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In the news: Cocoa for People with PAD; Vinegar Pre-Treatment for Safer Grilling

Cocoa May Help PAD Patients Walk Further

Researchers from Northwestern University report that drinking a bioflavonoid-rich cocoa beverage daily improved walking distance, blood flow to the calves and some measures of muscle function in a study of patients with peripheral artery disease or PAD. The study was published in Circulation Research, a journal of the American Heart Association.

PAD, which affects about 10% of the American pop-ulation, is a circulatory problem in which narrowed arteries reduce blood flow to the limbs, most frequently the legs. While some people with PAD have no symptoms, others experience pain, numbness, or heaviness in their leg muscles when walking or climbing stairs. Pain when walking means that the legs aren’t receiving enough blood flow to keep up with the increased demand of physical activity.

Research has also identified impaired vessel wall function, poor blood flow in tiny vessels like arterioles and capillaries, poor mitochondrial function and altered skeletal muscle structure in patients with PAD (1).

In the present study (2), 44 older participants with PAD were randomly assigned to take placebo or 15 g of cocoa providing 75 mg of the bioflavonoid epicatechin daily for 6 months. The total amount of cocoa was divided into three beverage servings daily. Studies point to epicatechin, a member of the flavanol class of bioflavonoids, as the compound largely responsible for cocoa and dark chocolate’s ability to dilate blood vessels.

Compared to the placebo group, those consuming cocoa were able to walk 43 meters (141 feet) farther in the 6-minute walking test conducted 2 ½ hours after drinking the cocoa beverage. Consistent with other studies, 6-minute walking distance declined for those in the placebo group over time.

At the 6-month mark, participants receiving the cocoa flavanols also had better blood flow to calf muscles and increased capillary density. In addition, the group showed greater activity in calf muscle mitochondria – the energy producing structures inside cells.

This study was small, and its findings of improved walking distance and better muscle health need to be replicated in larger trials. If the benefits of cocoa are confirmed it would be clinically meaningful since few medical therapies can improve the 6-minute walk test or prevent decline in those with PAD.

It’s possible that people with PAD may get a prescription to eat more dark chocolate in the future! The cocoa used in the study is available as unsweetened cocoa powder which is present in dark chocolate (85% or more cacao) compared with milk chocolate.

A Strategy for More Safely Grilling Meats

While it’s still too early in the season to think about charcoal grilling, a new study (3) has found an easy-to-apply strategy to making charcoal-grilled meats a little safer.

University researchers in Portugal investigated the effect of applying five different vinegars as seasoning on the formation of polycyclic aromatic hydrocarbons (PAHs) in charcoal-grilled pork loin. PAHs are chemicals that occur naturally in coal (and other sources), and high temperature cooking forms PAHs in meat and other foods. Many PAHs are believed to be carcinogenic.

The researchers found that spraying the meat with vinegar prior to grilling significantly inhibited or prevented PAH formation. Elderberry vinegar was most efficient (82% inhibition), followed by white vinegar (79%), red wine and cider vinegars (66%), and raspberry vinegar (55%).

References

1. Matsui R and Hamburg N. Editorial: Eating chocolate to improve muscle health and walking ability in patients with peripheral artery disease. Circ Res, 126:600-602.
2. McDermott MM, et al. Cocoa to improve walking performance in older people with peripheral artery disease. The COCOA-PAD Pilot Randomized Clinical Trial. Circ Res. 126:589–99, 2020.
3. Cordeiro T, et al. Inhibitory effect of vinegars on the formation of polycyclic aromatic hydrocarbons in charcoal-grilled pork. Meat Sci. Epub Feb. 5, 2020.