Cocoa flavanols help repair and maintenance of blood vessels,

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Cocoa flavanols could be an important part of a healthy diet for people with cardiovascular disease

New findings indicate that cocoa flavanols may be an important part of a healthy diet for people with cardiovascular disease, which affects more than 80 million Americans, according to research by a team of internationally-renowned researchers, including scientists from Mars, Incorporated.

The breakthrough study conducted at the University of California San Francisco and published in the prestigious Journal of the American College of Cardiology (JACC) found that daily cocoa flavanol consumption more than doubled the number of circulating angiogenic cells (CACs) in the blood. These cells have been shown to have vessel repair and maintenance functions, which can contribute to healthy blood vessels. Poor blood vessel function is recognized as an early stage in the development process of cardiovascular diseases (CVD), including coronary artery disease. Increasing levels of CACs have also been associated with a decreased risk of death from cardiovascular causes, according to a 2005 study published in the New England Journal of Medicine.

Other cutting-edge research has demonstrated that physical activity and experimental drug therapy can increase CAC levels, however the study published in JACC is the first to demonstrate such benefits from a dietary intervention. In this randomized, double-masked, controlled dietary intervention trial, study participants drank either a high-flavanol cocoa drink, containing cocoa made with the Mars Cocoapro® process (which guarantees a consistent flavanol level), or a low-flavanol nutrient-matched control cocoa drink, twice a day for 30 days.

The study also showed that drinking high-flavanol cocoa significantly reduced systolic blood pressure, an important risk factor for heart disease and stroke, and improved blood vessel function by 47% compared to low-flavanol consumption in optimally-medicated adults with severe cardiovascular disease. This research supports findings previously published by Mars scientists and their academic collaborators, who have found a positive correlation between cocoa flavanols consumed and subsequent improvements in flow-mediated dilation (FMD), a measure of vessel health, i.e. the ability of a vessel to relax.

“It’s the best of both worlds. It’s not often that we’re able to identify a natural food compound that can demonstrate a benefit on top of traditional medical treatment,” said Carl Keen, PhD, Professor of Nutrition and Internal Medicine at University of California Davis and one of the study authors. “And perhaps most importantly, for the first time, we found that cocoa flavanols might even directly mobilize important cells that could repair damaged blood vessels. The benefits are substantial, without any observed adverse effects,” added study author Christian Heiss, MD, Heinrich-Heine University.

“Together with academic partners, Mars Incorporated has been studying cocoa flavanols for nearly two decades,” said Hagen Schroeter, PhD, Mars, Incorporated scientist and study co-author. “This is one of the most fascinating and potentially far-reaching findings we’ve uncovered in recent years, opening a completely new avenue of research to understand how cocoa flavanols might benefit human health. Of course, more research is needed to confirm and build upon these observations, but we’re intrigued by the potential for flavanols in the context of dietary and pharmaceutical strategies for the prevention and treatment of cardiovascular diseases.”

Cocoa Flavanols: The Body of Evidence

A number of previously published studies already suggest that the consumption of cocoa flavanols can have important beneficial effects on the function of the body’s network of blood vessels. Yet, contrary to statements often made in the popular media, the collective research demonstrates that the cardiovascular effects of cocoa flavanols are independent of general "antioxidant" effects that cocoa flavanols exhibit in a test tube, outside of the body. The body of research not only suggests that these cocoa flavanols may provide a dietary approach to maintaining cardiovascular function and health, but also points to new possibilities for cocoa flavanol-based interventions associated with age-related blood vessel dysfunction and vascular complications of type 2 diabetes.

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Want to slow aging? New research suggests it takes more than antioxidants

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Research published in the journal Genetics shows that your genes may be more important than antioxidants in slowing the body's aging process

Don't put down the red wine and vitamins just yet, but if you're taking antioxidants because you hope to live longer, consider this: a new study published in the June 2010 issue of the journal GENETICS (http://www.genetics.org) casts doubt on the theory that oxidative stress to our tissues shortens lifespan. That's because researchers from McGill University in Canada have identified mutations in 10 different genes of worms (genes believed to have counterparts in humans) that extend their lifespan without reducing the level of oxidative stress the worms suffer. The results contradict the popular theory that production of toxic reactive oxygen species in tissues is responsible for aging.

"We hope that our study will help in tempering the undue emphasis put on the notion that oxidative stress causes aging and thus that antioxidants could combat aging," said Siegfried Hekimi, Ph.D, the senior author of the study from the Department of Biology at McGill University in Montreal. "We also hope that the genes we have discovered can be used in the future to modulate energy metabolism in a way that can help delay the health issues linked to aging, and possibly increase lifespan itself."

