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New research suggests that taking daily cocoa extract supplements may help boost in cognitive function in older adults. Getty Images
  • Older adults taking daily cocoa extract supplements saw a modest boost in cognitive function, but only if they had lower diet quality.
  • Researchers say it’s too soon to recommend coca extract supplements for improving cognitive function.
  • Many lifestyle interventions can reduce the risk of dementia, including better diet, regular physical activity, and good sleep hygiene.

Older adults who took a daily cocoa extract supplement for two years saw modest improvements in cognitive function, a new randomized clinical trial found.

The benefits, though, were only seen in people who had lower diet quality at the start of the study. Those with healthy dietary patterns didn’t see a similar boost in cognition.

“[The findings] raise the possibility of utilizing flavanol-rich diets or supplements to enhance cognitive function among older adults with lower diet quality,” said Chirag Vyas, MB,BS from the Department of Psychiatry at Massachusetts General Hospital in Boston.

Researchers from Brigham and Women’s Hospital and Harvard Medical School also carried out the study, which was published Dec. 7 in The American Journal of Clinical Nutrition.

The new study, which is part of the larger Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), included 573 older males and females who were randomly assigned to take daily cocoa extract or an inactive placebo for two years.

The average age of participants was 70 years, with around half female. In addition, 11% of participants reported eating chocolate daily before the start of the trial.

People in the cocoa extract group took two capsules a day containing a total of 500 milligrams of cocoa flavanols, including 80 milligrams of epicatechin.

Flavanols, also known as flavan-3-ols, are a sub-class of plant compounds known as flavonoids. Flavanols are found in teas, cocoa-based products, grapes, apples and berries.

Participants underwent cognitive testing when they were enrolled in the study; 492 participants repeated the testing two years later.

When researchers examined data for the entire group, daily cocoa extract supplements had no effect on people’s overall cognition.

However, when they looked at people with lower diet quality at the start of the study, people taking daily cocoa supplements had “relatively better” changes in overall cognition and executive function.

Executive function is a set of cognitive skills needed for self-control and managing behaviors.

The results are consistent with the findings of an earlier study done among COSMOS participants, which found that daily flavanols improved a certain type of memory in older adults with lower diet quality.

However, it contrasts with another COSMOS study, which found that a daily multivitamin/mineral improved overall cognition, but cocoa extract had no effect. This research, though, did not look separately at people with lower diet quality.

The new study included funding and other support from Mars Edge, a segment of food company Mars; and Pfizer Consumer Healthcare (now Haleon). Neither company was involved in analyzing the data, interpreting the results or preparing the study manuscript.

Although the study shows a potential benefit of cocoa extra supplements on cognition for people with lower diet quality, more research is needed.

“Based on our results, we can’t recommend daily supplementation of cocoa extract for preserving cognitive function,” Vyas told Healthline.

“But our findings still underscore the significance of factoring in diet and nutritional status in future trials that are assessing the impact of cocoa extract supplements on cognition,” he said.

He would like to see future studies done in a more diverse population, as well as specifically focusing on people with lower diet quality.

Dr. Thomas Holland, a physician scientist in the Division of Digestive Diseases and Nutrition at RUSH University in Chicago, said the new study is intriguing because it focused on such a specific food compound, with very specific flavanols.

He contrasts this with a study that he co-authored, which looked at overall dietary intake of flavonols, another type of flavonoid.

In that study, published in 2020 in Neurology, he and his colleagues assessed participants’ intake of flavonols by asking detailed questions about what they ate, including flavonol-rich foods like kale, spinach, tomatoes, olive oil, beans and tea.

The results of that showed that people who consumed more flavonols in their food had a reduced risk of developing Alzheimer’s disease.

As for the new study, Holland highlighted that the results show that cocoa extract supplements didn’t benefit people with better diet quality. This, he said, suggests that if people improve their diet quality, there would be no need for the supplement.

However, “if people are not going to improve their diets — or have a dietary deficiency, for whatever reason — this cocoa extract, or for that matter, a multivitamin, has the potential to bridge that nutritional gap,” he told Healthline.

In those cases, he recommends that people talk to their doctor or health care provider before starting any supplements. There may be other steps you can take to reduce your risk of dementia, heart disease, diabetes or other chronic condition.

At the end of the day, “maintaining a healthy, diverse, nutritious diet is going to be beneficial for brain health,” said Holland.

Diversity of food is key, because different types of foods have different nutrients, including vitamins, minerals, and phytochemicals such as flavonoids.

He gives the example of a spring salad with arugula, spinach, onion, tomatoes, walnuts and potentially raspberries or strawberries. “This salad could contain upwards of 90 to 100 different vitamins, minerals and bioactives,” he said, including omega-3 and omega-6 fatty acids.

While research shows that diet can reduce the risk of dementia, Holland said this condition is influenced by a number of factors, so you have to use as many “tools” as possible.

This includes not just eating a healthy diet, but also getting regular physical activity, fostering an active social life, participating in activities that stimulate your brain, ensuring good quality and quantity of sleep, and practicing stress reduction.

The good thing is, ”it’s never too early or too late to embrace these multifaceted lifestyle changes,” he said.

In a randomized clinical trial, older adults who took daily cocoa extract supplements for two years saw improvements in their cognitive function, but only if they had lower diet quality at the start of the study.

The results are in line with earlier research, which found that daily flavanol intake — a compound found in cocoa — improved cognitive function in people with lower diet quality.

Experts say more research is needed before recommending cocoa extract supplements for improving cognition, but there are other ways to reduce your risk of dementia, including improving overall diet and getting regular exercise.