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The POWER OF. COCOA CACAO The Modern Problem Population is aging –Chronic illness Coronary heart disease Hypertension Diabetes mellitus Obesity Strokes.

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Presentation on theme: "The POWER OF. COCOA CACAO The Modern Problem Population is aging –Chronic illness Coronary heart disease Hypertension Diabetes mellitus Obesity Strokes."— Presentation transcript:



3 The Modern Problem Population is aging –Chronic illness Coronary heart disease Hypertension Diabetes mellitus Obesity Strokes Certain cancers Arthritis Depression Dementia Generalized inflammation

4 Cardiovascular Risk Factors smoking diabetes High blood pressure High cholesterol Estrogen withdrawal Oxidative stress decrease nitric oxide Constriction of blood vessels Blood clots and plaque formation inflammation Heart attack strokes Obesity

5 Why ? How? Oxidation and inflammation Decay When oxygen is burnt or used as fuel Oxidation occurs forming Free Radicals

6 Cytokines Plaque formation Foam cell Monocytes LUMEN MEDIA INTIMA Oxidized LDL Adhesion molecules Lp-PLA 2 The role of Lp-PLA 2 in vascular inflammation Lyso-PC OxFA Macrophage

7 Free Radicals O O2 NO OH

8 Free Radicals Free radicals have been associated with greater than 200 diseases It is responsible for premature aging, wrinkling of the skin, hardening of the arteries, stiffening of joints, development of cancer It sets us up for serious illnesses

9 Nature’s solution Nature has given naturally occurring fruits and vegetables which contain phytochemicals The pigments, tastes, and colors serve to protect, reproduce, and benefit the plants One group of phytochemicals are polyphenols and the largest category is flavonoids


11 The Bodies’ Own Defenses –Natural anti oxidants –Natural enzyme processes Anti oxidants converts free radicals to harmless molecules –Body needs extra anti oxidants Exercise chronic illness fever stresses Diet from natural food phytonutrients The government is recommending 5-9 servings of fruits and vegetables


13 Dietary Flavonoids vs. CHD Mortality (Seven Country Study) Hertog MGL. Arch Intern Med 1995; 155:381 Age Adjusted 25 year Mortality (%) 2040 6080 30 0 EF WF US ZR UJ SL TJ DA ZU CR MO VR BE CO CR ZR Total Dietary Flavonoids mg/day

14 Flavonoids Flavonoids have the capacity to act as powerful antioxidants by stopping the free radical process and the oxidative process They also chelate metal ions Modulate cellular functioning


16 Testing ORAC oxygen radical absorbance capacity HORAC NORAC SORAC Total phenolic Epicatechin and catechin


18 COCOA Dark unprocessed cocoa –Bitter is better the highest ORAC value –It is very rich in flavonoids especially (-)epicatechin (+) catechin procyanidins It is loaded with vitamins, minerals, essential fatty acids, fiber

19 Chocolate is a divine, celestial drink, the sweat of the stars, the vital seed, divine nectar, the drink of the gods, panacea and universal medicine Geronimo Piperni, 1796



22 COCOA Dark Cocoa why not spoil bitter is better highest ORAC –Rich in flavonoids (-) epicatechin (+) catechin and procyanidins –Vitamins, minerals, essential fatty acids, fiber –Increases good cholesterol –Dilates blood vessels decreases BP platetes stops clots –Anti-inflammatory antihistamine –Helps the blood use insulin better –Helps with depression PEA –Theobromine no caffeine –Memory –Dental caries and gum disease –Arthritis energy

23 Modern Day Evidence Cocoa flavonoids have been associated in medical studies with decreasing Cancer Cardiovascular diseases Neurodegenerative diseases Dental diseases Depression Inflammatory diseases

24 Epicatechin Properties –Insulin mimetic action –Protective effects on red blood cells( restores the acetylcholinesterase activity) –Protects against lipid peroxidation –Inhibits platelet aggregration –Preserves pancreatic islet cells –Prevent the digestion and absorption of carbohydrates –Help normalize blood sugars

25 (-)Epicatechin and (+) Catechin Improves blood flow Reduce atherosclerotic plaques Anti neurodegenerative effect protect brain cells from amyloid beta protein development May impact Caco-2 cells (human colon adenocarcinoma cell line)

26 Cardiovascular health dark cocoa Studies have found: –Stops the oxidative process of the LDL (bad) cholesterol –Increases nitric oxide (NO) dilating blood vessels and lowering blood pressure – decreases platelet formation and clot development – increases HDL (good) cholesterol and lowers triglycerides

27 JACN vol 23,No 3, 197-204 (2004)

28 ↓Insulin resistance↓Blood pressure Study Design: N=20, crossover, 15 d Intervention: 100 g dark chocolate bar vs. 90 g white chocolate bar Result (dark chocolate): 45% ↓ insulin resistance 10 mm ↓ SBP

29 (-) Epicatechin vascular function Kuna Indians –Drink 4-5 cups of a high flavonoid rich beverage a day Decrease blood pressures Low cholesterol levels Improved cardiovascular health When they move away and stop drinking the beverage they develop cardiovascular diseases

