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Reaching for Cocoa for Your Arteries

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When we think of cardiovascular health, it’s easy to just focus on the health of the heart’s arteries and vessels and miss the importance of peripheral arteries.  The arteries in the lower legs can narrow over time because of peripheral artery disease (PAD), reducing blood flow, causing cramps, or sensations of tightness when walking.  Recent research shows that there’s an unexpected ally in the fight against PAD that comes in a tasty beverage.

                When PAD patients in the study by the American Heart Association drank cocoa mixed in water three times a day over a 6-month period, they increased their walking endurance by 42.6 meters.  The control group in the study who drank the same amount of milk without cocoa did not have any improvement in their walking distances.

                Taste aside, how could such a simple change have made such a difference?  The answer lies in the flavanols in cocoa.  The unsweetened cocoa powder is a concentrated source of a specific type of flavanol called epicatechin.  It’s estimated that the cocoa the participants mixed in water contained 75 mgs of epicatechin per 15 grams of cocoa.  Epicatechin is one the major health benefits to choosing to eat dark chocolate over milk chocolate because it’s found in chocolate products that contain more than 85% cacao.

                Instead of experiencing a decline in the distance walked over the 6-minute walking test that PAD patients are expected to have without any interventions, the participants who drank the cocoa made serious gains.  The epicatechin improves the blood flow to the muscles of the legs, especially the calves of people with PAD, and scientists believe that it can also boost the activity of mitochondria in the lower limbs, giving the body more energy and also increasing capillary strength.

                Cocoa is also a source of antioxidants and polyphenols which can be helpful for overall cardiovascular health and general well-being.  If you have PAD, talk to your doctor about if adding in cocoa may be a good fit for you.


Mary M. McDermott, Michael H Criqui, Kathryn Domanchuk,et al. Cocoa to Improve Walking Performance in Older People With Peripheral Artery Disease: The Cocoa-Pad Pilot Randomized Clinical TrialCirculation Research, 2020; DOI: 10.1161/CIRCRESAHA.119.315600


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