Does Cocoa improve Walking performance in older people with
Does 6 months of daily cocoa improve walking performance in people with peripheral artery disease (PAD) as compared to placebo?

The authors concluded that preliminary results from this pilot randomized trial suggest a potential therapeutic effect of cocoa on walking performance in patients with PAD.

The cocoa beverage contained 15 grams of cocoa and 75 mg of epicatechin. The two primary outcomes were change in 6-minute walk distance measured at 2.5 hours and 24 hours after study beverage consumption (both measured after 6 months of study drug consumption). Calf muscle biopsy demonstrated improvements in mitochondrial cytochrome c oxidase activity, increased capillary density, improved calf muscle perfusion, and reduced central nuclei, as compared to placebo.

Cocoa flavanols, including epicatechin, are present in dark chocolate and may increase limb perfusion and skeletal muscle mitochondrial activity/regeneration. This pilot clinical trial suggests potential benefit from daily cocoa consumption as measured by the 6-minute walk distance performed 2.5 hours after study drink consumption. While the 6-minute walk distance measure was not statistically significant when performed 24 hours after drink consumption, the pilot study was likely underpowered to detect such a difference.

While the clinical outcome measures were suggestive of a potential benefit, the calf muscle biopsy findings explain a possible mechanism. Before regular dark chocolate consumption can be recommended for patients with PAD, larger confirmatory studies must be performed.