The Efficacy of  Dietary Supplementation with Cocoa to Improve Cognitive Function in Adults

ABSTRACT

Background: Cocoa is a product of processing of the cocoa bean. It is rich in flavanols, a subgroup of flavonoids, a common compound in plants.  Cocoa flavanols have positive effect on the cardiovascular system. Cognitive effects of these compounds have been investigated, but not proved to be of significance in the past.

Methods: An exhaustive search of available literature was conducted using the MEDLINE-Ovid, Google Scholar and CINAHL databases. Keywords searched included cocoa and cognition. Articles that assessed effects of cocoa flavanols on cognition were included. The quality of relevant articles was evaluated using the GRADE Working Group guidelines.

Results:  This review summarizes the accumulated evidence of research of cognitive effects of cocoa flavanols not covered by  Scholey et al and Sokolov et al. Three randomized controlled studies met eligibility criteria and were included in this systematic review. One study of 37 adults found a statistically significant improvement in performance of cognitive tests in patients using cocoa flavanols supplementation. A second study of 90 adults showed acute improvements in performance of fatigability tests. In the third study 37 adults patients showed improvements in activation of dentate gyrus of the  hippocampus as well as some memory tests. All studies had low quality of evidence based on the GRADE guidelines.

Conclusion:  Cocoa-derived flavanols need further investigation to understand their effect on cognition and memory but preliminary results are promising.

Keywords: Cocoa and cognition.

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REVIEWED STUDIES:

Mastroiacovo D, Kwik-Uribe C, Grassi D, et al. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study–a randomized controlled trial. Am J Clin Nutr. 2015;101(3):538-48. doi:10.3945/ajcn.114.092189

Brickman AM, Khan UA, Provenzano FA, et al. Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults. Nat Neurosci. 2014;17(12):1798-803. doi:10.1038/nn.3850

Massee LA, Ried K, Pase M, et al. The acute and sub-chronic effects of cocoa flavanols on mood, cognitive and cardiovascular health in young healthy adults: a randomized, controlled trial. Front Pharmacol. 2015;6:93. doi:10.3389/fphar.2015.00093

AUTHOR: Alex Kaplun is currently completing his second year in the School of PA Studies at Pacific University, Oregon.  He will graduate with an MS degree in August, 2016.