CClinicalTrials.gg
CompletedNCT01882881CASUpdated Aug 21, 2023

Effects of Polyphenolic-rich Dark Chocolate/Cocoa and Almonds on Cardiovascular Disease Risk Factors

An interventional study of Healthy American Control Diet and Dark Chocolate/Cocoa Diet in Cardiovascular Disease, sponsored by Penn State University. Completed at 1 site in United States. Open to participants aged 30 Years to 70 Years. Per ClinicalTrials.gov, last updated 2023-08-21.

Sponsored by Penn State University · Not applicable, Interventional, and Prevention

From the registry’s dates

  • Registered 1 year 1 month after the study started (first participant enrolled Mar 2012, registered Apr 2013).
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
30 Years to 70 Years
Sex
All
01

Study summary

The purpose of this study is to investigate the individual and combined effects of dark chocolate/cocoa and almonds on lipids, lipoproteins, antioxidant defense, lipid peroxidation, phenolic acids, inflammatory status, blood pressure and arterial health. It is hypothesized that dark chocolate/cocoa and/or almonds will favorably affect lipids, lipoproteins, antioxidants, inflammatory status, blood pressure and arterial health compared to a healthy American control diet; however, the effects will be greater when dark chocolate/cocoa and almonds are consumed together versus consumption of each food individually.

02

Conditions studied

  • Cardiovascular Disease
03

In context

Cardiovascular Diseases

4,904 studies on the registry are indexed under Cardiovascular Diseases; 919 are open to participants now.

This study's enrollment of 48 is below the median of 100 across 2,738 interventional studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

Penn State University is the lead sponsor of 263 studies on the registry; 51 are open to participants now.

Of its 13 completed or terminated interventional studies of FDA-regulated products, 10 (77%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Overweight and obese (BMI ≥25, ≤40 kg/m2)
  • Moderately elevated LDL-C between the 25-95th percentile from NHANES:

105-194 mg/dL for males; 98-190 mg/dL for females.

Exclusion criteria

Exclusion Criteria:

  • Tobacco use
  • Systolic blood pressure ≥159 mm Hg
  • Diastolic blood pressure ≥ 99 mm Hg
  • A history of myocardial infarction, stroke, diabetes mellitus, liver disease, kidney disease, and thyroid disease (unless controlled on meds)
  • Blood pressure or cholesterol-lowering medication use
  • Refusal to discontinue intake of putative cholesterol-lowering supplements (e.g. psyllium, fish oil, soy lecithin, niacin, fiber, flax, stanols/sterols)
  • Vegetarianism or dietary practices that are inconsistent with the test diets
  • Nut allergies
  • Refusal to discontinue nutritional supplements, herbs, or vitamins
  • History of inflammatory gastrointestinal disease
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Investigator)
Enrollment
48 participants (actual)

Study arms

  • Active comparator
    Healthy American Control Diet

    Other: Healthy American Control Diet

  • Experimental
    Dark Chocolate/Cocoa Diet

    Other: Dark Chocolate/Cocoa Diet

  • Experimental
    Almond Diet

    Other: Almond Diet

  • Experimental
    Dark Chocolate/Cocoa + Almond Diet

    Other: Dark Chocolate/Cocoa + Almond Diet

Interventions

  • OtherHealthy American Control Diet

    The Control Diet will be comprised of the same foods as the test diets except for the isocaloric substitution of almonds and/or dark chocolate and cocoa for sources of saturated fat; an approximate 250 kcal substitution. In an effort to keep all the diets consistent (except for the specific foods to be tested), the Control Diet will be slightly higher in fiber (20-25g) and lower in cholesterol (\~250 mg) than the typical consumption practices (15g and 278 mg, respectively).

