coffee and chocolate help body fight disease

[Guest guest]

This was the " tease " on a local late nite news segment. They hinted that

coffee and chocolate may help ward off cancer. Al, is there any research or

paper so that we might hear more?

[Guest guest]

Hi All,

This review is quite good for overall risks and suggest more cancer for bladders and fewer for the more frequent colon cancers. Looking at coffee chemicals is misleading, because you do not know the overall effect of drinking coffee. Statistics I have seen say the overall mortality from drinking coffee and tea are 0.99 and 0.98 and not significant.

Eur J Cancer Prev 2000 Aug;9(4):241-56

Coffee and cancer: a review of epidemiological studies, 1990-1999.

Tavani A, La Vecchia C

Epidemiological studies on the relation between coffee consumption and cancer risk have been mainly focused on cancers of the urinary bladder, pancreas and colorectum. The relation between coffee and bladder cancer is controversial, despite a large number of studies published over the last three decades. In most studies, the risk tends to be higher in coffee drinkers than in those who do not drink coffee, but the excess risk is generally moderate and is neither dose- nor duration-related. Thus, a strong association between coffee drinking and bladder cancer can be excluded, although it is still unclear whether the weak association is causal or nonspecific and due to some bias or confounding. For pancreatic cancer, a possible association with coffee consumption has been postulated in a large case-control study published in 1981; since then, however, most studies have shown no substantial association, and overall evidence suggests that coffee is not materially related to pancreatic cancer risk. Overall evidence on the coffee-colorectal cancer relation suggests an inverse association, since most case-control studies found odds ratios below unity, particularly for colon cancer. The pattern of risk is less clear for cohort studies. A plausible biological explanation has been given in terms of coffee-related reduction of bile acids and neutral sterol secretion in the colon. For other cancer sites, including oral cavity, oesophagus, stomach, liver, breast, ovary, kidney and lymphoid neoplasms, the relation of coffee drinking with cancer risk has been less extensively investigated, but the evidence is largely reassuring

Review

PMID: 10958327 [PubMed - indexed for MEDLINE]

For chocolate there is the next paper that talks about total risk too. It seems to be good but only the theoretical reason why it could reduce cancer is given. The last sentence was useful in recommending no cocoa butter.

Exp Biol Med (Maywood) 2001 Nov;226(10):891-7

Chemopreventive effects of cocoa polyphenols on chronic diseases.

Weisburger JH

We have explored the causes of the major chronic diseases prevailing in the world and the relevant mechanisms as a sound basis for recommendations for their prevention. Research shows that the cocoa bean, and tasty products derived from the cocoa bean such as chocolate, and the beverage cocoa, popular with many people worldwide, is rich in specific antioxidants, with the basic structure of catechins and epicatechin, and especially the polymers procyanidins, polyphenols similar to those found in vegetables and tea. Metabolic epidemiological studies indicate that regular intake of such products increases the plasma level of antioxidants, a desirable attribute as a defense against reactive oxygen species (ROS). The antioxidants in cocoa can prevent the oxidation of LDL-cholesterol, related to the mechanism of protection in heart disease. Likewise, a few studies show that ROS associated with the carcinogenic processes is also inhibited, although there have not been many studies on a possible lower risk of various types of cancer either in humans or in animal models consuming cocoa butter or chocolates. Based on the knowledge acquired thus far, it would seem reasonable to suggest inhibition of the several phases of the complex processes leading to cancer, as a function of quantitative intake of antioxidants, including those from cocoa and chocolates. Cocoa and chocolate also contain fats from cocoa butter. These are mainly stearic triglycerides (C18:0) that are less well absorbed than other fats, and are excreted in the feces. Thus, cocoa butter is less bioavailable and has minimal effect on serum cholesterol

Review

PMID: 11682694 [PubMed - indexed for MEDLINE]

Cheers, Al.