30 Copyright ©2006 by the National Academy of Sciences Schroeter, Hagen et al. (2006) Proc. Natl. Acad. Sci. USA 103, 1024-1029 Fig. 3. Proof-of-concept: Vascular response after oral ingestion of (-)-epicatechin

31 Zutphen Study Studied 470 men ages 65-84 and free of chronic illnesses over 15 years Those who ate at least 10 grams of dark chocolate a day had a 45-50% reduction in cardiovascular deaths and overall deaths They ate more calories overall but tended to be slightly less fat than those who didn’t Archives of Internal Medicine 2006 166:411-417

32 Meta Analysis boosts cocoa’s blood pressure lowering effects April 2007 Archives of Internal Medicine 173 participants Germany University of Cologne “The magnitude of the hypotensive effects of cocoa is clinically noteworthy; it is in the range that is usually achieved with monotherapy of beta blockers or ACE inhibitors Better than green or black tea (it appeared they had no effect) A

33 Cocoa reduces LDL March 2007 24% increase in HDL cholesterol with a cocoa group versus 5% in a controlled group Showed a reduction in LDL oxidation Measured marked urinary increases in epicatechins and catechins

34 Reverse Blood Vessel Damage March 2007 Journal of Cardiovascular Pharmacology “Within two days… showed a significant improvement in blood vessel function and researcher noted that impairment of blood flow could almost be reversed with the high flavanol cocoa”

35 Heart Health and Exercise Journal of International Sport Nutrition and Exercise Metabolism Elite bicyclists exercised to exhaustion –Given chocolate milk –Gatorade –Carbohydrate replacement drink Exercised again Chocolate milk was the winner Journal of International Sport Nutrition and Exercise Metabolism, 2006:16:78-91

36 Spatial Memory Mice study (Journal of Neuroscience) –Four groups Running wheel and epicatechins Epicatechins Running wheel and nothing else The typical American lifestyle –Results Water maze the best Running wheel and epicatechins –Improved Spatial Memory –Showed increase blood vessel growth –

37 Neurodegenerative diseases Several studies have looked at flavonoids and decreases in: –Parkinson’s disease –Dementia – Polyphenols have been found to delay onset of Alzheimer's disease. A recent study showed older Japanese-Amercian men and women who drank fruit or vegetable juices three times a week had a 75% reduction of developing Alzheimer's disease. No benefit was seen with supplemental or dietary vitamins like E, C, or betacarotene. –Neurology Reviews December 2005, pp.44-45.

38 Diabetes Numerous studies have shown that the flavonoids in cocoa increase insulin sensitivity ORIGINAL RESEARCH COMMUNICATION Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons1,2,3 Davide Grassi, Cristina Lippi, Stefano Necozione, Giovambattista Desideri and Claudio Ferri 1 From the Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila, Italy. Background: Numerous studies indicate that flavanols may exert significant vascular protection because of their antioxidant properties and increased nitric oxide bioavailability. In turn, nitric oxide bioavailability deeply influences insulin-stimulated glucose uptake and vascular tone. Thus, flavanols may also exert positive metabolic and pressor effects. Results: HOMA-IR was significantly lower after dark than after white chocolate ingestion (0.94 ± 0.42 compared with 1.72 ± 0.62; P < 0.001), and QUICKI was significantly higher after dark than after white chocolate ingestion (0.398 ± 0.039 compared with 0356 ± 0.023; P = 0.001). Although within normal values, systolic blood pressure was lower after dark than after white chocolate ingestion (107.5 ± 8.6 compared with 113.9 ± 8.4 mm Hg; P < 0.05). Conclusion: Dark, but not white, chocolate decreases blood pressure and improves insulin sensitivity in healthy persons Tomaru, M Dietary Supplementation with Cacao Liquor Proanthocyanidins Prevents Elevation of Blood Glucose Levels in Diabetic Obese Mice Nutrition 2007 1:7 Insulin sensitivity helping the body utilize sugars better

39 Neuropathy –recent report in Neurology Review outlines the results of a study on how diabetes and high blood sugar cause damage to the body in particular causing nerve damage and nerve pain (neuropathy). The findings suggest that oxidative damage to the inner part of the cells cause the cells to die (apoptosis). This damage to the nerve cells cause burning and or numbness in extremities. This numbness further leads to ulcers in feet and often amputations. The oxidation in the body produces superoxide or free radicals which damage the nerve cells at the molecular level (mitochrondrial level). The oxidation is the result of high blood sugars. In one of the reviews of a study on rats that 20% of the nerve cells DNA were damaged only after three months of high blood sugars. –Vincent AM, McLean LL, Backus C, Feldman, EL Short term hypergylcemia produces oxidative damage and apoptosis in neurons, FASEB J 2005;19:638-640

40 Cancer and flavonoids Many studies have shown inhibition of cancer cells in lungs, oral, esophagus, stomach, colon, skin, prostate, and breast cancer The research is just beginning in this area Substances found in edible fruits and vegetables... that exhibit a potential for modulating human metabolism in a manner favorable for cancer prevention.” JADA. 95(4):493-496, 1995

