Evidence map›Paper›PMID 40966617›Full record

Trial reportAge and ageing2025

Effects of 2-year cocoa extract supplementation on inflammaging biomarkers in older US adults: findings from the COcoa Supplement and Multivitamin Outcomes Study randomised clinical trial.

Sidong Li, Rikuta Hamaya, Haidong Zhu, Allison Clar, Pamela M Rist, Ying Huang, JoAnn E Manson, Howard D Sesso, Yanbin Dong

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sidong LiUniversity of Science and Technology of China, Institute of Public Health Sciences, Division of Life Sciences and Medicine, Hefei, Anhui, China.ORCID 0000-0002-4798-8920
Rikuta HamayaBrigham and Women's Hospital, Division of Preventive Medicine, Boston, MA, USA.
Haidong ZhuAugusta University, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA, USA.
Allison ClarBrigham and Women's Hospital, Division of Preventive Medicine, Boston, MA, USA.
Pamela M RistBrigham and Women's Hospital, Division of Preventive Medicine, Boston, MA, USA.
Ying HuangAugusta University, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA, USA.
JoAnn E MansonBrigham and Women's Hospital, Division of Preventive Medicine, Boston, MA, USA.
Howard D SessoBrigham and Women's Hospital, Division of Preventive Medicine, Boston, MA, USA.ORCID 0000-0002-9698-9954
Yanbin DongAugusta University, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA, USA.

Funding

Cocoa Supplement and Multivitamin Outcomes Study in the Mind (COSMOS-Mind)R01AG050657 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BAKER, LAURA D., ESPELAND, MARK ANDREW · 2016 to 2020
$3.8M
Effect of randomized cocoa supplementation on inflammaging and epigenetic agingR01HL157665 · NHLBI · AUGUSTA UNIVERSITY · PI DONG, YANBIN, SESSO, HOWARD D · 2021 to 2024
$2.9M
COcoa Supplement and Multivitamins Outcomes Study (COSMOS): Effects on Falls and Physical PerformanceR01AG071611 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI CRANDALL, CAROLYN JANET, LEBOFF, MERYL SUSAN · 2021 to 2024
$2.7M
COSMOS Eye: Cataract and AMD in a Trial of a Multivitamin and Cocoa ExtractR01EY025623 · NEI · BRIGHAM AND WOMEN'S HOSPITAL · PI SESSO, HOWARD D · 2016 to 2020
$2.6M
NEI NIH HHS R01 EY025623NHLBI NIH HHS R01 HL157665NIA NIH HHS R01 AG050657NIA NIH HHS R01 AG071611NIH HHS AG050657NIH HHS AG071611NIH HHS EY025623NIH HHS HL157665
6 · The paper itself

Abstract

objectiveTo examine the long-term effect of cocoa flavanols on inflammaging biomarkers in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).

methodsCOSMOS is a large, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial testing the effects of a cocoa extract supplement (containing 500 mg cocoa flavanols/day, including 80 mg (-)-epicatechin) among women aged ≥65 years and men aged ≥60 years. This ancillary study measured five widely used serum inflammaging biomarkers, including three pro-inflammatory markers (high-sensitivity C-reactive protein [hsCRP], interleukin-6, tumour necrosis factor-α), one anti-inflammatory cytokine (interleukin-10) and one pleotropic cytokine (interferon-γ [IFN-γ]) in a random sample of 598 participants with biospecimens collected at baseline, Year 1, and Year 2.

resultsThe mean age was 70.0 ± 5.6 years, and 49.8% were female. Cocoa extract supplementation significantly decreased hsCRP levels compared with placebo, with a between-group difference in yearly percentage change relative to baseline levels of -8.4% (95% CI, -14.1% to -2.3%; nominal P = .008; Holm-adjusted P value = .039). Moreover, cocoa extract increased IFN-γ with a 6.8% (95% CI, 1.5% to 12.2%, nominal P = .011; Holm-adjusted P value = .043) difference in yearly percentage change versus placebo. The effects of cocoa extract on other inflammatory markers were not significant (all adjusted P values >.05).

conclusionCocoa extract supplementation significantly decreased hsCRP, supporting a role in modulating the chronic inflammaging process as a potential mechanism underlying its cardio-protective effects, including a 27% reduction in cardiovascular disease death in the COSMOS trial. The biological effect of increased IFN-γ by cocoa extract warrants further exploration.

Indexed as

AgingCacaoDietary SupplementsInflammationInflammation MediatorsPlant ExtractsAgedAge FactorsBiomarkersCatechinC-Reactive ProteinDouble-Blind MethodFemaleHumansInterferon-gammaMaleBiomarkersCatechinC-Reactive ProteinInflammation MediatorsInterferon-gammaPlant Extractscocoa extracthsCRPinflammagingolder adultsrandomised controlled trial

Identifiers

PMID40966617
PMCPMC12449576

What Socratic holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.