Epicatechin, a flavanol found in cocoa, tea and wine, could be so important to the diet that it should be classified as a vitamin, says a Harvard researcher.
Dr Norman Hollenberg from Harvard Medical School and Brigham and Women's Hospital reports that the island-dwelling Kuna people, who do drink up to 40 cups per week of the flavanol-rich cocoa, have a 10 percent lower risk of four of the five most common killer diseases: stroke, heart failure, cancer and diabetes, than people who live on mainland Panama.
And such is the importance of epicatechin in the diet that it should be considered a 'vitamin', Hollenburg told Chemistry & Industry magazine.
"There are opportunities to develop high-flavanol cocoa varieties or supplements. Cocoa is already really popular, but no doubt some people would prefer to get their epicatechin in capsule form," said Hollenburg.
The research, supported by confectionary giant Mars, extends previous studies linking consumption of flavanol-rich cocoa products to improved cardiovascular health. Mars has been very active in this research area, supporting numerous studies in the area for more than 15 years.
The link between cocoa flavanols and cardiovascular health has been linked to the improving blood flow via increased production of nitric oxide, a molecule used by the endothelium to signal surrounding muscle to relax.
How the research was done
Hollenburg's data, published in the current issue of the International Journal of Medical Sciences, used death certificates to compare the cause of death of island-dwelling Kuna to those who live on mainland Panama. It showed that the relative risk of death from heart disease on the Panama mainland was 1 280 percent higher than on the islands and death from cancer was 630 percent higher, compared to the islanders.
"If these observations predict the future, then we can say without blushing that they are among the most important observations in the history of medicine," said Hollenberg. "We all agree that penicillin and anaesthesia are enormously important. But epicatechin could potentially get rid of 4 of the 5 most common diseases in the western world. How important does that make epicatechin? I would say very important."
However, writing in the International Journal of Medical Sciences Hollenberg and his colleagues added some perspective: "Although the findings are comparable with effect of the flavanol-rich cocoa on health, clearly a large number of alternative possibilities exist, involving diet, physical activity, stress and genetic factors."
"An observation study of this kind cannot prove causality. Indeed, only a randomised, controlled clinical trial in which all of these factors can be controlled will lead to a definitive conclusion," they said.
A 'striking' link
Daniel Fabricant, vice president scientific affairs at the Natural Products Association, said: "The link between high epicatechin consumption and a decreased risk of killer disease is so striking, it should be investigated further. It may be that these diseases are the result of epicatechin deficiency."
But calls for the compound to be classified as a 'vitamin' are premature, said Fabricant. "Vitamins are defined as being essential to the normal functioning, metabolism, regulation and growth of cells. At the moment, the science does not support epicatechin having an essential role."
Experts counsel moderation for consumption of chocolate due to the calorific load.
Ellen Mason, a cardiac nurse at the British Heart Foundation, told the BBC that the observation between epicatechin and disease risk was interesting, but was confined to a "unique culture".
"We do not advise that people in the UK take up drinking cocoa in high quantities in order to protect their hearts," she said. - (Decision News Media, March 2007)
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