-----Original Message-----From: Francesca Skelton [mailto:fskelton@...]Sent: Thursday, August 22, 2002 9:56 AMsupport groupSubject: [ ] coffee and chocolate help body fight diseaseThis was the "tease" on a local late nite news segment. They hinted thatcoffee and chocolate may help ward off cancer. Al, is there any research orpaper so that we might hear more?

[Guest guest]

Oops, All,

I should have said cocoa but is good because little gets taken up where it can get into the blood and increase cholesterol levels.

Cheers, Al.

-----Original Message-----From: Alan Pater [mailto:apater@...

..........

Cocoa and chocolate also contain fats from cocoa butter. These are mainly stearic triglycerides (C18:0) that are less well absorbed than other fats, and are excreted in the feces. Thus, cocoa butter is less bioavailable and has minimal effect on serum cholesterol

Review

PMID: 11682694 [PubMed - indexed for MEDLINE]

Cheers, Al.

-----Original Message-----From: Francesca Skelton [mailto:fskelton@...]Sent: Thursday, August 22, 2002 9:56 AMsupport groupSubject: [ ] coffee and chocolate help body fight diseaseThis was the "tease" on a local late nite news segment. They hinted thatcoffee and chocolate may help ward off cancer. Al, is there any research orpaper so that we might hear more?

[Guest guest]

Hi

Yes, you are correct. The fats cannot be utilized by the body if they go

straight through. They come in one end and a lot goes out the other. So

the benefits of the phytochemicals that do get in are active, while the fats

and calories they have are largely negated.

As a matter of fact, this may be of interest:

Am J Clin Nutr 2001 Nov;74(5):596-602

Comment in:

Am J Clin Nutr. 2001 Nov;74(5):563-4.

Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility

and prostaglandin concentrations in humans.

Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PM

" .....

OBJECTIVE: We evaluated the effects of a diet high in cocoa powder and dark

chocolate (CP-DC diet) on LDL oxidative susceptibility, serum total

antioxidant capacity, and urinary prostaglandin concentrations. DESIGN: We

conducted a randomized, 2-period, crossover study in 23 healthy subjects fed

2 diets: an average American diet (AAD) controlled for fiber, caffeine, and

theobromine and an AAD supplemented with 22 g cocoa powder and 16 g dark

chocolate (CP-DC diet), providing approximately 466 mg procyanidins/d.

RESULTS: LDL oxidation lag time was approximately 8% greater (P = 0.01)

after the CP-DC diet than after the AAD. Serum total antioxidant capacity

measured by oxygen radical absorbance capacity was approximately 4% greater

(P = 0.04) after the CP-DC diet than after the AAD and was positively

correlated with LDL oxidation lag time (r = 0.32, P = 0.03). HDL cholesterol

was 4% greater after the CP-DC diet (P = 0.02) than after the AAD; however,

LDL-HDL ratios were not significantly different. Twenty-four-hour urinary

excretion of thromboxane B(2) and 6-keto-prostaglandin F(1)(alpha) and the

ratio of the 2 compounds were not significantly different between the 2

diets. CONCLUSION: Cocoa powder and dark chocolate may favorably affect

cardiovascular disease risk status by modestly reducing LDL oxidation

susceptibility, increasing serum total antioxidant capacity and

HDL-cholesterol concentrations, and not adversely affecting prostaglandins. "

Randomized Controlled Trial

PMID: 11684527 [PubMed - indexed for MEDLINE]

Cheers, Al.

-----Original Message-----

From: Frenzen, [mailto:cfrenzen@...]

Sent: Thursday, August 22, 2002 5:14 PM

Subject: RE: [ ] coffee and chocolate help body fight disease

Al,

Since little cocoa butter gets taken up, does that mean that

the calories in chocolate are not fully utilized by the body and

thus chocolate is not in practice as high calorie as its labelling

might otherwise indicate? And I guess you are also saying that

the saturated fats in chocolate are not as bad as I have always

thought they were? Just checking to see if I understand the gist

of your message below......

--Chris

-----Original Message-----

From: Alan Pater [mailto:apater@...]

