Cacao flavanols

Tier 2 — promising · Cardiovascular · Cognition · Blood pressure

The COSMOS trial (21,442 adults) did not meet its primary composite cardiovascular endpoint, but the prespecified secondary analysis showed a 27% reduction in cardiovascular death with 500 mg/day cocoa flavanols vs placebo. EFSA upholds an approved health claim that 200 mg/day cocoa flavanols help maintain normal endothelial function. Also shows modest cognitive benefits in older adults (COSMOS-Mind sub-study). Regular chocolate contains very little flavanol due to Dutch-process alkalisation. Use a standardised cocoa flavanol supplement for reliable dosing.

Dose: 200–500 mg/day cocoa flavanols (EFSA-approved); regular chocolate is NOT an equivalent source