Dietary Cocoa Flavanols improve micro-vascular health in hemo patients

[kickingandscreaming]

We're talking about real cocoa powder, and it probably works for all patients with CKD and on Dialysis.  My question is.  What is the phosphorus content of genuine, high-flavanol cocoa?

http://cjasn.asnjournals.org/content/11/1/108.abstract?sid=07a1a74d-a4d1-406c-8abc-1271767d33a8

Vasculoprotective Effects of Dietary Cocoa Flavanols in Patients on Hemodialysis: A Double–Blind, Randomized, Placebo–Controlled Trial


Abstract
Background and objectives Hemodialysis (HD) per se entails vascular dysfunction in patients with ESRD. Endothelial dysfunction is a key step in atherosclerosis and is characterized by impaired flow–mediated dilation (FMD). Interventional studies have shown that cocoa flavanol (CF)–rich supplements improve vascular function. Aim of this study was to investigate the effect of flavanol–rich bioactive food ingredients on acute and chronic HD–induced vascular dysfunction in ESRD.

Design, setting, participants, & measurements We conducted a randomized, double–blind, placebo–controlled trial from 2012 to 2013. Fifty-seven participants were enrolled, ingested CF-rich beverages (900 mg CF per study day), and were compared with those ingesting CF-free placebo. This included (1) a baseline cross–over acute study to determine safety and efficacy of CF and (2) a subsequent chronic parallel group study with a 30-day follow-up period to study effects of CF on HD–mediated vascular dysfunction entailing (3) an acute substudy during HD in flavanol-naive patients and (4) an acute on chronic study during HD. Primary and secondary outcome measures included changes in FMD and hemodynamics.

Results CF ingestion was well tolerated. Acute ingestion improved FMD by 53% (3.2±0.6% to 4.8±0.9% versus placebo, 3.2±0.7% to 3.3±0.8%; P<0.001), with no effects on BP or heart rate. A 30-day ingestion of CF led to an increase in baseline FMD by 18% (3.4±0.9% to 3.9±0.8% versus placebo, 3.5±0.7% to 3.5±0.7%; P<0.001), with reduced diastolic BP (73±12 to 69±11 mmHg versus placebo, 70±11 to 73±13 mmHg; P=0.03) and increased heart rate (70±12 to 74±13 bpm versus placebo, 75±15 to 74±13 bpm; P=0.01). No effects were observed for placebo. Acute ingestion of CF during HD alleviated HD–induced vascular dysfunction (3.4±0.9% to 2.7±0.6% versus placebo, 3.5±0.7% to 2.0±0.6%; P<0.001). This effect was sustained throughout the study (acute on chronic, 3.9±0.9% to 3.0±0.7% versus placebo, 3.5±0.7% to 2.2±0.6; P=0.01).

Conclusions Dietary CF ingestion mitigates acute HD–induced and chronic endothelial dysfunction in patients with ESRD and thus, improves vascular function in this high-risk population. Larger clinical trials are warranted to test whether this translates into an improved cardiovascular prognosis in patients with ESRD.

[hatedialysis2]

THANKS for posting this research!   Below is the mineral content in 1 ounce of unsweetened cocoas

Calcium35.8mg4%
Iron3.9mg22%
Magnesium140mg35%
Phosphorus206mg21%
Potassium427mg12%
Sodium5.9mg0%
Zinc1.9mg13%
Copper1.1mg53%
Manganese
Protein 16.9 g

Source nutritiondata.self.com


Read More http://nutritiondata.self.com/facts/sweets/5471/2#ixzz41bMjZACR

[hatedialysis2]

Sorry for previous typo.   protein is 5.5 g in one ounce of dry unsweetened cocoa, not 16.9g.   Still, that would  make a good meal if you have with unflavored, unsweetened protein powder to make a shake

[kickingandscreaming]

Thank you for looking it up.  I had tried but all that came up was those sweet supermarket cocoas with hardly any virtue to them.  Some nice hot cocoa with almond milk would hit the spot too.  I'm amazed at how much protein it contains.

[hatedialysis2]

Or chocolate pudding for a decadent dessert or snack. 

[Charlie B53]

I wish they would add a paragraph at the end of these reports in PLAIN English for people like me.

Does this mean that it is O.K. for me to open that box of chocolates that Daughter gave me?   And by open I mean EAT them.   I doubt if I could just look.    Then how many?  One enough, 6 too many?    I also still have the other box she gave me for Christmas.   I thought I've been pretty good keeping out of them.

[kickingandscreaming]

Probably not.  That box of chocolates probably has very little in the way of flavanols.  It has to be dark, dark, dark, at least 90% cocoa---not milk chocolates and sickly sweet candies.  A higher percentage of cacao (cocoa) means a higher amount of flavanols.  Not to mention how bad for you all that sugar is.  Most of the chocolate that has "medicinal value" doesn't taste like the chocolates in your box.  Sorry.

