Daily Intake of Cocoa Flavanols and Arterial Stiffness in Humans

Cocoa flavanols (CF) are plant-derived compounds commonly present in the human diet. Examples
of flavanol-containing foods and beverages are apples, chocolate, tea, wine, berries,
pomegranate and nuts. Flavanols encompass a group of different compounds, and the final
profile of flavanols in foods will depend on multiple factors including plant origin, time of
harvesting, storage, food processing, and cooking techniques. The term "cocoa flavanols" (CF)
as used here refers to the particular profile of flavanols and procyanidins naturally found
in cocoa beans, and CF mainly consist of the monomeric flavanol (−)-epicatechin and its
oligomeric derivatives (procyanidins) containing up to 10 monomer subunits.

Accumulating data resulting from dietary intervention studies suggest that the intake of
diets rich in flavanols can exert a beneficial cardiovascular health effect in humans.
However, most of these investigations have been conducted with patients with diverse health
complications (e.g. hypertension, diabetes and coronary heart disease) rather than healthy
subjects. Thus, the interpretation of these data in the context of nutrition, primary
prevention, and dietary recommendations is limited. In the current study, the investigators
propose to investigate the effects of cocoa flavanol intake on arterial stiffness in a
healthy population of adults. The investigators submit that this investigation will provide
novel insights into the potential health benefits of dietary flavanols and procyanidins in
the context of cardiovascular health in humans. The data resulting from this study will be
key to the design of larger scale studies in this context, which are needed to
comprehensively study the role of dietary flavanols and procyanidins with regard to potential
dietary recommendations and public health.

Inclusion Criteria:

- 25-65 years old

- BMI 18.5 - 34.9 kg/m2

- Weight ≥ 110 pounds

- Previously consumed cocoa and peanut products, with no adverse reactions

- Having completed physical exercise similar to 5 MET within the last 2 months without
having any physical limitations [e.g. i) Brisk walking (at 4 mph); ii) Mowing lawn;
iii) Bicycling-light effort (10 mph) and iv) Playing tennis-doubles.]

Exclusion Criteria:

- Adults unable to consent

- Individuals who are not yet adults (infants, children, teenagers)

- Pregnant women

- Prisoners

- Non-English speaking*

- BMI ≥ 35 kg/m2

- More than 150 minutes of moderate-intensity aerobic activity or 75 minutes of
vigorous-intensity aerobic activity weekly and more than two days a week of muscle
strengthening activities that work all major muscle groups (CDC recommended physical
activity guidelines for adults)

- Allergies to nuts, cocoa and chocolate products

- Active avoidance of coffee and caffeinated soft drinks

- A history of cardiovascular disease, stroke, renal, hepatic, or thyroid disease

- History of clinically significant depression, anxiety or other psychiatric condition

- History of difficult blood draws

- History of Raynaud's disease

- Indications of substance or alcohol abuse within the last 3 years

- Current use of herbal, plant or botanical supplements (multi-vitamin/mineral
supplements are allowed)

- Blood Pressure >140/90 mm Hg

- Blood Pressure < 100/60 mm Hg, or heart rate < 50 bpm (due to limitations in the
assessment of arterial stiffness

- GI tract disorders, previous GI surgery (except appendectomy)

- Self-reported malabsorption (e.g. difficulty digesting or absorbing nutrients from
food, potentially leading to bloating, cramping or gas)

- Diarrhea within the last month, or antibiotic intake within the last month

- Vegetarian, Vegan, food faddists, individuals using non-traditional diets, on a weight
loss diet or individuals following diets with significant deviations from the average
diet

- Metabolic panel results or complete blood counts that are outside of the normal
reference range and are considered clinically relevant by the study physician

- Cold, flu, or upper respiratory condition at screening

- Currently participating in a clinical or dietary intervention study

- *Non-English speaking volunteers will be excluded for safety reasons, as we do not
have staff that can adequately provide interpretation services that can explain and
answer questions with regard to study procedures.