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Daily consumption of flavanol rich dark chocolate bar with added sterol esters improves cardiovascular markers in a population with elevated cholesterol

Studies with plant sterols (PS) and cocoa flavanols (CF) support their use in the diet as a strategy for maintaining cardiovascular (CV) health. This study evaluated the CV benefits of daily consumption of dark chocolate bars enriched with CF +/− PS in subjects. Fifty subjects (33 female, 17 male) with total cholesterol levels of 200–280 mg/dL and blood pressure 159/99 were recruited and randomized to receive either a flavanol rich dark chocolate bar with PS (1.1 g sterol ester per bar , PS+) or without PS (PS‐). Bars were macronutrient matched (100 kcals, 180 mg CF/22g bar). In a double‐blind, placebo controlled, cross‐over study design, participants consumed a bar twice daily within 30 minutes of a meal for 4 weeks then crossed‐over to the other intervention for another 4 weeks. Lipids were assessed at baseline, 4 and 8 weeks. Blood pressure was measured every 2 weeks. Regular consumption of the PS+ bar for 4 weeks resulted in significant reductions in total and LDL cholesterol, 2.0% and 5.1%, respectively. There was a significant reduction in systolic BP at 4, 6, and 8 weeks and in diastolic BP at 4 and 6 weeks irrespective of PS content. This study demonstrated that within a balanced diet, PS enriched, flavanol rich chocolate bars may promote CV health by effectively lowering cholesterol and improving other CV markers.