Sent: Thursday, August 22, 2002 6:52 AM

Subject: RE: [ ] coffee and chocolate help body fight disease

Oops, All,

I should have said cocoa but is good because little gets taken up where it

can get into the blood and increase cholesterol levels.

Cheers, Al.

-----Original Message-----

From: Alan Pater [ mailto:apater@... <mailto:apater@...>

..........

Cocoa and chocolate also contain fats from cocoa butter. These are mainly

stearic triglycerides (C18:0) that are less well absorbed than other fats,

and are excreted in the feces. Thus, cocoa butter is less bioavailable and

has minimal effect on serum cholesterol

Review

PMID: 11682694 [PubMed - indexed for MEDLINE]

Cheers, Al

[Guest guest]

Al,

Since little cocoa butter gets taken up, does that mean that

the calories in chocolate are not fully utilized by the body and

thus chocolate is not in practice as high calorie as its labelling

might otherwise indicate? And I guess you are also saying that

the saturated fats in chocolate are not as bad as I have always

thought they were? Just checking to see if I understand the gist

of your message below......

--Chris

-----Original Message-----From: Alan Pater [mailto:apater@...]Sent: Thursday, August 22, 2002 6:52 AM Subject: RE: [ ] coffee and chocolate help body fight disease

Oops, All,

I should have said cocoa but is good because little gets taken up where it can get into the blood and increase cholesterol levels.

Cheers, Al.

-----Original Message-----From: Alan Pater [mailto:apater@...

..........

Cocoa and chocolate also contain fats from cocoa butter. These are mainly stearic triglycerides (C18:0) that are less well absorbed than other fats, and are excreted in the feces. Thus, cocoa butter is less bioavailable and has minimal effect on serum cholesterol

Review

PMID: 11682694 [PubMed - indexed for MEDLINE]

Cheers, Al.

-----Original Message-----From: Francesca Skelton [mailto:fskelton@...]Sent: Thursday, August 22, 2002 9:56 AMsupport groupSubject: [ ] coffee and chocolate help body fight diseaseThis was the "tease" on a local late nite news segment. They hinted thatcoffee and chocolate may help ward off cancer. Al, is there any research orpaper so that we might hear more?

[Guest guest]

-----Original Message-----From: Francesca Skelton [mailto:fskelton@...]Sent: Thursday, August 22, 2002 6:36 PM Subject: Re: [ ] coffee and chocolate help body fight disease

Al: please let me get this straight: Does this mean we can virtually eat aton of chocolate and "get away with it"??? As you say below: "fats andCALORIES are negated" .If so, I'm going on a pig out from the moment you sayso :-))on 8/22/2002 4:23 PM, Alan Pater at apater@... wrote:> Hi > > Yes, you are correct. The fats cannot be utilized by the body if they go> straight through. They come in one end and a lot goes out the other. So> the benefits of the phytochemicals that do get in are active, while the fats> and calories they have are largely negated .

Hi Francesca and All.

No, I do not mean that. The below editorial on the paper is most informative on the whole issue of focusing on one small part of our diets and the importance of variety. Eat variety, not a lot of “good” foods, I believe.

Cheers, Al.

Am J Clin Nutr 2001 Nov;74(5):563-4

How good is chocolate?

Nestel PJ

PMID: 11684518 [PubMed - indexed for MEDLINE]

Editorial

How good is chocolate?1,2

J Nestel

Many thousand polyphenolics in the plant world contribute importantly to the human food supply. Probably the most abundant are the flavonoids, which comprise the isoflavones in soybean, the flavonol catechins and epicatechins in grapes and tea, quercetin in onions and apples, naringin in citrus, and others. The role of flavonoids as likely mediators of the health benefits of eating fruit and vegetables and the potential of flavonoids in promoting health as individual nutrients has stimulated substantial research as well as speculation. On occasion, epidemiologic associations and preliminary research have led to overly simplistic extrapolations; eg, the Japanese paradox is based on soy and green tea, the French paradox is based on red wine, and the benefits of the Mediterranean diet are based on olive oil. In each instance, single polyphenolics such as genistein, epicatechins, resveratrol, or hydroxytyrosol have been claimed to have powerful antioxidant activity. However, essential information such as the bioavailability, pharmacokinetics, and plasma concentrations of these compounds is generally lacking in clinical studies.

