Effects of COcoa Supplement in FRail Elderly Subjects (COFRE)

The study use a double blind, placebo-controlled design enrolling male and female subjects between 55-90 yo randomly assigned to consumption of a flavonoid rich mixture (flavonoids; F), alkalinized cocoa which eliminates flavonoid content (no flavonoids; NF) or placebo. All beverages had similar physical characteristics and flavor. Cocoa beverages were provided in individual sachets containing a dry powder that was reconstituted with water just before consumption. Subjects were instructed as above to maintain their usual lifestyle, to limit intake of high caloric foods and flavonoid-containing foods and beverages, and to walk for 30 min/day.

To determine the effect of flavonoids, study evaluates anthropometric measures, metabolic parameters as glycemia and a lipid profile (triglycerides, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol). To evaluate oxidative stress damage as lipid oxidation is measured with the malondialdehyde (MDA) assay. Protein carbonylation is measured using an assay for detection of carbonyl groups that relies on 2,4-dinitrophenylhydrazine (DNPH) as a substrate. The investigators also evaluate interleukin-6 and tumor necrosis factor levels.

For physical performance is evaluated the handgrip strength, and mobility assesment with the following test: Six-minute walk test, two-minute step, sit-up test and the up & go test.

The investigators also assessed quality of life using the Health Related QoL (EQ-5D) questionnaire.

Inclusion criteria

• Sex: both
• Age: 55-90 yo
• Waist circumference: Women > 80 cm, Men > 90 cm
• HDL-c: Women < 50 mg/dL, Men < 40 mg/dL
• Triglycerides: ≥ 150 mg/dL
• Glycemia: ≈100 mg/dL
• Hand strength: Women< 20 kg, Men < 30 kg
• Up & Go test: > 10 seconds

Non-inclusion criteria:

• Any active infections
• Malignancies
• Habitual consumers of antioxidant supplements and cocoa products
• Use of benzodiazepines or protein supplements