Cocoa, Postprandial Lipoproteins, And Inflammation in Type 2 Diabetes: A Secondary Data Analysis

Rickelle Tallent


Background: Type 2 Diabetes (T2D) is associated with dyslipidemia and chronic low-grade inflammation, which greatly increases the risk of cardiovascular disease (CVD) in this population. Hyperlipidemia and inflammation in the postprandial state substantially contribute to atherosclerosis development and CVD risk, and have shown to be exacerbated by high-fat meals. Dietary cocoa is a rich source of flavanols that is associated with favorable effects on cardiovascular health, such as improvements in the lipid profile and chronic inflammation, in non-diabetic adults.

Objective: To conduct a secondary data analysis using unpublished data from a previously conducted clinical study to determine whether acute cocoa supplementation reduces postprandial metabolic stress, through improvements in serum markers of lipid metabolism and inflammation, in obese T2D adults after a high-fat fast-food-style meal.

Methods: Adults with T2D [n = 18; age (mean ± SE): 56±3y; BMI (kg/m2): 35.3±2.0; 14 women; 4 men] were randomly assigned to receive cocoa beverage (960 mg total polyphenols; 480 mg flavanols) or flavanol-free placebo with a high-fat fast-food-style breakfast [766kcal, 50g fat (59% energy)] in a crossover trial. After an overnight fast, participants consumed the breakfast with cocoa or placebo, and blood sample collection [serum apoB, apoA1, NEFA, IL- 1β, IL-6, and IL-18] was conducted at fasting, 1, 2, 4, and 6 h postprandial time points.

Results: Cocoa significantly decreased serum IL-18 levels at the 1, 4, and 6-h postprandial time points compared to placebo (p < 0.001), but had no effects on serum apoB, apoA1, NEFA, IL- 1β, or IL-6 levels.

Conclusion: Cocoa may play a protective role against the development and progression of CVD through selective anti-inflammatory effects on postprandial IL-18.