Cocoa consumption may improve walking in patients with peripheral artery disease, according to results from a small phase II preliminary study published today in the American Heart Association's journal Circulation Research..

In a small study of 44 patients with peripheral artery disease over 60 years of age, those who drank a drink containing flavanol-rich cocoa three times a day for six months were able to walk 42.6 meters further in a 6-minute walking test,. net Peripheral arterial disease, or PAD, a narrowing of the arteries that reduces blood flow from the heart to the legs, affects more than 8.5 million people aged 40 and over. The most common symptoms are pain, tightness, spasms, weakness, or other discomfort in the leg muscles when walking..

" Jeremiah Stamler at the School of Medicine. Feinberg at Northwestern University in Chicago. “In addition to reduced blood flow to the legs, people with peripheral artery disease had damage to the mitochondria in the calf muscles, possibly caused by reduced blood flow.. Mitochondria are known as the energy source of the cell, converting food into energy.. Previous research has shown that improving mitochondrial health and activity is associated with better walking performance, and improving damaged mitochondria may lead to better walking.”.

The researchers hypothesized that epicatechin, the main component of cocoa flavanol, may enhance mitochondrial activity and muscle health in patients with lower extremity peripheral artery disease, potentially improving patient walking. Epicatechins and flavanols may also improve blood flow.

Study participants were randomly assigned to drink milk or water mixed with the contents of a powder pack containing flavanol-rich cocoa (15 grams of cocoa and 75 mg of epicatechin per day) or a placebo powder pack without cocoa or epicatechin three times a day for six months. Walking was measured at baseline and six months later, with a 6-minute walking test measured twice: 2.5 hours after drinking and 24 hours after drinking.. Participants also took a treadmill walking test and measured blood flow in their legs using magnetic resonance imaging (MRI). Participants who consented had a calf muscle biopsy to assess muscle condition..

The cocoa used in the study is a commonly available natural unsweetened cocoa powder that is rich in the flavanol epicatechin, which is found in higher amounts in dark chocolate (\u003e85% cocoa) than in milk chocolate.. Regular chocolate won't have the same effect..

The researchers found that patients who consumed cocoa showed a significant improvement - walking an average of almost 43 meters in a 6-minute walking test compared to their baseline results during a test performed 2.5 hours after the last drink.. The researchers also found increases in mitochondrial activity, increased capillary density, and other improvements in muscle health in those who consumed cocoa.. Patients who drank the placebo drink walked 24.2 meters 2.5 hours after the final drink study compared to their baseline results. This is in line with other studies in which people with PAD without treatment have a decrease in 6 minutes of walking over time..

Cocoa seemed to have no effect on walking on the treadmill. However, McDermott said the treadmill walk and the 6 mile test are different measures of walking endurance and do not respond equally to the same therapy.. Improvement in 6-minute distance walking better reflects the type of walking required in daily life, and therefore these results are a more meaningful outcome for patients with PAD..

“While we expected improvement with walking, we were particularly pleased to see that cocoa treatment was also associated with increased capillary density, limb perfusion, mitochondrial activity, and an additional measure of overall skeletal muscle health,” McDermott said.. "

Limitations for this pilot study include: small sample size; imbalance between the two study groups in terms of the number of participants of each gender, race, and body mass index; and lack of data for total dietary intake.

“PAD patients have difficulty walking, which is just as bad as people with advanced heart failure..

Leg muscles don't get enough blood in the PAD, resulting in injury, and in this study, cocoa appears to protect muscles and improve metabolism,” said Naomi Hamburg, M.D., FAHA, chair of the Peripheral Vascular Diseases Council of America. “We know that exercise therapy helps people with PAD walk further, and this early study suggests that cocoa may be a new way to treat people with PAD.. We will need larger studies to confirm whether cocoa is an effective treatment for PAD, but perhaps someday, if the studies confirm this, we may be able to write a prescription for chocolate for our PAD patients.”.

medical-heal. en.