41 Inflammation Studies have shown the flavonoids work like a COX inhibitor blocking the pathway stopping inflammation in the body The cocoa flavonoids act as anti histamine helping with asthma and stomach discomfort as well as a potent anti - diarrhea agent

42 Theobromine increases feeling of well being mild antidepressant Stimulates muscular system Not addictive Opens up the lungs bronchodilator

43 Mood Elevation Psychoactive chemicals in cocoa PEA phenylethylamine love chemical Anandamide bliss chemical MAO inhibitor Vitamins like magnesium Tryptophan serotonin dopamine Decrease in depression Mood elevation Appetite depressant

44 Brain Power Study done found that chocolate –Increased verbal and visual memory –Improved impulse and reaction time –Overall enhanced cognitive performance –Raudenbush, B Wheeling Jesuit University West Virginia soon to be published study, 2006

45 A Kiss is Just A Kiss April 2007 Heartbeats per minutes more than doubled from eating chocolate than kissing and a more sustained reaction up to four times longer than by a kiss The feel good factor from serotonin

46 Neurobiology of Chocolate University of Nottingham Medical School 2007 “Our study showed that acute consumption of flavanol-rich cocoa was associated with increased grey matter flow for two to three hours… it raises the possibility that cocoa maybe beneficial in enhancing brain function … helping with fatigue, sleep, deprivation, ageing, and even dementia”

47 Flavonoids improve mental health June 2007 –Better cognitive performance done over 10 years –It improved the Mini Mental State Examination

48 Aging Studies recently done with animals show improvement in aging with a diet high in flavonoids and antioxidants It slowed down the aging process Prior USDA, 2005

49 Other Areas Flavonol rich diet may slash pancreatic cancer risks American Association for Cancer Research may cut risk by 25% up to 59% in smokers “Anti carcinogenic effects of flavanoids in general have been attributed to the ability of these constituents to inhibit cell cycle, cell proliferation and oxidative stress, and to induce detoxification enzymes and apotosis”

50 Other Medical Properties Cocoa protects the sun from UV damage and helps reducing wrinkles and skin damage Cocoa has been found to help with diarrhea Stop smoking cravings Helps with inflammatory bowel diseases Macular degeneration Weight Loss ( Great during pregnancy and lactation –sweet babies

51 Myths Rarely are people allergic to chocolate Does not increase acne Does not cause migraine headaches Does not increase acid reflux Does not increase your weight Does not cause insomnia Pure cocoa beans have no to minimal caffeine Milk does not interfere with absorption

52 Fiber Cocoa Fiber –Feel fuller faster –Helps with irritable bowel syndrome –Lowers blood sugars –Lowers cholesterol –Colon

53 Cocoa Butter Made up of –Stearic acid (34%) –Oleic acid (34%) –Palmitic acid (25%) –Others (7%) Neutral in regard to lipid profile and weight gain

54 Dental Health Prevention and healing of gum disease Prevention of dental caries Two studies done this year in Japan showed decrease in oral bacteria counts resulting in improved breath

55 Should it be a Vitamin??? Vitamin-C(ocoa) “Epicatechin could potentially get rid of FOUR of the five most common diseases in the Western World – In Kuna Indians 90% less risk of cancer, stroke, heart failure and diabetes

56 Need a cocoa that is raw unprocessed cold pressed cocoa not heated –Without the added high glycemic sugars – refined sugars, added fats, waxes, preservatives, tested for lead and bacteria –Mixed with other high antioxidant fruits or products –Avoid Dutching or alkalization

57 XOCAI Xocai has the great benefits of not only cocoa but Acai Omega 3 blueberries dark grapes The weighted benefits far outweight any minor problem with any individual component

58 Effectiveness of Cocoa Flavonoids “This does not preclude the possibility that flavonoids may accumulate in tissues where they might exert local antioxidant effects or that very low concentrations of flavonoids may modulate cell signalling, gene regulation, antiogenesis,and other biological processes by non-antioxidant mechanisms, which may explain the purported health benefits of flavonoids” Free Radical Biology and Medicine

59 Ideal Primary Prevention Agent Natural dietary factor (not a medicine) Palatable—even tasty Convenient Affordable/available Positive incentives to use regularly Feasible for long-term adherence Supplement or partial replacement Maximizes positive elements Minimizes negative elements Scientifically established –Benefits –Safety

60 The Antioxidant Paradox Oxidation promotes CVD, and Low CVD risk associates with: A diet high in antioxidant-rich foods associates with low CVD risk High blood levels of antioxidants, but Antioxidant vitamins do not lower CVD risk! Why not? Somehow the benefit is lost: Other important antioxidants are removed, and/or Antioxidants need to be with other factors in the food

61 WEIGH THE EVIDENCE For centuries cocoa was a medicine TODAY new studies are tipping the balance again in favor of flavonoids and especially cocoa phytonutrients combined with a balanced diet and active life

62 FOR MORE INFORMATION: –The Power of Dark Chocolate by Steven Warren MD – – – –Health Matters with Dr Steve TV this Fall





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