To make their discovery, the scientists exposed a passel of worms (Caenorhabditis elegans) to a chemical that causes random changes in its DNA, and looked among the mutagenized worms for those appearing to have a slow rate of metabolism, manifested in their slow development and slow behavioral responses. They then identified the mutations in these worms that caused this effect, revealing 10 distinct genes involved in metabolism. The scientists' expected that the slowly metabolizing worms would have less oxidative stress, but to the investigators' surprise that was not the case. This suggests that a slow rate of living and reduced energy metabolism is sufficient to increase longevity, even when oxidative stress is not reduced.

"It looks like there's more truth to the cliché, 'slow and steady wins the race,' than we imagined," said Mark Johnston, Editor-in-Chief of the journal GENETICS. "This research suggests that if we just eat less, we may not have to suffer eating all that broccoli simply for its antioxidants."

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Low vitamin D linked to the metabolic syndrome in elderly people

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A new study adds to the mounting evidence that older adults commonly have low vitamin D levels and that vitamin D inadequacy may be a risk factor for the metabolic syndrome, a condition that affects one in four adults. The results were presented at The Endocrine Society's 92nd Annual Meeting in San Diego.

"Because the metabolic syndrome increases the risk of diabetes and cardiovascular disease, an adequate vitamin D level in the body might be important in the prevention of these diseases," said study co-author Marelise Eekhoff, MD, PhD, of VU University Medical Center, Amsterdam.

The researchers found a 48 percent prevalence of vitamin D deficiency. The study consisted of a representative sample of the older Dutch population: nearly 1,300 white men and women ages 65 and older.

Nearly 37 percent of the total sample had the metabolic syndrome, a clustering of high blood pressure, abdominal obesity, abnormal cholesterol profile and high blood sugar.

Subjects with blood levels of vitamin D (serum 25-hydroxyvitamin D) lower than 50 nanomoles per liter, considered vitamin D insufficiency, were likelier to have the metabolic syndrome than those whose vitamin D levels exceeded 50. That increased risk especially stemmed from the presence of two risk factors for the metabolic syndrome: low HDL, or "good" cholesterol, and a large waistline.

There was no difference in risk between men and women, the authors noted.

The study included subjects who were participating in the Longitudinal Aging Study Amsterdam. Although the data were from 1995 and 1996, Eekhoff said they expect that vitamin D inadequacy remains prevalent among whites in the Netherlands.

Using follow-up data from 2009, the researchers plan to study how many of the subjects with low vitamin D levels developed diabetes.

"It is important to investigate the exact role of vitamin D in diabetes to find new and maybe easy ways to prevent it and cardiovascular disease," Eekhoff said.

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DHEA Increases Fertility Threefold

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According to the American Pregnancy Association, six million women a year deal with infertility. Now, a Tel Aviv University study is giving new hope to women who want to conceive — in the form of a pill they can find on their drugstore shelves right now.

Prof. Adrian Shulman of Tel Aviv University's Sackler Faculty of Medicine and the Meir Medical Center has found a statistical connection between the over-the-counter vitamin supplement DHEA, used to counter the effects of aging, and successful pregnancy rates in women undergoing treatment for infertility.

In the first controlled study on the effects of the supplement, Prof. Shulman found that women being treated for infertility who also received supplements of DHEA were three times more likely to conceive than women being treated without the additional drug. The results were recently published in AYALA, the journal of the Israeli Fertility Association.

A natural supplement to fertility treatments

After hearing anecdotal evidence from his patients and the medical community on the benefits of combining fertility treatments with DHEA, a supplement marketed as an anti-aging drug around the world, Prof. Shulman decided to put this old wives' tale to the statistical test.

He and his fellow researchers conducted a study in which a control group of women received treatment for poor ovulation, and another group received the same treatment with the addition of the DHEA supplement. The latter group took 75mg of the supplement daily for 40 days before starting fertility treatments, and continued for up to five months.

Not only were women who combined infertility treatment with DHEA more likely to conceive, the researchers discovered, they were also more likely to experience a healthy pregnancy and delivery.

"In the DHEA group, there was a 23% live birth rate as opposed to a 4% rate in the control group," explains Shulman. "More than that, of the pregnancies in the DHEA group, all but one ended in healthy deliveries."

Making grade-A eggs?