If you want the value of flavanols from your cocoa, the cocoa can't be "dutched."  That's a way that many commercial cocoas are prepared with alkali.  This process destroys the flavanols.

[Charlie B53]

Do you mean that dark bar that Mom used to bake with?

As a little kid I found out Mom had this big chunk of chocolate/  I got into it.  Never finished the first bite.

[kickingandscreaming]

A higher percentage of cacao (cocoa) means a higher amount of flavanols.

I'm no expert on chocolate.  Baker's chocolate is sugarless and quite bitter.  Not recommended--for taste.  There are bars that are 85% cacoa that taste quite good.  Here's an article that ranks a whole bunch of them.
https://healthyeater.com/dark-chocolate-best-and-worst

[Charlie B53]

A higher percentage of cacao (cocoa) means a higher amount of flavanols.

I'm no expert on chocolate.  Baker's chocolate is sugarless and quite bitter.  Not recommended--for taste.  .....................

Bitter,  It was TERRIBLE!!!!!      I'm 62 now and haven't touched Baker's Chocolate in prolly 55 YEARS.

I'm looking into your link.    Thanks!

[Athena]

Thanks for this thread K&S. As a fan of chocolate, this is very interesting.

I know what Charlie means about them being so bitter that it's not worth even tasting! The only chocolate that is healthy are those awful bitter ones. There is a Lindt chocolate bar in my supermarket that is about 85% cocoa - but it's not something you want to finish. My favourite chocolates are Lindt Lindor dark chocolate pieces with 60% cocoa solids. It has only 16mg of sodium per 100g weight & 33grams of carbs. Would 60% be enough to pass the kidney test?

[kickingandscreaming]

Would 60% be enough to pass the kidney test?

Sorry, I don't think so.  I think the good stuff has minimum 70%. The lower the %, the more of what you're eating is just plain sugar.  I rather like 85%.  Very chocolatey, but not too sweet.

"The U.S. Department of Agriculture’s Database of Flavonoid Content reports that unsweetened baking chocolate has 206 milligrams of flavanols per 100 grams of chocolate, dark chocolate has half that amount, and flavanol content drops down to 15 milligrams per gram in milk chocolate." http://healthyeating.sfgate.com/flavonoid-chocolate-8424.html

[Fabkiwi06]

I love the 85% cocoa bars! All the more reason to eat them!

Bakers chocolate, like vanilla extract, itself is nasty, but would be so easy to transform in to something delicious by adding just a touch of sweetener. And since you'd be doing it at home, it would be far less than what would be added commercially.

[kickingandscreaming]

Here's something I just read:

What's the Healthiest Type of Chocolate?

The closer your cocoa is to its natural raw state, the higher its nutritional value. If you're after health benefits, raw cacao nibs are what you're looking for. Cacao refers to the plant, a small evergreen tree of the species Theobroma cacao, and its dried seeds, also known as cacao beans or cocoa beans, prior to processing.

Ideally, buy them whole and grind them yourself (a coffee grinder can be used for this) when using in recipes. Alternatively, you can eat them whole, just like you'd eat conventional chocolate chips. A healthy amount would probably be around one-half to 1 ounce per day. I personally grind 1 tablespoon of raw cacao nibs twice a day and put them into my smoothies.

When selecting chocolate, look for higher cacao and lower sugar content. In general, the darker the chocolate, the higher the cacao content. However, since cacao is bitter, the higher the percentage cacao, the more bitter it is (the polyphenols are what make the chocolate bitter, so manufacturers often remove them. But, it's those polyphenols that are responsible for many of chocolate's health benefits).

To counteract the bitterness, most chocolate is sweetened, so it's a matter of balancing nutritional benefit with palatability. For health benefits, choose chocolate with a cacao percentage of about 70 or higher. Milk chocolate is not a good choice as it contains both pasteurized milk and large quantities of sugar, which will significantly dampen its health benefits. White chocolate which isn't true chocolate anyway, because it doesn't contain any cocoa powder or chocolate solids - is also high in sugar and contains none of the phytonutrients, so is not a good choice either.

Due to the potential for lead and cadmium contamination, I suggest also contacting your chocolate's manufacturer to find out whether their products are regularly tested for such contaminants.

http://articles.mercola.com/sites/articles/archive/2016/04/23/chocolate-production.aspx?utm_source=dnl&utm_medium=email&utm_content=art2&utm_campaign=20160423Z1_UC&et_cid=DM103373&et_rid=1455071616

[Fabkiwi06]

Oooh! As it happens, my favorite dark chocolate bar has cacao nibs in them and is over 70% cocoa!

http://www.chocolatebar.com/?portfolio=dark-chocolate-with-cacao-nibs-2

You can also order the nibs on Amazon and they're pretty tasty stirred in Rice Crispie treats.