A recent randomized clinical trial discovered that older adults who took daily cocoa extract supplements experienced a slight improvement in cognitive function. However, this improvement was only observed in individuals who had a lower quality diet. Therefore, it is premature to recommend cocoa extract supplements as a means to enhance cognitive function. It is important to note that there are various lifestyle interventions that can reduce the risk of dementia, such as maintaining a better diet, engaging in regular physical activity, and practicing good sleep hygiene. The study conducted by researchers from Brigham and Women’s Hospital and Harvard Medical School found that older adults who consumed a daily cocoa extract supplement for two years saw modest enhancements in cognitive function. However, these benefits were not observed in individuals who already had healthy dietary patterns. Chirag Vyas, MB,BS from the Department of Psychiatry at Massachusetts General Hospital in Boston suggests that the findings indicate the potential use of flavanol-rich diets or supplements to improve cognitive function in older adults with lower diet quality. The study was published in The American Journal of Clinical Nutrition on December 7th.
👉Cocoa extract offers advantages for individuals with a subpar diet.
The recent study, conducted as part of the larger Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), consisted of 573 older males and females who were randomly assigned to either take daily cocoa extract or an inactive placebo for a duration of two years.
The average age of the participants was 70 years, with approximately half of them being female. Additionally, 11% of the participants reported consuming chocolate on a daily basis prior to the commencement of the trial.
Individuals in the cocoa extract group were instructed to consume two capsules per day, which contained a total of 500 milligrams of cocoa flavanols, including 80 milligrams of epicatechin.
Flavanols, also known as flavan-3-ols, belong to a sub-class of plant compounds called flavonoids. They can be found in various sources such as teas, cocoa-based products, grapes, apples, and berries.
Upon enrollment in the study, participants underwent cognitive testing, and 492 of them repeated the testing after two years.
Upon analyzing the data for the entire group, it was determined that daily cocoa extract supplements did not have any impact on the overall cognition of the individuals.
However, when focusing on individuals with lower diet quality at the beginning of the study, it was observed that those who took daily cocoa supplements experienced "relatively better" improvements in overall cognition and executive function.
Executive function refers to a set of cognitive skills necessary for self-control and managing behaviors.
These findings align with a previous study conducted among COSMOS participants, which demonstrated that daily flavanols enhanced a specific type of memory in older adults with lower diet quality.
However, these results contradict another COSMOS study, which revealed that a daily multivitamin/mineral improved overall cognition, while cocoa extract had no effect. It is important to note that this research did not specifically examine individuals with lower diet quality.
The funding and support for this new study were provided by Mars Edge, a division of the food company Mars, and Pfizer Consumer Healthcare (now Haleon). However, neither company was involved in the analysis of the data, interpretation of the results, or preparation of the study manuscript.
👉It is premature to suggest the use of cocoa extract at this time.
Vyas, the researcher, stated that despite the potential benefit of cocoa extract supplements on cognition for individuals with lower diet quality, the study does not support the recommendation of daily supplementation for preserving cognitive function. However, he emphasized the importance of considering diet and nutritional status in future trials investigating the impact of cocoa extract supplements on cognition. Vyas also expressed the need for future studies to include a more diverse population and specifically focus on individuals with lower diet quality.
Dr. Thomas Holland, a physician scientist at RUSH University, found the study intriguing because it focused on a specific food compound, namely flavanols. In contrast, a study he co-authored examined the overall dietary intake of flavonols, another type of flavonoid. This study, published in Neurology in 2020, assessed participants' flavonol intake by asking detailed questions about their consumption of flavonol-rich foods such as kale, spinach, tomatoes, olive oil, beans, and tea. The results of that study indicated that individuals who consumed higher amounts of flavonols had a reduced risk of developing Alzheimer's disease.
👉Maintaining cognitive function requires a varied diet and implementing other alterations.
Regarding the recent study, Holland emphasized that the findings indicate that cocoa extract supplements do not provide any benefits for individuals with a better diet quality. This implies that if people enhance the quality of their diet, there would be no necessity for the supplement.
However, Holland informed Healthline that "if individuals are not inclined to improve their diets or have a dietary deficiency for any reason, this cocoa extract, or even a multivitamin, has the potential to fill that nutritional gap."
In such cases, he advises individuals to consult their doctor or healthcare provider before starting any supplements. There may be alternative measures one can take to decrease the risk of conditions like dementia, heart disease, diabetes, or other chronic illnesses.
Ultimately, Holland states that "maintaining a healthy, varied, and nutritious diet will be advantageous for brain health." The key lies in the diversity of food, as different types of food offer various nutrients, including vitamins, minerals, and phytochemicals such as flavonoids.
He provides an example of a spring salad consisting of arugula, spinach, onion, tomatoes, walnuts, and possibly raspberries or strawberries. According to him, "this salad could contain over 90 to 100 different vitamins, minerals, and bioactives," including omega-3 and omega-6 fatty acids.
While research demonstrates that diet can reduce the risk of dementia, Holland emphasizes that this condition is influenced by multiple factors, necessitating the utilization of as many "tools" as possible.
This encompasses not only consuming a healthy diet but also engaging in regular physical activity, fostering an active social life, participating in brain-stimulating activities, ensuring sufficient and quality sleep, and practicing stress reduction.
The positive aspect is that "it is never too early or too late to adopt these multifaceted lifestyle changes," according to Holland.
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