Effect of 12-week dark chocolate intake combined with low-energy diet and exercise on weight loss in obese adults: a phase II randomized controlled trial protocol

Main Article Content

Roberta Diaz Savoldelli
Catherine Pui Yin Mok
Wilson Luiz da Costa Junior
Andreia Sapienza
Fayez Bahmad Jr
Juraci Aparecida Rocha
Marcio Ferreira Marcelino
Miho Fukuda
Pierre Elias Piera
Renata Buccheri
Sara Tavarez
Angelica Richart Csipak
Carlos Jimenez Conde
Carlos Mario Palomino
Edgar Bortolini
Florian Anzengruber
Luis Ivan Garcia Gutierrez
Marcus Unterrainer
Maria Rita Dionisio
Marianne Yang Yu
Mohammed Guba
Nelson Murillo
Paulo Bernardo
Ryoji Tominaka
Wilfredo Gomez Herrera
Livia Stocco Sanches Valentin

Abstract

Background: Obesity is a public health problem affecting 35% of the adult population in the US.A 5-10% weight loss decreases the risk of cardiovascular disease and diabetes mellitus. Diet and exercise have shown to be effective in the treatment of obesity, but adherence is a limitation. Dark chocolate (DC) polyphenols were proven to have beneficial effects on blood pressure, endothelial function, HDL cholesterol, lipoprotein ratios and inflammation markers. Also, it might play a role in improving fat metabolism and satiety; however, its effects on weight loss are still not clear. We propose a protocol to explore the effects of DC associated with hypocaloric diet and exercise on weight loss during a 12-week period in obese adults. Methods and Design: The study is a randomized controlled trial with 2 parallel arms comparing hypocaloric diet + exercise with hypocaloric diet + exercise + 50g dark chocolate/day during a 12 week period. A total of 408 obese adults (18 to 45 years old) with no comorbidities that could compromise the exercise program will be recruited. Primary outcome is proportion of patients who had 5% or more weight loss after 12 weeks. Secondary outcomes are glucose levels and insulin resistance (HOMA-IR), lipid profile, abdominal circumference, body fat mass (estimated by skinfold thickness) and blood pressure, satiety perception and drop-out rates. Primary outcome (percentage of patients achieving 5% or more weight loss) will be analyzed by chi-square test with an Intention-to-Treat approach. Conclusions: This phase II randomized controlled trial has the aim to explore the effects of including dark chocolate as an adjuvant to classical therapies (hypocaloric diet and exercise) on weight loss in a 12-week period Trial registration: the trial will be registered at www.clinicaltrials.gov

Article Details

How to Cite
Effect of 12-week dark chocolate intake combined with low-energy diet and exercise on weight loss in obese adults: a phase II randomized controlled trial protocol. (2016). Principles and Practice of Clinical Research, 2(2). https://journal.ppcr.org/index.php/ppcrjournal/article/view/33
Section
Clinical Research Design

How to Cite

Effect of 12-week dark chocolate intake combined with low-energy diet and exercise on weight loss in obese adults: a phase II randomized controlled trial protocol. (2016). Principles and Practice of Clinical Research, 2(2). https://journal.ppcr.org/index.php/ppcrjournal/article/view/33

References

Bermudez-Soto, M., Tomas-Barberan, F., & Garcia-Conesa, M. (2007). Stability of polyphenols in chokeberry (Aronia melanocarpa) subjected to in vitro gastric and pancreatic digestion. Food Chemistry, 102(3), 865–874. http://doi.org/10.1016/j.foodchem.2006.06.025

FAO. (2004). Human energy requirements . Report of a Joint FAO/WHO/UNU Expert Consultation . FAO Food and Nutrition Technical Report Series.

Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates. Health Affairs, 28(5), w822–w831. http://doi.org/10.1377/hlthaff.28.5.w822

Grundy, S. M. (2004). Obesity, Metabolic Syndrome, and Cardiovascular Disease. The Journal of Clinical Endocrinology & Metabolism, 89(6), 2595–2600. http://doi.org/10.1210/jc.2004-0372

Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983). Obesity as an independent risk factor for cardiovascular disease: a 26- year follow-up of participants in the Framingham Heart Study. Circulation, 67(5), 968–977. http://doi.org/10.1161/01.CIR.67.5.968

Institute of Medicine. (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, D.C.: National Academies Press. http://doi.org/10.17226/10490

Larsen, S. H., Wagner, G., & Heitmann, B. L. (2007). Sexual function and obesity. International Journal of Obesity, 31(8), 1189–1198. http://doi.org/10.1038/sj.ijo.0803604

Sabu, M.C., Smitha, K., & Kuttan, R. (2002). Anti-diabetic activity of green tea polyphenols and their role in reducing oxidative stress in experimental diabetes. Journal of Ethnopharmacology, 83(1-2), 109–116. http://doi.org/10.1016/S0378-8741(02)00217-9

