascular disease (CVD) in men suffering from CVD.
“To our knowledge, this is the first prospective cohort study to examine specifically the association between dietary epicatechin intake and CVD mortality,” wrote the researchers in the American Journal of Clinical Nutrition.
“Previous cohort studies have focused on total flavan-3-ol monomer intake and showed conflicting results. An explanation could be that individual flavan-3-ol monomers differ in their metabolic effects. Epicatechin is of particular interest because it is the major flavan-3-ol monomer of cocoa, and a meta-analysis of randomized controlled cocoa trials showed that cocoa and chocolate improved [blood pressure] and endothelial function in adults.”
The Zutphen Elderly Study started in 1985 and included 774 older men. Epicatechin intake was estimated four times over 15 years, and then correlated with cardiovascular disease over 25 years.
Results showed that he mean intake of epicatechin was 15.2 mg per day. Participants were divided into three groups (tertiles) based on average epicatechin intakes. The highest average intake was 21.9 mg per day, the middle group was 14.7 mg per day, and the lowest average intake was 7.9 mg per day.
Over 25 years of study, 329 deaths from CVD were recorded, with an additional 148 dying from CHD and 72 from stroke.
Crunching the numbers indicated that men with the highest average intakes had a significantly lower risk of CHD mortality than men in the lowest tertile.
Commenting on the potential mechanism(s) of action, the researchers note that epicatechin has been shown to influence endothelial function by improving blood flow via increased bioavailability of the vasodilator nitric oxide (NO). There may also be an effect of epicatechin on insulin resistance, they said.
“Our findings suggest that higher epicatechin intake is associated with lower risk of long-term CHD mortality in a population-based study of elderly men as well as with CVD mortality in men with prevalent CVD,” wrote the researchers.
“More and larger studies are needed to confirm these associations before statements can be made about the strength of the association of epicatechin with CVD mortality,” they concluded.
Source: American Journal of Clinical Nutrition
Published online ahead of print, doi:
“Dietary epicatechin intake and 25-y risk of cardiovascular mortality: the Zutphen Elderly Study”
Authors: J.I. Dower et al.