Joining the lengthening list of candidate flavonoids are the procyanidins found in grape seeds, tea, and cocoa. Procyanidins are present in several oligomeric forms that are by no means equipotent (1) and are complex molecules in which catechins, epicatechins, and their gallic esters are linked (2). Like other polyphenols, procyanidins display strong antioxidant activity in vitro as well as other biological properties that have led to possibly premature claims for cardiovascular protection. The antioxidant activity of procyanidins has a linear relation to their concentration in tests such as the oxygen radical absorbance capacity (ORAC) assay (3). In vitro, procyanidins are powerful inhibitors of tyrosine nitration by peroxynitrite (4).

Rein et al (5) recently published in this Journal a study of the inhibition by cocoa of platelet activation ex vivo. Several indexes of platelet activation were diminished between 2 and 6 h after a cocoa beverage was consumed. ADP-stimulated P-selectin expression, an important biomarker of thrombogenicity, and epinephrine-induced fibrinogen binding conformation of glycoprotein IIb-IIIa, a target of modern antiplatelet therapy, were both lessened.

In the current issue of the Journal, Wan et al (6) report a study of similar design, although the outcomes may be less persuasive. Their interest was in the effects of the combined consumption of cocoa and dark chocolate, which delivered a substantial 466 mg procyanidins/d. Plasma epicatechin concentrations rose quickly to a peak within 2 h of consumption and then declined rapidly. The peak concentration was only in the low nanomolar range. Ex vivo antioxidant activity was measured by LDL oxidizability, and serum antioxidant capacity was assessed with use of the ORAC assay. LDL oxidizability and serum antioxidant capacity both changed significantly, although the LDL oxidation lag time was only 8% greater and ORAC was only 4% greater after the subjects consumed 466 mg procyanidins/d compared with an average American diet. Although the conclusion would have been more convincing had the concentration of epicatechins in plasma correlated with an index of antioxidant activity, the results indicate support for beneficial biological activity of cocoa procyanidins. Kondo et al (7) reported similar prolongation in lag times after cocoa consumption. Another reported effect of cocoa procyanidins in humans is immunomodulatory; ie, interleukin 2 expression in circulating mononuclear cells was found to be suppressed (1).

The study by Wan et al raises several issues that are common to several recent published effects of flavonoids: their bioavailability, the robustness of their biomarkers, and the clinical relevance of the findings. Recent improvements in analytic methods have enabled measurements of flavonoids and their metabolites in plasma and urine. It is clear that the absorption and pharmacokinetics of these compounds vary widely among individuals, reflecting conjugation, oligomeric forms, and the degree of conversion to metabolites. Absorption and excretion of some of these flavonoids is rapid. We found that, on average, only 25% of isoflavones are absorbed (8), and because daidzein is excreted more rapidly than is genistein, the apparent bioavailability of the 2 isoflavones may be misjudged. Reviewing the subject, Duthie and Crozier (9) point out that the reported absorption of quercetin ranges between 0% and 50% and may depend on its different glucosides.

The robustness of biomarkers is critical to nutritional interventions. Results of such studies rank lower in the hierarchy of evidence than do large clinical trials that are the hallmark of drug-based therapeutic trials. Hence, the credibility of outcomes derived from diet-based or nutrient-supplemented experimental designs depends critically on biomarkers that serve as surrogates of disease outcome. The robustness of the much used ex vivo oxidizability of LDL has been questioned in recent years. A major conference on the subject concluded that this assay be replaced by measurements of plasma concentrations and excretion of isoprostanes, of hydroxy fatty acid concentrations, and of the emerging monoclonal antibodies that target various epitopes of oxidized lipid-linked lipoprotein (10). Furthermore, indexes of total antioxidant capacity, such as ORAC, should be limited to assays of foods and should not be used for biological fluids.

