Skip to main content Accessibility help
×
Home

Effect of cocoa on the brain and gut in healthy subjects: a randomised controlled trial

  • Mark Fox (a1) (a2), Anne Christin Meyer-Gerspach (a3), Maria Janina Wendebourg (a1) (a4), Maja Gruber (a1), Henriette Heinrich (a1) (a2), Matthias Sauter (a1) (a2), Bettina Woelnerhanssen (a3), Dieter Koeberle (a5) and Freimut Juengling (a5)...

Abstract

Dark chocolate is claimed to have effects on gastrointestinal function and to improve well-being. This randomised controlled study tested the hypothesis that cocoa slows gastric emptying and intestinal transit. Functional brain imaging identified central effects of cocoa on cortical activity. Healthy volunteers (HV) ingested 100 g dark (72 % cocoa) or white (0 % cocoa) chocolate for 5 d, in randomised order. Participants recorded abdominal symptoms and stool consistency by the Bristol Stool Score (BSS). Gastric emptying (GE) and intestinal and colonic transit time were assessed by scintigraphy and marker studies, respectively. Combined positron emission tomography–computed tomography (PET–CT) imaging assessed regional brain activity. A total of sixteen HV (seven females and nine males) completed the studies (mean age 34 (21–58) years, BMI 22·8 (18·5–26·0) kg/m2). Dark chocolate had no effect on upper gastrointestinal function (GE half-time 82 (75–120) v. 83 (60–120) min; P=0·937); however, stool consistency was increased (BSS 3 (3–5) v. 4 (4–6); P=0·011) and there was a trend to slower colonic transit (17 (13–26) v. 21 (15–47) h; P=0·075). PET–CT imaging showed increased [18F]fluorodeoxyglucose (FDG) in the visual cortex, with increased FDG uptake also in somatosensory, motor and pre-frontal cortices (P<0·001). In conclusion, dark chocolate with a high cocoa content has effects on colonic and cerebral function in HV. Future research will assess its effects in patients with functional gastrointestinal diseases with disturbed bowel function and psychological complaints.

Copyright

Corresponding author

*Corresponding author: M. Fox, Department of Gastroenterology and Internal Medicine, Klinik Arlesheim, CH-4144 Arlesheim, Switzerland, email dr.mark.fox@gmail.com

