The action of phytochemicals present in cocoa in the prevention of vascular dysfunction and atherosclerosis.
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2022
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Background: Chronic non-communicable diseases, including cardiovascular diseases (CVDs), have
caused many deaths worldwide. Atherosclerotic plaque formation is common in individuals with
CVDs. Thus, antioxidant and anti-inflammatory nutritional strategies can be used to prevent or inhibit
this process. Due to its higher concentrations of cocoa, dark chocolate is considered a functional food
due to the presence and action of phytochemical compounds, with anti-inflammatory and antioxidant
actions. However, the recommended amounts of these compounds to prevent atherosclerosis have not
yet been fully elucidated.
Aim: The aim of the studywas to review the effects of cocoa and dark chocolate intake on the
prevention of cardiovascular dysfunction and atherosclerosis.
Methods: This narrative review was based on a search of PubMed and Lilacs. The search was
conducted from September 2021 to February 2022 using the following keywords: flavonoids, cocoa,
atherosclerosis, oxidative stress, and inflammation. The inclusion criteria were original articles, meta-
analyses, and experimental and clinical studies published between 2002 and 2022 in English, focusing
on the subject addressed. The exclusion criteria were the title and abstract reading and duplication of
articles in the databases.
Results: The antioxidant and anti-inflammatory functions of phytochemicals in cocoa and dark
chocolate are related to the modulation of nitric oxide through activation/phosphorylation and acting
as a vasodilator. Furthermore, these phytochemicals reduce the formation of reactive oxygen species
and activate antioxidant enzymes. The anti-inflammatory activities are related to the modulation of
nuclear factor kappa B in the reduction of inflammatory markers, such as tumor necrosis factor-alpha,
C-reactive protein, and pro-inflammatory cytokines, as well as in the reduction of adhesion molecules
in the wall of the vases.
Conclusion: The main phytochemicals present in cocoa and dark chocolates are catechins and
their epicatechin isomers, which are responsible for improving inflammatory, metabolic, and
antioxidant profiles. Its consumption can be encouraged, but with caution, owing to the caloric
supply and forms of chocolate production, as these factors can reduce the presence of flavonoids
in its composition.
Relevance for Patients: The antioxidant and anti-inflammatory functions of the phytochemicals in
cocoa and dark chocolate are responsible for modulating nitric oxide via activation/phosphorylation
and acting as a vasodilator. Reducing the formation of reactive oxygen species, as well as activating
antioxidant enzymes. As for the anti-inflammatory activities, they modulate the nuclear factor kappa
B, reducing inflammatory markers, thus improving the antioxidant and inflammatory profile of these
patients.
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Palavras-chave
Flavonoids, Cocoa, Atherosclerosis, Oxidative stress, Inflammation
Citação
SILVA, T. de P. et al. The action of phytochemicals present in cocoa in the prevention of vascular dysfunction and atherosclerosis. Journal of Clinical and Translational Research, v. 8, n. 6, p. 509-515, nov. 2022. Disponível em: <https://www.jctres.com/en/08.202206.011/>. Acesso em: 01 ago. 2023.