The clinical relevance of antioxidant assays needs to take into account that tissue and cellular effects are not necessarily reflected in events measured in plasma. Do the concentrations in tissues reach biological potency? How small an effect is still clinically useful; is an 8% prolongation in the ex vivo lag time of LDL meaningful? In many studies of several flavonoids, changes of this order were interpreted as being clinically relevant because the differences were statistically significant.

The emerging data on procyanidins in cocoa are interesting and likely to be nutritionally relevant. However, would healthy adults necessarily benefit from further antioxidant supplementation in the form of dark chocolate? One lesson from the negative findings of several vitamin E trials is that in the absence of biomarker measurements, it is impossible to conclude whether the test population was already replete with antioxidants before the interventions began and, therefore, unlikely to benefit from supplementation. What weighting should nutritionists place on each piece of evidence relating to the biological efficacy of single flavonoids? Given that there are thousands of flavonoids in the foods that we eat at one time or another, or daily of the more common ones, should each new finding be greeted as an encouragement to eat that particular source because it contains a specific flavonoid? Is it not more purposeful to view the evidence on individual flavonoids as integral to our understanding of the potential of a diversified food supply and the mechanisms through which that potential is mediated?

These issues lend support to those who argue for the consumption of greater varieties of plant foods, the evidence for which is derived from large prospective cohort studies.”

REFERENCES

1.Mao TK, JJ, Van De Water J, Keen CL, Schmitz HH. The influence of cocoa procyanidins on the transcription of interleukin-2 in peripheral blood mononuclear cells. Int J Immunother 1999; 15:23–9.

2.Lazarus SA, on GE, Hammerstone JF, Schmitz HH. High-performance liquid chromatography/mass spectrometry analysis of proanthocyanidins in foods and beverages. J Agric Food Chem 1999;47:3693–701.[Medline]

3.on GE, Lazarus SA, AE, et al. HPLC method for the quantification of procyanidins in cocoa and chocolate samples and correlation to total antioxidant capacity. J Agric Food Chem 1999;47:4184–8.[Medline]

4.Arteel G, Sies H. Protection against peroxynitrite by cocoa polyphenol oligomers. FEBS Lett 1999;462:167–70.[Medline]

5.Rein D, Paglieroni TG, Wun T, et al. Cocoa inhibits platelet activation and function. Am J Clin Nutr 2000;72:30–5.[Abstract/Full Text]

6.Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PM. Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans. Am J Clin Nutr 2001;74:596–602.[Abstract/Full Text]

7.Kondo K, Hirano R, Matsumoto A, Igarashi O, Itakura H. Inhibition of LDL oxidation by cocoa. Lancet 1996;348:1514 (letter).

8.Nestel PJ, Pomeroy S, Kay S, et al. Isoflavones from red clover improve systemic arterial compliance but not plasma lipids in menopausal women. J Clin Endocrinol Metab 1999;84:895–8.[Abstract/Full Text]

9.Duthie G, Crozier A. Plant-derived phenolic antioxidants. Curr Opin Lipidol 2000;11:43–7.[Medline] 10.Offord E, van Poppel G, Tyrrell R. Markers of oxidative damage and antioxidant protection: current status and relevance to disease. Free Radic Res 2000;33(suppl):S5–19.[Medline]

[Guest guest]

Al: please let me get this straight: Does this mean we can virtually eat a

ton of chocolate and " get away with it " ??? As you say below: " fats and

CALORIES are negated " .If so, I'm going on a pig out from the moment you say

so :-))

on 8/22/2002 4:23 PM, Alan Pater at apater@... wrote:

> Hi

>

> Yes, you are correct. The fats cannot be utilized by the body if they go

> straight through. They come in one end and a lot goes out the other. So

> the benefits of the phytochemicals that do get in are active, while the fats

> and calories they have are largely negated.

>