Shulman believes that women who are finding little success with their current fertility treatments could look to DHEA to improve their chances of conceiving. "We recommend that women try this DHEA treatment, in conjunction with fertility treatments, for four to five months," says Prof. Shulman. It could also be used as a regular "vitamin" for women who have already conceived and are pregnant, but more research would need to be done on the compound to determine its effects, says Prof. Shulman.

DHEA, for 5-Dehydroepiandrosterone (5-DHEA), is a naturally-occurring steroid found in the brain, which plays an important biological role in humans and other mammals. Produced in the adrenal glands, it is also synthesized in the brain. The pharmaceutical version of this molecule is known as Prastera, Prasterone, Fidelin and Fluasterone, and identical generics are widely available over the counter in the United States without a prescription. Women interested in using DHEA to conceive, however, should consult their practitioner first, suggests Prof. Shulman, a gynecologist and director of the IVF Unit of the Obstetric and Gynecology Department at Meir Medical Center.

While studies on the effects of DHEA are far from complete — his test group only included around 20 women — Prof. Shulman hopes that further research will unlock the secrets of why the supplement aids in successful conception in women with an otherwise poor response to fertility treatments. "We need to look into what the drug actually does to make the body more fertile," he says. "It could be affecting components such as the quality of the eggs or the follicles."

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Nutrition's Potential to Save Sight

While 20/20 vision is a symbol of visual acuity, between now and the year 2020, more and more people will experience some extent of vision loss due to age-related macular degeneration (AMD) and other sight-robbing diseases.

Now, Agricultural Research Service (ARS)-funded scientists at the Laboratory for Nutrition and Vision Research are finding that healthy eating can reduce not only health care costs, but also the decline of quality of life due to these diseases. The laboratory, directed by Allen Taylor, is part of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston, Mass.

One study indicated that regularly consuming a combination of protective nutrients and a low-glycemic-index, or "slow carb," diet provided an AMD protective effect. A food's glycemic index is an indicator of how fast the carbohydrate it contains will spike blood sugar levels. The macula is a 3-millimeter-wide yellow spot near the center of the retina responsible for the central field of vision.

For the study, the researchers analyzed dietary intake and other data from more than 4,000 men and women, aged 55 to 80, who had participated in the long-term Age-Related Eye Disease Study, or AREDS. Led by Chung-Jung Chiu, the researchers ranked intake of each of several nutrients consumed during the AREDS study, then calculated a compound score to gauge their combined dietary effect on the risk of AMD. The scoring system allowed them to evaluate associations between individual—and combined—dietary nutrients.

The nutrients that were found to be most protective in combination with the low-glycemic-index diet were vitamins C and E, zinc, lutein, zeaxanthin, and the omega-3 fatty acids known as DHA and EPA. The 2009 study was published in Ophthalmology.

Read more about this and other research related to improving health through nutrition in the July 2010 issue of Agricultural Research magazine.

ARS is the principal intramural scientific research agency of the U.S. Department of Agriculture (USDA).

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Health Benefits of Urban Cycling Outweigh Risks

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Researchers analyze effects of air pollution, traffic accidents, and physical activity


Even though urban cyclists face hazards such as exposure to car exhaust and the risk of traffic accidents, it’s still far healthier to park the car and get on a bike. The health of the individual cyclists may improve as they drive less and exercise more, and the resulting reduction in exhaust emissions will benefit the entire community, according to a study published online June 30 ahead of print in the peer-reviewed journal Environmental Health Perspectives (EHP).

“The promotion of walking and cycling is a promising way to increase physical activity across the population by integrating it into daily life,” state the study authors. However, they note that if cycling is to be promoted for health reasons, the health benefits of cycling should outweigh the risks. Studies in Denmark, Finland, and China have shown that cycling is healthier than driving, but these studies have not tried to quantify specific health risks and benefits related to cycling, making it difficult to extrapolate results to specific environments and populations.

To develop an integrated assessment of the health risks and benefits of cycling, the researchers analyzed data from international studies on exposure to components of automobile exhaust, traffic fatalities, and benefits of exercise. For their analysis, the authors estimated the health impacts if 500,000 Dutch people aged 18–64 years were to switch from driving to cycling for one round trip of 7.5–15 km each day. They chose to estimate health in terms of mortality (years of life gained or lost) rather than morbidity (illness) because data about mortality tend to be more consistent; for example, minor traffic accidents involving cyclists tend to be far underreported compared with traffic deaths.

