Effect of dark chocolate/ cocoa consumption on oxidative stress and inflammation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of controlled trials

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-06-24 DOI:10.1016/j.ctim.2024.103061

Mehrdad Behzadi , Mohammad Vesal Bideshki , Maryam Ahmadi-Khorram , Meysam Zarezadeh , Alireza Hatami

{"title":"Effect of dark chocolate/ cocoa consumption on oxidative stress and inflammation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of controlled trials","authors":"Mehrdad Behzadi , Mohammad Vesal Bideshki , Maryam Ahmadi-Khorram , Meysam Zarezadeh , Alireza Hatami","doi":"10.1016/j.ctim.2024.103061","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Oxidative stress and inflammation play critical roles in the pathogenesis of many chronic diseases. Dark chocolate (DC)/cocoa, as a rich source of polyphenols like flavonoids, has anti-inflammatory and antioxidant properties that may confer health benefits, but findings in this context are inconsistent.</p></div><div><h3>Objective</h3><p>This systematic review and dose-response meta-analysis aimed to provide a comprehensive overview of the controlled trials (CTs) that have examined the effects of DC/cocoa on oxidative stress and inflammation biomarkers in adults.</p></div><div><h3>Search methods</h3><p>Databases including PubMed, Web of Science, and Scopus, were searched for relevant studies through April 2024.</p></div><div><h3>selection criteria</h3><p>Studies assessed C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), P-selectin, E-selectin and thiobarbituric acid reactive substances (TBARS) in adults were included.</p></div><div><h3>Data analysis</h3><p>Based on the random-effects model, we calculated WMDs, SMDs and 95 % confidence intervals (CIs). Sensitivity, sub-group, meta-regression and dose-response analyses were also conducted.</p></div><div><h3>Results</h3><p>Thirty-three eligible CTs with 1379 participants were included. All studies reported the intervention types (cocoa powder, beverages and chocolate bars) and dosage. However, sixteen studies didn’t do/report testing for purity and potency by independent groups. Also, none of the studies mentioned the risk of contamination with heavy metals. Another limitation was the lack of blinding assessment in studies. DC/cocoa significantly reduced MDA (SMD: −0.69, 95 %CI: −1.17, −0.2, p = 0.005) and increased NO levels (SMD: 2.43, 95 %CI: 1.11,3.75, p < 0.001); However, it has no significant effects on the other outcomes. Greater anti-inflammatory effects occurred at higher flavonoid doses (>450 mg/day) and for shorter durations (≤4 weeks) in the non-healthy participants. Non-linear dose-response relationships between cocoa dosage and CRP level and also between flavonoid dosage and IL-6 level were observed. Based on the GRADE evaluation, just CRP and MDA results were considered as high certainty evidence and the other outcomes results were categorized as very low to moderate certainty.</p></div><div><h3>Conclusions</h3><p>DC/cocoa may improve systemic oxidative status and inflammation in adults. However, further studies should be performed to determine its benefits.</p></div>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000499/pdfft?md5=952b37a0f4c496bc52cc0162d035ba0a&pid=1-s2.0-S0965229924000499-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0965229924000499","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Oxidative stress and inflammation play critical roles in the pathogenesis of many chronic diseases. Dark chocolate (DC)/cocoa, as a rich source of polyphenols like flavonoids, has anti-inflammatory and antioxidant properties that may confer health benefits, but findings in this context are inconsistent.

Objective

This systematic review and dose-response meta-analysis aimed to provide a comprehensive overview of the controlled trials (CTs) that have examined the effects of DC/cocoa on oxidative stress and inflammation biomarkers in adults.

Search methods

Databases including PubMed, Web of Science, and Scopus, were searched for relevant studies through April 2024.

selection criteria

Studies assessed C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), P-selectin, E-selectin and thiobarbituric acid reactive substances (TBARS) in adults were included.

Data analysis

Based on the random-effects model, we calculated WMDs, SMDs and 95 % confidence intervals (CIs). Sensitivity, sub-group, meta-regression and dose-response analyses were also conducted.

Results

Thirty-three eligible CTs with 1379 participants were included. All studies reported the intervention types (cocoa powder, beverages and chocolate bars) and dosage. However, sixteen studies didn’t do/report testing for purity and potency by independent groups. Also, none of the studies mentioned the risk of contamination with heavy metals. Another limitation was the lack of blinding assessment in studies. DC/cocoa significantly reduced MDA (SMD: −0.69, 95 %CI: −1.17, −0.2, p = 0.005) and increased NO levels (SMD: 2.43, 95 %CI: 1.11,3.75, p < 0.001); However, it has no significant effects on the other outcomes. Greater anti-inflammatory effects occurred at higher flavonoid doses (>450 mg/day) and for shorter durations (≤4 weeks) in the non-healthy participants. Non-linear dose-response relationships between cocoa dosage and CRP level and also between flavonoid dosage and IL-6 level were observed. Based on the GRADE evaluation, just CRP and MDA results were considered as high certainty evidence and the other outcomes results were categorized as very low to moderate certainty.

Conclusions

DC/cocoa may improve systemic oxidative status and inflammation in adults. However, further studies should be performed to determine its benefits.

Abstract Image

查看原文本刊更多论文

食用黑巧克力/可可对成人氧化应激和炎症的影响：对对照试验进行GRADE评估的系统综述和剂量反应荟萃分析。

背景：氧化应激和炎症在许多慢性疾病的发病机制中起着至关重要的作用。黑巧克力（DC）/可可作为黄酮类等多酚类物质的丰富来源，具有抗炎和抗氧化特性，可能对健康有益，但这方面的研究结果并不一致：本系统综述和剂量反应荟萃分析旨在全面概述研究 DC/可可对成人氧化应激和炎症生物标志物影响的对照试验（CT）：检索数据库包括PubMed、Web of Science和Scopus，搜索截至2024年4月的相关研究：筛选标准：纳入评估成人 C 反应蛋白 (CRP)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)、丙二醛 (MDA)、一氧化氮 (NO)、P-选择素、E-选择素和硫巴比妥酸活性物质 (TBARS) 的研究：基于随机效应模型，我们计算了WMDs、SMDs和95%置信区间（CIs）。我们还进行了敏感性分析、亚组分析、元回归分析和剂量反应分析：结果：共纳入了 33 项符合条件的 CT，1379 名参与者。所有研究都报告了干预类型（可可粉、饮料和巧克力棒）和剂量。但是，有 16 项研究没有进行/报告由独立小组进行的纯度和效力测试。此外，没有一项研究提到重金属污染的风险。另一个限制因素是研究缺乏盲法评估。DC/ 可可显著降低了非健康参与者的 MDA（SMD：-0.69，95%CI：-1.17，-0.2，p=0.005），提高了 NO 水平（SMD：2.43，95%CI：1.11，3.75，p450mg/天），且持续时间较短（≤4 周）。观察到可可用量与 CRP 水平之间以及类黄酮用量与 IL-6 水平之间存在非线性剂量反应关系。根据 GRADE 评估，只有 CRP 和 MDA 结果被认为是高确定性证据，其他结果被归类为极低至中等确定性：结论：DC/可可可改善成年人的全身氧化状态和炎症。结论：DC/可可可改善成年人的全身氧化状态和炎症，但应进一步研究以确定其益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567