Might supplements derived from cocoa extract, packed with cocoa flavanols, help lower inflammation levels and thereby ward off chronic conditions linked to aging? Researchers from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), conducted by experts at Mass General Brigham and their collaborators, examined shifts in five key inflammation markers associated with aging. Their analysis revealed that among those taking daily cocoa supplements over multiple years, levels of hsCRP—a critical indicator of inflammation that often points to heightened cardiovascular risks—dropped significantly. This finding points to the supplement’s anti-inflammatory properties as a possible reason for its benefits in protecting heart health. The detailed results appear in the journal Age and Ageing.
Nutritional Strategies to Combat Inflammaging
In recent years, dietary interventions have gained prominence as promising approaches to mitigate “inflammaging,” the chronic low-grade inflammation that accompanies the aging process. Prior smaller-scale investigations have demonstrated that cocoa extract can effectively lower various inflammatory markers, primarily due to its high content of flavanols. These are potent, bioactive molecules present in cocoa beans as well as in a range of other plant foods like berries, grapes, tea leaves, and more. To extend these observations into real-world human applications, scientists initiated the expansive COSMOS trial. This study specifically explores the impact of cocoa extract on cardiovascular disease outcomes and investigates whether reductions in inflammaging could underlie these positive effects.
Origins of the Research Focus
The exploration into cocoa extract’s role in addressing inflammaging stemmed from earlier evidence linking cocoa consumption to decreased cardiovascular disease risks, explained Howard Sesso, ScD, MPH, the study’s corresponding author. He serves as associate director of the Division of Preventive Medicine and associate epidemiologist at Brigham and Women’s Hospital, part of the Mass General Brigham network. “We recognized the strong connections between successful aging and cardiovascular well-being,” Sesso noted. “Inflammation tied to aging can stiffen arteries and contribute to heart disease development. With this in mind, we aimed to determine if long-term supplementation with cocoa extract, compared to a placebo, could influence inflammaging markers—and the evidence indicates that it indeed can.”
Details of the Landmark COSMOS Trial
From 2014 through 2020, Brigham and Women’s Hospital spearheaded the COSMOS trial, a major randomized, double-blind, placebo-controlled clinical study involving 21,442 individuals aged 60 and older. The trial impressively showed that daily cocoa extract supplementation led to a 27% reduction in cardiovascular disease mortality.
Analyzing Key Inflammation Biomarkers
In this latest analysis, the research team gathered and evaluated blood samples from 598 COSMOS participants. They focused on five inflammaging biomarkers: three pro-inflammatory proteins (hsCRP, IL-6, and TNF-α), one anti-inflammatory protein (IL-10), and one protein involved in immune regulation (IFN-γ). By comparing biomarker levels at the study’s start, after one year, and after two years, they observed that hsCRP concentrations declined by 8.4% annually in the cocoa group relative to the placebo group. Meanwhile, the other markers showed either stability or only slight increases.
Unexpected Findings and Future Directions
“Notably, we detected a rise in interferon-γ, a cytokine linked to immune function, which sparks intriguing avenues for further investigation,” commented senior author Yanbin Dong, MD/PhD. He directs the Georgia Prevention Institute and works as a cardiologist and population geneticist at the Medical College of Georgia/Augusta University. “Although cocoa extract cannot substitute for a balanced lifestyle, these outcomes are promising and underscore its capacity to influence inflammation during the aging process.”
The observed hsCRP reduction could provide insights into the cardiovascular protective benefits identified in the broader COSMOS trial, where cocoa supplementation correlated with fewer deaths from heart disease. The researchers emphasized that variations in other markers—such as a minor IL-6 decrease noted only in women—require deeper exploration. Moving forward, the team plans to delve further into COSMOS data to assess if cocoa extract and multivitamin protocols can suppress more intense inflammaging and improve additional health metrics related to aging.
Emphasizing Plant-Based Nutrition
“This research urges greater recognition of plant-derived foods’ benefits for heart health, particularly those like cocoa rich in flavanols,” Sesso added. “It bolsters the value of incorporating a varied, vibrant array of plant-based foods into diets, especially to manage inflammation effectively.”
