Cocoa supplements appear to inhibit age-related changes in inflammation, according to new follow-up findings from the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) published by researchers from Mass General Brigham.

The COSMOS study investigated either multivitamins, cocoa flavanols, or a combination of both in a population of 21,442 women and men over the age of 60, over a median period of 3.6 years, with primary outcomes related to cognitive decline and age-related conditions. In the initial findings, researchers found that cocoa supplementation decreased cardiovascular mortality rates by 27%.

The researchers found that hsCRP, an inflammatory marker that can signal increased risk of cardiovascular disease, decreased in participants who took the cocoa extract supplement, suggesting that this pathway may be responsible for cocoa’s cardioprotective properties.

The findings were published in Age and Aging.

Previous research has established a connection between cocoa extracts and reductions in inflammatory biomarkers, primarily thanks to bioactive compounds such as flavanols. The researchers of the present study posited that COSMOS results would provide insights into whether these compounds would have an effect on ‘inflammaging,’ or age-related changes in a plethora of inflammatory processes in the body.

“Our interest in cocoa extract and inflammaging started on the basis of cocoa-related reductions in cardiovascular disease,” said corresponding author Howard Sesso, ScD, associate director of the division of preventive medicine and associate epidemiologist at Brigham and Women’s Hospital. “We also appreciate the important overlap between healthy aging and cardiovascular health, where aging-related inflammation can harden arteries and lead to cardiovascular disease. Because of that, we wanted to see whether multi-year cocoa extract supplementation versus a placebo could modulate inflammaging, and the data suggest it does.”

The new study relied on blood samples of 598 COSMOS participants to measure several inflammaging biomarkers: three pro-inflammatory proteins, hsCRP, IL-6, and TNF-a; one anti-inflammatory protein (IL-10); and one immune-mediating protein (IFN-y), all of which were measured at baseline and after a one- and two-year follow-up.

Levels of hsCRP decreased by 8.4%, while other biomarkers were relatively consistent or increased modestly. However, a small reduction in IL-6 was observed in women, warranting further research, the authors noted.

 “Interestingly, we also observed an increase in interferon-y, an immune-related cytokine, which opens new questions for future research,” said Yanbin Dong, MD, PhD, senior author and director of the Georgia Prevention Institute and cardiologist/population geneticist at the Medical College of Georgia/Augusta University. “While cocoa extract is not a replacement for a healthy lifestyle, these results are encouraging and highlight its potential role in modulating inflammation as we age.”

“This study calls for more attention to the advantage of plant-based foods for cardiovascular health, including cocoa products rich in flavanols,” said Sesso. “It reinforces the importance of a diverse, colorful, plant-based diet, especially in the context of inflammation.”