Flavanol-Rich Cocoa improves exercise capacity

From 01 September 2022 my regular posts on the health benefits of cocoa have been on consumption of polyphenol-rich cocoa on exercise capacity and muscle function. The Vice President, His Excellency, Dr. Mahamadu Bawumia led thousands of Ghanaians at the Accra Sports Stadium for the maiden edition of the National Fitness Day on Saturday 10 September 2022 (https://www.gbcghanaonline.com/).

As I often relate whenever I get the opportunity, till date Ghana produces the best quality cocoa in the world- till date Ghana’s cocoa is the benchmark for cocoa produced across the world. My own readings show that the health benefits of cocoa span from the top of the head to the toe. For this piece I will dwell on the health benefits of cocoa on exercise and muscle function. There is a point to make about the cardiovascular benefit of polyphenol-rich cocoa because of its key link to exercise performance. It is known that cocoa flavanols (CFs) stimulate nitric oxide (NO) production resulting in improved vasodilation and endothelial function and reduced blood pressure (BP). Moreover, CF can reduce platelet activity and aggregation. In addition, CFs protect against oxidative stress and inflammation. It has also been shown that CF can improve insulin sensitivity and lipid profiles in participants with or without cardiovascular risks. CFs can cross the blood-brain barrier and increase cerebral blood flow (Decroix et al. Cocoa flavanol supplementation and exercise: A systematic review. Article in Sports Medicine · April 2018).

CF gained the attention of exercise physiologists, because endurance-type exercise also exerts beneficial effects on the same parameters that are influenced by CF intake. Thus, combining physical activity with CF intake is regarded as a successful strategy to prevent cardiovascular diseases, insulin resistance, and other age-related disorders. Strenuous training generates excessive levels of ROS with detrimental effects on cell structure and function. When increased levels of ROS exceed the antioxidant capacity of our body, the body’s homeostatic balance is disturbed, and as a result oxidative stress occurs. The large amount of ROS can then interact with lipids, proteins, and DNA, and cause oxidative damage to the mitochondria and muscle contractile proteins and consequent muscular damage and fatigue after exercise. CF can therefore improve exercise performance and recovery through its strong antioxidant capacity and consequent reduction in oxidative stress (Peschek et al. The Effects of Acute Post Exercise Consumption of Two Cocoa-Based Beverages with Varying Flavanol Content on Indices of Muscle Recovery Following Downhill Treadmill Running. Nutrients 2014, 6, 50-62; doi:10.3390/nu6010050).

Cocoa flavanol increases nitric oxide (NO) production.  NO is a major vasodilator and, thus, an increased (physiological) level of NO increases blood flow to the muscle, allowing for improved nutrient and oxygen delivery and waste removal., NO is involved in muscle contractility and mitochondrial biogenesis and respiration. Therefore, increased NO bioavailability by CF intake leads to enhanced mitochondrial efficiency and enhanced muscle function. CF intake can improve executive function (decision making) and motor control through its beneficial vascular effect and thus increase cerebrovascular blood flow (acute intake), and through interaction with critical protein and lipid kinase signaling cascades in the brain, lead to promotion of neuronal survival and synaptic plasticity (chronic intake). Therefore, improving executive function and motor control are two important factors influencing sports performance.

Dietary flavanols with antioxidant properties have gained attention in their potential to reduce oxidative stress and aid in post exercise muscle recovery. Antioxidants can prevent lesser radicals from transforming to more damaging radicals, and antioxidants can convert reactive oxygen species into less active versions. Dietary flavanols found in natural cocoa powder provide cardiovascular health benefits including decreasing blood pressure by improving endothelial function, and improving blood circulation. Consumption of polyphenol-rich cocoa significantly reduces the level of perceived muscle soreness 24 to 48 h following exhaustive exercise. The significant decrease in perceived muscle soreness between 24 and 48 h post exercise is linked to the increased levels of antioxidants in polyphenol-rich cocoa.

It is widely recognized that essential to the preservation of overall cardiometabolic health is the inclusion of regular physical activity. Current guidelines suggest that individuals perform at least 150 min of moderate exercise activity/week in order to achieve this goal. However, for subjects 50 years and over, physical activity can be limited by a variety of chronic degenerative diseases or conditions such as osteoarthritis and obesity. Thus, many of these subjects fail to engage in physical conditioning leading to a deterioration of cardiometabolic health. Thus the great interest in identifying natural products/supplements and/or novel agents that may preserve and/or stimulate physical conditioning so as to mitigate the effects of inactivity. Even in sedentary, middle age subjects, the consumption of polyphenol-rich cocoa leads to gains in exercise capacity. These effects are also accompanied by improvements in blood metabolic endpoints particularly, HDL. Remarkably, these changes were induced in the absence of any physical conditioning as the subjects Taub et al. Beneficial effects of dark chocolate on exercise capacity in sedentary subjects: Underlying mechanisms: A double blind, randomized, placebo controlled trial. Food Funct. Author manuscript; available in PMC 2017 September 14. It needs to be stressed that acute, sub-chronic (2 weeks) and chronic (3 months) CF intake reduced exercise-induced oxidative stress. Regular intake of flavanol-rich cocoa alters fat and carbohydrate metabolism during exercise.

The Ghana Cocoa Board (COCOBOD) is 75 years old. This year’s Cocoa Day is under the theme “COCOBOD @75: Sustaining our Environment, Wealth and Health”. The thrust is to promote cocoa as a healthy food and encourage its consumption regularly and acknowledge and express commitment towards the sustainability of the cocoa industry. If flavanol-rich cocoa’s health benefits clearly fit into our National Fitness Campaign, then it needs to be regularly consumed by everyone to safeguard health and increase the wealth of the country.

BY DR. EDWARD O. AMPORFUL

CHIEF PHARMACIST

COCOA CLINIC