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Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease.


ABSTRACT: NOX-2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow-mediated dilation (FMD). Dark chocolate exerts artery dilatation via down-regulating NOX2-mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress-mediated mechanism.FMD, serum levels of isoprostanes, nitrite/nitrate (NOx) and sNOX2-dp, a marker of blood NOX2 activity, maximal walking distance (MWD) and maximal walking time (MWT) were studied in 20 PAD patients (14 males and 6 females, mean age: 69±9 years) randomly allocated to 40 g of dark chocolate (>85% cocoa) or 40 g of milk chocolate (?35% cocoa) in a single blind, cross-over design. The above variables were assessed at baseline and 2 hours after chocolate ingestion. Dark chocolate intake significantly increased MWD (+11%; P<0.001), MWT (+15%; P<0.001), serum NOx (+57%; P<0.001) and decreased serum isoprostanes (-23%; P=0.01) and sNOX2-dp (-37%; P<0.001); no changes of the above variables were observed after milk chocolate intake. Serum epicatechin and its methylated metabolite significantly increased only after dark chocolate ingestion. Multiple linear regression analysis showed that ? of MWD was independently associated with ? of MWT (P<0.001) and ? of NOx (P=0.018). In vitro study demonstrated that HUVEC incubated with a mixture of polyphenols significantly increased nitric oxide (P<0.001) and decreased E-selectin (P<0.001) and VCAM1 (P<0.001).In PAD patients dark but not milk chocolate acutely improves walking autonomy with a mechanism possibly related to an oxidative stress-mediated mechanism involving NOX2 regulation.http://www.clinicaltrials.gov. Unique identifier: NCT01947712.

SUBMITTER: Loffredo L 

PROVIDER: S-EPMC4310398 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease.

Loffredo Lorenzo L   Perri Ludovica L   Catasca Elisa E   Pignatelli Pasquale P   Brancorsini Monica M   Nocella Cristina C   De Falco Elena E   Bartimoccia Simona S   Frati Giacomo G   Carnevale Roberto R   Violi Francesco F  

Journal of the American Heart Association 20140702 4


<h4>Background</h4>NOX-2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow-mediated dilation (FMD). Dark chocolate exerts artery dilatation via down-regulating NOX2-mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress-mediated mechanism.<h4>Methods and results</h4>FMD, serum level  ...[more]

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