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Table 5 Findings from chronic studies, including reported outcome measures for placebo and cocoa interventions and the direction of effect

From: The role of cocoa flavanols in modulating peripheral and cerebral microvascular function in healthy individuals and populations at-risk of cardiovascular disease: a systematic review

 

Monitoring technique/ outcome measure (units)

Rest/ vasodilator stimulus

Outcome measures (control) Mean ± SD pre/post, unless otherwise stated

Outcome measures (cocoa flavanols) Mean ± SD pre/post, unless otherwise stated

P values

Vote counting (direction of effect)

Risk of bias

Cutaneous

(b) Heiss 2015 [72]

Laser doppler perfusion imaging (LDPI, forearm)

Rest

(b1) 42 ± 4.7/39 ± 4.7 PU

(b2) 39 ± 4.5/40 ± 4.5 PU

(b1) 39 ± 4.7/40 ± 4.7 PU

(b2) 40 ± 4.5/39 ± 4.5 PU

 

1

1

Low risk

RH

(b1) 260 ± 103/258 ± 79.7 PU

(b2) 178 ± 22.4/180 ± 22.4 PU

(b1) 307 ± 65.7/ 296 ± 79.7 PU

(b2) 214 ± 53.6/213 ± 53.6 PU

p < 0.05

p < 0.05

1

1

(n) Heinrich 2006 [68]

Laser Doppler (blood flow)

Rest

6 weeks: 17 ± 9/17 ± 6 AU

12 weeks: 17 ± 9/16 ± 6 AU

6 weeks:16 ± 7/24 ± 12 AU

12 weeks: 16 ± 7/32 ± 16 AU

p < 0.05

p < 0.05

1

1

Some concerns

Skeletal muscle

(b) Heiss 2015 [72]

VOP (forearm)

Rest

(b1) 1.5 ± 0.47/1.4 ± 0.47

(b2) 0.8 ± 0.045/0.9 ± 0.045

(b1) 1.6 ± 0.47/1.6 ± 0.47

(b2) 1.1 ± 0.45/1.1 ± 0.045

 

1

1

Low risk

RH

(b1) 13.7 ± 7.97/13.8 ± 7.04

(b2) 11.6 ± 7.60/11 ± 6.71

(All ml/100 ml*min)

(b1) 16.9 ± 2.81/16.9 ± 5.16

(b2) 14.0 ± 6.26/13.9 ± 4.92

(All ml/100 ml*min)

p < 0.05

p < 0.05

1

1

(o) Decroix 2018b [66]

NIRS (SO2)

Rest

59.2 ± 2%

60.2 ± 2%

 

1

Low risk

Hypoxia

60.5 ± 1.5%

58.5 ± 1%

 

0

 

Exercise

57 ± 1.5%

56.8 ± 1.5%

 

0

(p) Farouque 2006 [67]

VOP (forearm)

Rest

2.49 ± 1.12/2.8 ± 1.57

2.82 ± 01.57/2.47 ± 0.98

 

0

Low risk

ACh infusion

5 ± 0.2/8 ± 1

8 ± 1/8.2 ± 1.5

p < 0.05

0

RH

28.09 ± 8.23/28.05 ± 7.83

31.15 ± 1.62/30.41 ± 7.38

 

0

Exercise

24.08 ± 9.48/23.06 ± 8.18

(all ml/100 ml/min)

22.72 ± 2.1/24.88 ± 9.84

(all ml/100 ml/min)

 

0

(q) Muniyappa 2008 [69]

Doppler (capillary blood flow)

Rest

0.68 ± 1.03 AU

0.51 ± 0.31 AU

 

0

Some concerns

Insulin infusion

0.67 ± 0.49 AU

0.74 ± 0.40 AU

p = 0.31

1

(r) Shaw 2020 [70]

NIRS (average oxyHb, change from baseline)

Exercise at simulated altitude

Sub max: -5.67 ± 5.34 AU

Time trial: -5.50 ± 5.31 AU

Sub max: -0.84 ± 3.56 AU

Time trial: -1.02 ± 3.41 AU

 

1

1

Some concerns

Cerebral

(o) Decroix 2018b [66]

NIRS (SO2)

Rest

61.5 ± 1%

64 ± 1%

p < 0.05

1

Low risk

Hypoxia

59 ± 1%

61.5 ± 1%

p < 0.05

1

 

Exercise

62 ± 0.5%

64 ± 1%

p = 0.004

1

(r) Shaw 2020 [70]

NIRS (average oxyHb- change from baseline)

Exercise at simulated altitude

Sub max: 10.7 ± 5.06 AU

Time trial: 3.99 ± 8.34 AU

Sub max: 24.4 ± 20.9 AU

Time trial: 10.8 ± 17.6 AU

 

0

Some concerns

(s) Sumiyoshi 2020 [71]

NIRS (oxyHb, at end of word tests)

Cognitive tasks

45 ± 15/40 ± 15 AU

60 ± 10/45 ± 5 AU

 

1

High risk

  1. Table is ordered by risk of bias within sub-sections for each vascular bed. Outcome measures are shown as mean ± SD for pre/post intervention unless otherwise stated, and data shown in italics has been estimated from graphs. VOP = venous occlusion plethysmography. NIRS = near-infrared spectroscopy
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Nutrition Journal

ISSN: 1475-2891

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