The authors found that cycling even short times in traffic can cause significant exposure to components of car exhaust, including ultrafine particles and soot, which can contribute to respiratory and cardiac illness. Cyclists tend to breathe about twice as deeply as drivers during their respective modes of travel, so cyclists inhale a larger dose of pollutants.

Cyclists are also more vulnerable to fatal traffic accidents than drivers, even in The Netherlands, which has a strong cycling culture and infrastructure, including dedicated bike trails. The authors estimated that in The Netherlands, the risk of dying in a traffic accident is four times greater per kilometer traveled for cyclists than for drivers. The risk ratios vary by age, because younger drivers are far more likely to die in traffic accidents than older drivers, so their risk of death might actually decrease if they switch to cycling.

Health benefits from cycling may also vary by the age. For example, older, sedentary adults tend to benefit most from increased exercise. However, benefits of exercise can be substantial for persons of all ages; some researchers estimate that inactive individuals who begin moderate exercise programs can lower their risk of death from all causes by 10% to 50%.

The researchers estimated that in The Netherlands the health benefits of cycling are at least nine times greater than the hazards, with the average person who switches to cycling living 3–14 months longer because of increased physical activity, while potentially losing 0.8–40 days of life due to increased exposure to air pollution and an average of 5–9 days due to fatal traffic accidents. The community health benefits are also greater than the risks to the individual cyclists, primarily because eliminating 500,000 car trips per day would reduce air pollution. In countries like the United Kingdom, which has a higher rate of traffic fatalities among cyclists, the researchers estimated that benefits of cycling would still be seven times greater than the risks.

The health benefits of cycling may be less in some developing countries where cyclists may face higher levels of pollution and higher risks in traffic, according to the researchers. Nevertheless, they state that their results are part of a growing body of research that supports the public health benefits of walking and cycling for transportation.

Authors of the paper were Jeroen Johan de Hartog, Hanna Boogaard, Hans Nijland, and Gerard Hoek. This work was funded by the European Union Sixth Framework Programme through the INTARESE (Integrated Assessment of Health Risks of Environmental Stressors in Europe) project.

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Statins associated with lower cancer recurrence following prostatectomy

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Men who use statins to lower their cholesterol are 30 percent less likely to see their prostate cancer come back after surgery compared to men who do not use the drugs, according to researchers at Duke University Medical Center. Researchers also found that higher doses of the drugs were associated with lower risk of recurrence.

The findings are published in the journal CANCER.

"The findings add another layer of evidence suggesting that statins may have an important role in slowing the growth and progression of prostate cancer," says Stephen Freedland, M.D., a member of the Duke Prostate Center and the Urology Section at the Durham Veterans Affairs Medical Center, and the senior author of the study. "Previous studies have shown that statins have anti-cancer properties, but it's not entirely clear when it's best to use them – or even how they work."

Researchers examined the records of 1319 men who underwent radical prostatectomy included in the Shared Equal Access Regional Cancer Hospital (SEARCH) database. They found that 18 percent of the men – 236 – were taking statins at the time of surgery.

Researchers followed the patients after surgery to evaluate recurrence rates, measured by slight rises in the PSA levels after surgery, a development known as "biochemcical recurrence." Time to biochemical recurrence is viewed as an important clinical factor because it is correlated with the risk of disease progression and death.

The authors found that 304 men had a rising PSA, including 37 (16 percent) of the statin users and 267 (25 percent) of the non-users. Taking into account various clinical and pathological features that differed between the two groups, the data showed that overall, statin use reduced the risk of biochemical recurrence by 30 percent.

Among men taking statins equivalent to 20 mg of simvastatin a day, the risk of recurrence was reduced 43 percent and among the men taking the equivalent of more than 20 mg of simvastatin a day, the risk of recurrence was reduced 50 percent. Men who took a statin dose the equivalent of less than 20 mg of simvastatin daily saw no benefit.

There were significant differences between those who took the drugs and those who did not. Statin users tended to be white, older and heavier than non-users. They also had lower clinical stages at diagnosis, but higher Gleason scores, a measure of tumor aggressiveness.

"These findings are intriguing, but we do need to approach them with some caution," says Robert Hamilton, M.D., a urologist at the University of Toronto and the lead author of the study. "For example, we don't know the diet, exercise or smoking habits of these men. So it's not entirely clear if the lower risk we detected is related to the statins alone – it could be due to other factors we were not able to measure. We do feel, however, that based on these findings and those from other studies, the time is ripe to perform a well-controlled randomized trial to test whether statins do indeed slow prostate cancer progression."

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