References

Hide All
1. Visioli, F, Bernaert, H, Corti, R, et al. (2009) Chocolate, lifestyle, and health. Crit Rev Food Sci Nutr 49, 299312.
2. Katz, DL, Doughty, K & Ali, A (2011) Cocoa and chocolate in human health and disease. Antioxid Redox Signal 15, 27792811.
3. Lippi, G, Franchini, M, Montagnana, M, et al. (2009) Dark chocolate: consumption for pleasure or therapy? J Thromb Thrombolysis 28, 482488.
4. Corti, R, Perdrix, J, Flammer, AJ, et al. (2010) Dark or white chocolate? Cocoa and cardiovascular health. Rev Med Suisse 6, 499500, 502–504.
5. Larsson, SC, Virtamo, J & Wolk, A (2012) Chocolate consumption and risk of stroke: a prospective cohort of men and meta-analysis. Neurology 79, 12231229.
6. Grassi, D, Desideri, G & Ferri, C (2013) Protective effects of dark chocolate on endothelial function and diabetes. Curr Opin Clin Nutr Metab Care 16, 662668.
7. Grassi, D, Socci, V, Tempesta, D, et al. (2016) Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals. J Hypertens 34, 12981308.
8. Alkerwi, A, Sauvageot, N, Crichton, GE, et al. (2016) Daily chocolate consumption is inversely associated with insulin resistance and liver enzymes in the Observation of Cardiovascular Risk Factors in Luxembourg study. Br J Nutr 115, 16611668.
9. Larsson, SC, Akesson, A, Gigante, B, et al. (2016) Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis. Heart 102, 10171022.
10. Muller-Lissner, SA, Kaatz, V, Brandt, W, et al. (2005) The perceived effect of various foods and beverages on stool consistency. Eur J Gastroenterol Hepatol 17, 109112.
11. Bruinsma, K & Taren, DL (1999) Chocolate: food or drug? J Am Diet Assoc 99, 12491256.
12. Scholey, A & Owen, L (2013) Effects of chocolate on cognitive function and mood: a systematic review. Nutr Rev 71, 665681.
13. Fox, MR, Kahrilas, PJ, Roman, S, et al. (2018) Clinical measurement of gastrointestinal motility and function: who, when and which test? Nat Rev Gastroenterol Hepatol 15, 568579.
14. Ford, AC, Talley, NJ, Spiegel, BM, et al. (2008) Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 337, a2313.
15. Ford, AC, Talley, NJ, Schoenfeld, PS, et al. (2009) Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. Gut 58, 367378.
16. Bohn, L, Storsrud, S, Tornblom, H, et al. (2013) Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol 108, 634641.
17. Parker, HL, Tucker, E, Hoad, CL, et al. (2016) Development and validation of a large, modular test meal with liquid and solid components for assessment of gastric motor and sensory function by non-invasive imaging. Neurogastroenterol Motil 28, 554568.
18. Rao, SS, Camilleri, M, Hasler, WL, et al. (2011) Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil 23, 823.
19. Lewis, SJ & Heaton, KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32, 920924.
20. Aziz, Q, Andersson, JL, Valind, S, et al. (1997) Identification of human brain loci processing esophageal sensation using positron emission tomography. Gastroenterology 113, 5059.
21. Parker, HL, Tucker, E, Blackshaw, E, et al. (2017) Clinical assessment of gastric emptying and sensory function utilizing gamma scintigraphy: establishment of reference intervals for the liquid and solid components of the Nottingham test meal in healthy subjects. Neurogastroenterol Motil 29, e13122.
22. Kwiatek, MA, Menne, D, Steingoetter, A, et al. (2009) Effect of meal volume and calorie load on postprandial gastric function and emptying: studies under physiological conditions by combined fiber-optic pressure measurement and MRI. Am J Physiol Gastrointest Liver Physiol 297, G894G901.
23. Heinrich, H, Goetze, O, Menne, D, et al. (2010) Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: randomised controlled crossover trial. BMJ 341, c6731.
24. Goetze, O, Steingoetter, A, Menne, D, et al. (2007) The effect of macronutrients on gastric volume responses and gastric emptying in humans: a magnetic resonance imaging study. Am J Physiol Gastrointest Liver Physiol 292, G11G17.
25. Feinle, C, Meier, O, Otto, B, et al. (2001) Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia. Gut 48, 347355.
26. Simren, M, Abrahamsson, H & Bjornsson, ES (2007) Lipid-induced colonic hypersensitivity in the irritable bowel syndrome: the role of bowel habit, sex, and psychologic factors. Clin Gastroenterol Hepatol 5, 201208.
27. Marciani, L, Cox, EF, Pritchard, SE, et al. (2015) Additive effects of gastric volumes and macronutrient composition on the sensation of postprandial fullness in humans. Eur J Clin Nutr 69, 380384.
28. Parker, HL, Curcic, J, Heinrich, H, et al. (2017) What to eat and drink in the festive season: a pan-European, observational, cross-sectional study. Eur J Gastroenterol Hepatol 29, 608614.
29. Fox, M, Barr, C, Nolan, S, et al. (2007) The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol 5, 439444.
30. Rao, SS, Welcher, K, Zimmerman, B, et al. (1998) Is coffee a colonic stimulant? Eur J Gastroenterol Hepatol 10, 113118.
31. Boekema, PJ, Samsom, M, van Berge Henegouwen, GP, et al. (1999) Coffee and gastrointestinal function: facts and fiction. A review. Scand J Gastroenterol Suppl 230, 3539.
32. Schuier, M, Sies, H, Illek, B, et al. (2005) Cocoa-related flavonoids inhibit CFTR-mediated chloride transport across T84 human colon epithelia. J Nutr 135, 23202325.
33. Strat, KM, Rowley, TJ, Smithson, AT, et al. (2016) Mechanisms by which cocoa flavanols improve metabolic syndrome and related disorders. J Nutr Biochem 35, 121.
34. Sarkar, A, Harty, S, Lehto, SM, et al. (2018) The microbiome in psychology and cognitive neuroscience. Trends Cogn Sci 22, 611636.
35. Schroeter, H, Heiss, C, Balzer, J, et al. (2006) (–)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proc Natl Acad Sci U S A 103, 10241029.
36. Sorond, FA, Lipsitz, LA, Hollenberg, NK, et al. (2008) Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatr Dis Treat 4, 433440.
37. Scholey, AB, French, SJ, Morris, PJ, et al. (2010) Consumption of cocoa flavanols results in acute improvements in mood and cognitive performance during sustained mental effort. J Psychopharmacol 24, 15051514.
38. Field, DT, Williams, CM & Butler, LT (2011) Consumption of cocoa flavanols results in an acute improvement in visual and cognitive functions. Physiol Behav 103, 255260.
39. Karabay, A, Saija, JD, Field, DT, et al. (2018) The acute effects of cocoa flavanols on temporal and spatial attention. Psychopharmacology (Berl) 235, 14971511.
40. Francis, ST, Head, K, Morris, PG, et al. (2006) The effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young people. J Cardiovasc Pharmacol 47, Suppl. 2, S215S220.
41. Canavan, C, West, J & Card, T (2014) The epidemiology of irritable bowel syndrome. Clin Epidemiol 6, 7180.
42. Kaplan, MA, Prior, MJ, Ash, RR, et al. (1999) Loperamide-simethicone vs loperamide alone, simethicone alone, and placebo in the treatment of acute diarrhea with gas-related abdominal discomfort. A randomized controlled trial. Arch Fam Med 8, 243248.

Keywords

Type Description Title
WORD
Supplementary materials

Fox et al. supplementary material
Table S1

 Word (61 KB)
61 KB

Effect of cocoa on the brain and gut in healthy subjects: a randomised controlled trial

  • Mark Fox (a1) (a2), Anne Christin Meyer-Gerspach (a3), Maria Janina Wendebourg (a1) (a4), Maja Gruber (a1), Henriette Heinrich (a1) (a2), Matthias Sauter (a1) (a2), Bettina Woelnerhanssen (a3), Dieter Koeberle (a5) and Freimut Juengling (a5)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed