The Study

This study investigated the effects of cocoa flavanol (CF) on markers of cardiovascular health in low risk, healthy, middle-aged individuals without history signs or symptoms of Cardiovascular disease (CVD).


The main focus was a 1-month double-masked, randomised, controlled trial in 100 participants without history, signs or symptoms indicative of CVD, including previous myocardial infarction (MI), stroke and peripheral artery disease or current or previous medication, and a BMI of 23–27 kg/m2. They were randomly assigned to one of two parallel groups (1:1 ratio of intervention and controls): either the CF intervention group (FLAVANOL; 450 mg of total flavanols twice daily) or the CF-free intervention group (CONTROL; 0 mg of total flavanols twice daily).


To evaluate the primary preventive potential of flavanols, the study calculated changes in components of the Framingham Risk Score using the age, the total and HDL-cholesterol and office SBP values.

Flavanol led to significant decreases in the estimated 10-year risk to be diagnosed with coronary heart disease (CHD) (percent decrease relative to baseline: 21 % (95 % CI 8, 33 %)) or CVD (percent decrease: 22 % (95 % CI 8, 36 %)) or experience MI (percent decrease: 31 % (95 % CI 9, 51 %)). The decrease in stroke risk was not statistically significant. The predicted 10-year risk to die from CHD or CVD was lowered (percent decrease: 37 % (95 % CI 17, 56 %) and 30 % (95 % CI 10, 49 %)) by flavanol over control.


The authors’ findings support the notion that cocoa flavanol intake in healthy individuals, “improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.”

Also, the study adds to “the accumulating body of evidence regarding the health benefits of dietary flavanols and procyanidins in general, thus contributing to evidence-based assessments of potential future dietary guidelines for these bioactives.”


Sansone R, et al (2015). Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. British Journal of Nutrition, 114, 1246–1255.