Postprandial effects of dark chocolate on portal hypertension in patients with cirrhosis: results of a phase 2, double-blind, randomized controlled trial
American Journal of Clinical Nutrition, 08/08/2012
De Gottardi A et al. – In patients with cirrhosis, dark chocolate blunted the postprandial increase in hepatic venous pressure gradient (HVPG) by improving flow–mediated hepatic vasorelaxation and ameliorated systemic hypotension.Methods
- In this phase 2, double–blind, controlled study, 22 cirrhotic patients referred for HVPG measurement were included and randomly assigned to receive a liquid meal containing either dark chocolate (active treatment; 85% cocoa, 0.55 g/kg body wt; n = 11) or isocaloric amounts of white chocolate (devoid of cocoa flavonoids; control subjects; n = 11).
- HVPG, arterial pressure, portal blood flow, serum flavonoids (catechin and epicatechin), and nitric oxide were measured at baseline and 30 min after meal administration.
- The main outcome measure was the change in HVPG 30 min after the test meal.
- Postprandial hyperemia was accompanied by a marked increase in HVPG in the white–chocolate group (16.0 ± 4.7–19.7 ± 4.1 mm Hg or +26.4 ± 12.7%; P < 0.0001), whereas the postprandial increase in HVPG was markedly attenuated in the dark–chocolate group (16.9 ± 2.9–18.7 ± 3.5 mm Hg or +11.5 ± 15.9%; P = 0.02 compared with white chocolate).
- Portal blood flow increased similarly after meals containing dark or white chocolate (median increase: 32% compared with 39%).
- Plasma flavonoids increased 15–50–fold after dark chocolate consumption.
- Dark but not white chocolate induced a mild increase in arterial pressure (+8.8 ± 8.8% compared with –0.3 ± 4.9%; P = 0.002).