  • OtherDark Chocolate/Cocoa Diet

    The Dark Chocolate/Cocoa Diet will include a daily hot cocoa beverage containing 11g of natural cocoa powder and 6 pieces of Hershey's Bliss Dark Chocolate (43g of dark chocolate). This amount of dark chocolate and cocoa will allow for the isocaloric substitution with 1.5oz almonds. The total diet will provide \~33% of calories from fat. The SFA (\~12%) in the Dark Chocolate/Cocoa Diet will match that of the Control Diet and be slightly higher than the Almond Diet, however the saturated fat will be comprised largely of stearic acid from the dark chocolate; cholesterol will be ≤200 mg/day. The fiber in the Dark Chocolate/Cocoa Diet will be higher than both the Control and Almond Diets due to the fiber content of the dark chocolate (\~9g).

  • OtherAlmond Diet

    The Almond Diet will include 1.5 oz of almonds daily and provide \~34% of calories from fat. The Almond Diet will be lower in SFA than the Control and Dark Chocolate/Cocoa Diets, containing \~ 8-9% calories from SFA. In addition, both almond containing diets will be slightly higher in MUFA and PUFA than the Control and Dark Chocolate/Cocoa Diets, as a result of the nutrient profile of the almonds. Cholesterol will be ≤200 mg/day; fiber will be increased compared to the Control Diet due to the inclusion of almonds.

  • OtherDark Chocolate/Cocoa + Almond Diet

    This diet is designed to test the additive effects of combining consumption of dark chocolate and cocoa with almonds. The diet will include the same hot cocoa beverage (11g) and dark chocolate pieces (43g) plus 1.5 oz of almonds. Additional high saturated fat foods are removed from the Control Diet to account for both the dark chocolate and almonds. As a result, the total fat will be similar to the other three test diets at \~34-35% and the SFA will match that of the Almond Diet at \~8-9%. The fiber content of this diet will be highest (\~35g); cholesterol will remain ≤200 mg/day.

06

What researchers measure

Primary outcomes

  1. Lipid/lipoprotein change (standard panel)

    Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  2. 24-hour ambulatory blood pressure change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  3. Flow-mediated dilation change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  4. Lipoprotein class and subclass change

    The VAP© Test provides a direct measure of the following lipid and lipoprotein classes and subclasses: LDL, Lp(a), IDL, LDL1, LDL2, LDL3, LDL4, HDL, HDL2, HDL3, VLDL, VLDL1+2, VLDL3, TC, TG, Non-HDL, Remnant Lipoproteins, ApoB100, and ApoA1.

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

Secondary outcomes

  1. Serum C-reactive protein change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  2. Serum insulin change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  3. Serum glucose change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  4. Plasma flavonoid change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  5. LDL oxidation potential change (plasma)

    The ex vivo resistance of LDL to Cu2+-mediated oxidation will be determined.

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  6. Urinary F2α-isoprostane change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  7. Plasma tocopherol change

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

Other outcomes

  1. PON1 activity change (serum)

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

  2. Ex vivo cholesterol efflux change (serum)

    Time frame: 0 wk, 4 wk, 10 wk, 16 wk, and 22 wk (at baseline and after each of the 4 diet periods)

07

Study locations

1 site
  • Penn State Clinical Research Center, Noll Lab
    University Park, Pennsylvania 16802, United States
08

References and documents

Publications

  • Lee Y, Berryman CE, West SG, Chen CO, Blumberg JB, Lapsley KG, Preston AG, Fleming JA, Kris-Etherton PM. Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial. J Am Heart Assoc. 2017 Nov 29;6(12):e005162. doi: 10.1161/JAHA.116.005162. PubMed 29187388 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 21, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01882881
Lead sponsor
Penn State University
Collaborators
Almond Board of California, The Hershey Company
Responsible party
Sponsor
First posted
Jun 21, 2013
Start date
Mar 2012
Primary completion
Aug 2016
Completion
Aug 2016
Last update
Aug 21, 2023

Study contacts

Penny M. Kris-Etherton, PhD, RD
principal investigator · Penn State University

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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