Effect of cocoa on the brain and gut in healthy subjects: a randomised controlled trial

• Published in: British journal of nutrition Vol. 121; no. 6; pp. 654 - 661
• Main Authors: Fox, Mark, Meyer-Gerspach, Anne Christin, Wendebourg, Maria Janina, Gruber, Maja, Heinrich, Henriette, Sauter, Matthias, Woelnerhanssen, Bettina, Koeberle, Dieter, Juengling, Freimut
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 28.03.2019
• Subjects: Abdomen; Adult; body mass index; Brain; Caffeine; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - drug effects; Chocolate; Chocolate - adverse effects; Cocoa; Colon - diagnostic imaging; Colon - drug effects; Computed tomography; Consistency; Cortex (frontal); Diet; digestive system diseases; electrons; Emission analysis; Emptying; Evidence-based medicine; Feces; Female; females; Flavonoids; Fluorodeoxyglucose F18; Gastric emptying; Gastrointestinal diseases; gastrointestinal transit; Gastrointestinal Transit - drug effects; Healthy Volunteers; Human and Clinical Nutrition; Humans; Hypotheses; image analysis; Intervention; Intestine; intestines; Irritable bowel syndrome; Male; males; Medical imaging; Metabolism; Middle Aged; Neuroimaging; patients; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography - methods; Randomization; randomized clinical trials; Regional analysis; Scintigraphy; Signs and symptoms; Somatosensory cortex; Tomography; Transit time; Visual cortex; volunteers; Well being; Young Adult; Switzerland; Chocolate; Gastric emptying; Colon transit time; [18F]fluorodeoxyglucose-positron emission tomography; Cocoa; VAS visual analogue scale; PET–CT positron emission tomography–computed tomography; HV healthy volunteer
• ISSN: 0007-1145; 1475-2662; 1475-2662
• DOI: 10.1017/S0007114518003689

Dark chocolate is claimed to have effects on gastrointestinal function and to improve well-being. This randomised controlled study tested the hypothesis that cocoa slows gastric emptying and intestinal transit. Functional brain imaging identified central effects of cocoa on cortical activity. Healthy volunteers (HV) ingested 100 g dark (72 % cocoa) or white (0 % cocoa) chocolate for 5 d, in randomised order. Participants recorded abdominal symptoms and stool consistency by the Bristol Stool Score (BSS). Gastric emptying (GE) and intestinal and colonic transit time were assessed by scintigraphy and marker studies, respectively. Combined positron emission tomography–computed tomography (PET–CT) imaging assessed regional brain activity. A total of sixteen HV (seven females and nine males) completed the studies (mean age 34 (21–58) years, BMI 22·8 (18·5–26·0) kg/m2). Dark chocolate had no effect on upper gastrointestinal function (GE half-time 82 (75–120) v. 83 (60–120) min; P=0·937); however, stool consistency was increased (BSS 3 (3–5) v. 4 (4–6); P=0·011) and there was a trend to slower colonic transit (17 (13–26) v. 21 (15–47) h; P=0·075). PET–CT imaging showed increased [18F]fluorodeoxyglucose (FDG) in the visual cortex, with increased FDG uptake also in somatosensory, motor and pre-frontal cortices (P<0·001). In conclusion, dark chocolate with a high cocoa content has effects on colonic and cerebral function in HV. Future research will assess its effects in patients with functional gastrointestinal diseases with disturbed bowel function and psychological complaints.