Manach, C., Mazur, A., & Scalbert, A. (2005). Polyphenols and prevention of cardiovascular diseases. Current Opinion in Lipidology, 16(1), 77–84. http://doi.org/10.1097/00041433-200502000-00013

Massolt, E. T., van Haard, P. M., Rehfeld, J. F., Posthuma, E. F., van der Veer, E., & Schweitzer, D. H. (2010). Appetite suppression through smelling of dark chocolate correlates with changes in ghrelin in young women. Regulatory Peptides, 161(1-3), 81–86. http://doi.org/10.1016/j.regpep.2010.01.005

Matsui, N., Ito, R., Nishimura, E., Yoshikawa, M., Kato, M., Kamei, M., … Hashizume, S. (2005). Ingested cocoa can prevent high-fat diet-induced obesity by regulating the expression of genes for fatty acid metabolism. Nutrition, 21(5), 594–601. http://doi.org/10.1016/j.nut.2004.10.008

Mellor, D. D., Sathyapalan, T., Kilpatrick, E. S., Beckett, S., & Atkin, S. L. (2010). High-cocoa polyphenol-rich chocolate improves HDL cholesterol in Type 2 diabetes patients. Diabetic Medicine, 27(11), 1318–1321. http://doi.org/10.1111/j.1464-5491.2010.03108.x

Min, S. Y., Yang, H., Seo, S. G., Shin, S. H., Chung, M.-Y., Kim, J., … Lee, K. W. (2013). Cocoa polyphenols suppress adipogenesis in vitro and obesity in vivo by targeting insulin receptor. International Journal of Obesity, 37(4), 584–592. http://doi.org/10.1038/ijo.2012.85

Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003). Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001. JAMA, 289(1), 76–79. http://doi.org/10.1001/jama.289.1.76

Nickols-Richardson, S. M., Piehowski, K. E., Metzgar, C. J., Miller, D. L., & Preston, A. G. (2014). Changes in body weight, blood pressure and selected metabolic biomarkers with an energy-restricted diet including twice daily sweet snacks and once daily sugar-free beverage. Nutrition Research and Practice, 8(6), 695. http://doi.org/10.4162/nrp.2014.8.6.695

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. JAMA, 311(8), 806. http://doi.org/10.1001/jama.2014.732

Pase, M. P., Grima, N. A., & Sarris, J. (2011). The effects of dietary and nutrient interventions on arterial stiffness: a systematic review. American Journal of Clinical Nutrition, 93(2), 446–454. http://doi.org/10.3945/ajcn.110.002725

Perez-Vizcaino, F., Duarte, J., & Andriantsitohaina, R. (2006). Endothelial function and cardiovascular disease: Effects of quercetin and wine polyphenols. Free Radical Research, 40(10), 1054–1065. http://doi.org/10.1080/10715760600823128

Piehowski, K. E., Preston, A. G., Miller, D. L., & Nickols-Richardson, S. M. (2011). A Reduced-Calorie Dietary Pattern Including a Daily Sweet Snack Promotes Body Weight Reduction and Body Composition Improvements in Premenopausal Women Who Are Overweight and Obese: A Pilot Study. Journal of the American Dietetic Association, 111(8), 1198–1203. http://doi.org/10.1016/j.jada.2011.05.013

Rostami, A., Khalili, M., Haghighat, N., Eghtesadi, S., Shidfar, F., Heidari, I., … Eghtesadi, M. (2015). High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension. ARYA Atheroscler, 11(1), 21–29.

Sørensen, L. B., & Astrup, A. (2011). Eating dark and milk chocolate: a randomized crossover study of effects on appetite and energy intake. Nutrition and Diabetes, 1(12), e21. http://doi.org/10.1038/nutd.2011.17

Tudor-Locke, C., & Bassett, D. R. (2004). How Many Steps/Day Are Enough? Sports Medicine, 34(1), 1–8. http://doi.org/10.2165/00007256-200434010-00001

U.S. Department of Agriculture, & Human, U. S. D. of H. and. (2010). Dietary Guidelines for Americans, 2010 (7th ed.). Washington, D.C.: U.S. Government Printing Office.

Vaughan, T. L., Davis, S., Kristal, A., & Thomas, D. B. (1995). Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia: adenocarcinoma versus squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev, 4(2), 85–92.

Zalifah, M. K., Greenway, D. R., Caffin, N. A., D’Arcy, B. R., & Gidley, M. J. (2008). Application of labelled magnitude satiety scale in a linguistically-diverse population. Food Quality and Preference, 19(6), 574–578. http://doi.org/10.1016/j.foodqual.2008.03.001

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>