Supplementing with Cocoa Flavanols May Help Lower the Risk of Atrial Fibrillation Over the Years: Study

Cocoa flavanols, naturally occurring compounds found in cocoa beans, are known for their potential cardiovascular benefits. Prior research has linked cocoa flavanols with improvements in blood pressure, endothelial function, and overall heart health.

While numerous large-scale, long-term cohort studies have investigated the impact of cocoa flavanols on cardiovascular health, the direct link between cocoa flavanols and atrial fibrillation remains unclear. Although research on chocolate consumption offers some indirect evidence supporting the role of cocoa flavanols, these studies are complicated by the variability in chocolate’s caloric and saturated fat content and inconsistent flavanol levels.

To fill this knowledge gap, Christine M Albert, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, and colleagues designed the COSMOS trial to investigate the effects of cocoa flavanol supplementation on various aspects of cardiovascular health.

For instance, the Danish Diet, Cancer, and Health cohort study found that participants who consumed chocolate up to six times a week had a 20% lower risk of developing AF than those who ate chocolate less than once a month (hazard ratio [HR] 0.80). Conversely, the Women’s Health Study and the Physicians’ Health Study did not observe any association between chocolate consumption and incident AF. Furthermore, a recent meta-analysis of five studies, including these cohorts, found no overall correlation between chocolate intake and AF.

"Given these mixed results and the limited focus on cocoa flavanols specifically, further research is required to clarify their role in preventing atrial fibrillation," the researchers wrote.

Adding that, "The variability in study findings underscores the necessity for large, well-designed primary prevention trials to better understand the potential benefits of cocoa flavanols on heart rhythm and overall cardiovascular health."

"Participants who received cocoa extract supplements experienced a significant reduction in the incidence of atrial fibrillation over 5.5 years. This effect may be attributed to the properties of cocoa flavanols, which potentially contribute to atrial remodeling and offer protection against the development of AF,' they concluded.

Reference:

Middeldorp, M. E., Manson, J. E., Aragaki, A. K., Clar, A., Sesso, H. D., & Albert, C. M. Cocoa flavanol supplementation and incident atrial fibrillation in the COSMOS trial. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwae229