A systematic review and meta-analysis of the effects of flavanol-containing tea, cocoa and apple products on body composition and blood lipids: exploring the factors responsible for variability in their efficacy

González-Sarrías, A. et al. (2017) A systematic review and meta-analysis of the effects of flavanol-containing tea, cocoa and apple products on body composition and blood lipids: exploring the factors responsible for variability in their efficacy. Nutrients, 9(7), 746. (doi:10.3390/nu9070746)

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Abstract

Several randomized controlled trials (RCTs) and meta-analyses support the benefits of flavanols on cardiometabolic health, but the factors affecting variability in the responses to these compounds have not been properly assessed. The objectives of this meta-analysis were to systematically collect the RCTs-based-evidence of the effects of flavanol-containing tea, cocoa and apple products on selected biomarkers of cardiometabolic risk and to explore the influence of various factors on the variability in the responses to the consumption of these products. A total of 120 RCTs were selected. Despite a high heterogeneity, the intake of the flavanol-containing products was associated using a random model with changes (reported as standardized difference in means (SDM)) in body mass index (−0.15, p < 0.001), waist circumference (−0.29, p < 0.001), total-cholesterol (−0.21, p < 0.001), LDL-cholesterol (−0.23, p < 0.001), and triacylglycerides (−0.11, p = 0.027), and with an increase of HDL-cholesterol (0.15, p = 0.005). Through subgroup analyses, we showed the influence of baseline-BMI, sex, source/form of administration, medication and country of investigation on some of the outcome measures and suggest that flavanols may be more effective in specific subgroups such as those with a BMI ≥ 25.0 kg/m2, non-medicated individuals or by specifically using tea products. This meta-analysis provides the first robust evidence of the effects induced by the consumption of flavanol-containing tea, cocoa and apple products on weight and lipid biomarkers and shows the influence of various factors that can affect their bioefficacy in humans. Of note, some of these effects are quantitatively comparable to those produced by drugs, life-style changes or other natural products. Further, RCTs in well-characterized populations are required to fully comprehend the factors affecting inter-individual responses to flavanol and thereby improve flavanols efficacy in the prevention of cardiometabolic disorders.

Item Type:Articles
Additional Information:The authors offer thanks for the financial support of the COST Action FA1403 “POSITIVe” to conduct two short-term scientific missions to A.G.-S. and P.P. at the University of Glasgow (E.C.) during which the data analysis was performed, and to M.G.-A. at the University College Dublin (E.G.) during which the protocol was developed.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Combet Aspray, Dr Emilie
Authors: González-Sarrías, A., Combet, E., Pinto, P., Mena, P., Dall’Asta, M., Garcia-Aloy, M., Rodríguez-Mateos, A., Gibney, E. R., Dumont, J., Massaro, M., Sánchez-Meca, J., Morand, C., and García-Conesa, M.-T.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Nutrients
Publisher:MDPI
ISSN:2072-6643
ISSN (Online):2072-6643
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Nutrients 9(7): 746
Publisher Policy:Reproduced under a Creative Commons license

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