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Eating Chocolate to Improve Muscle Health and Walking Ability in Patients with Peripheral Artery Disease.

Peripheral artery disease (PAD) is rising in worldwide along with population aging. Patients with PAD experience chronic leg ischemia that impairs walking ability. Obstruction to distal blood flow to leg muscle due to atherosclerotic lesions characterizes peripheral artery disease. However, a simple model of reduced blood supply due to arterial stenosis does not fully explain functional limitations in patients with PAD. Impaired endothelial function, reduced microcirculatory flow, and altered skeletal muscle structure and function all have been associated with reduced walking ability in patients with PAD.1 Heightened oxidative stress leading to impaired mitochondrial function has been demonstrated in muscle biopsies in PAD.2 Exercise interventions improve a broad array of pathogenic aspects in PAD resulting in marked improvement in clinical status; thus, structured exercise therapy is the first-line treatment for patients with symptomatic PAD.3 However, patients with PAD frequently suffer from residual functional impairment and decline over time.