The inclusion of cocoa in combination with other food ingredients, e.g. with hazelnuts, may have positive effects on cardiovascular diseases and their biomarkers. One point of departure for evaluating the cardiovascular risk (risk to heart and vascular system) is the ratio between the so-called apolipoproteins B and A (Apo B and A). Apolipoproteins are manufactured by the body to transport cholesterol and nutritional fats in the blood stream. Apo B is particularly correlated with high LDL cholesterol values and promotes atherosclerosis, while Apo A is correlated with HDL cholesterol and combats atherosclerosis. Too low Apo A concentrations are just as unfavourable as too high Apo B concentrations. However, the ratio between Apo B and Apo A is clearly a more meaningful value.
A study by Solà et al. (2012) investigated the effects of four cocoa cream products on some of these biomarkers. A total of 113 subjects aged between 43 and 65 years participated in this randomised, controlled, double-blind study. The participants, who suffered from high blood pressure and high cholesterol values, received one of the four cocoa cream products (13 g / portion; 6 portions / day; 465 kcal / day) as part of a calorie-controlled diet.
Group A was used as a control group and received only cocoa cream. Group B received cocoa hazelnut cream. Group C received a cream made from cocoa, hazelnuts and phytosterols. The latter are components of vegetable oils and fats with a cholesterol-reducing effect. Group D received the same cream as Group C, with additional soluble fibre.
The following results were achieved after a 4-week trial period: in comparison with Group A, Group C was observed to have a significant reduction in LDL cholesterol, Apo B and the Apo B / Apo A quotient. For Group D, which had received additional fibre, the LDL cholesterol levels dropped slightly less than for Group C, but the effect in the reduction of Apo B and the ratio between Apo B and Apo A was stronger than for Group C. The reduction in blood pressure was similar for all groups.
In summary, it may be said that the cocoa creams with hazelnuts, especially when consumed with soluble fibre, have anti-inflammatory and anti-oxidative effects. It may thus be concluded that a moderate consumption of cocoa hazelnut cream with soluble fibre and sterols could be used as component of nutritional therapy.
Solà R et al. (2012): Cocoa, Hazelnuts, Sterols and Soluble Fiber Cream Reduces Lipids and Inflammation Biomarkers in Hypertensive Patients: A Randomized Controlled Trial. PLoS One 7(2):e31103.