According to a recent study conducted as part of the broader COSMOS experiment, older persons with poor diets may benefit from taking supplements containing cocoa extract, while those with healthy diets would not experience this effect.
Although there has been mixed evidence from randomized clinical trials in older persons, cocoa extract may have a protective effect on cognition. The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), a recent randomized trial on cognition, indicates that older adults with lower habitual diet quality at the time of enrollment in the study may benefit cognitively from taking supplements containing 500 mg of cocoa flavanols per day. Those who began the research with healthy eating habits did not, however, see any cognitive improvements.
573 older persons participated in the study, which was carried out by Mass General Brigham experts. It was published on December 7 in The American Journal of Clinical Nutrition. The participants completed comprehensive, in-person cognitive testing.
Study Results
Comprehensive neuropsychological tests conducted over a two-year period yielded results that indicated daily treatment with cocoa extract had no overall beneficial effects on global or domain-specific cognitive function when compared to placebo. Secondary analyses, however, revealed that taking the cocoa extract supplement improved cognitive function in those with low-quality diets.
The results of an earlier study that used a web-based cognitive assessment administered over the internet to a separately recruited set of COSMOS participants are consistent with the findings from this study, which was conducted among COSMOS participants who presented in-person for detailed cognitive testing.
The COSMOS Trial and Its Wider Consequences
Brigham and Women’s Hospital is leading the large-scale, long-term clinical trial called COSMOS, which was started by the investigators. This randomized, double-blind, placebo-controlled study enrolled over 21,000 older men and women nationwide to determine whether taking a common multivitamin or a cocoa extract supplement on a daily basis lowers the risk of heart disease, stroke, cancer, and other major health outcomes. COSMOS data analysis is still providing new information regarding the relationships between dietary supplements and human health.
Researchers from Mass General Brigham, including Drs. Howard Sesso and JoAnn Manson at Brigham and Women’s Hospital and Chirag Vyas and Olivia I. Okereke at Massachusetts General Hospital, led the study.
An investigator-initiated funding from Mars Edge, a division of Mars devoted to nutrition research and products, is supporting the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). The grant included infrastructure assistance as well as the contribution of study tablets and packaging. Support was given by Pfizer Consumer Healthcare (now Haleon), who supplied certain study tablets and packaging. Additionally, funding from the National Institutes of Health, Bethesda, MD, AG050657, AG071611, EY025623, and HL157665, partially support COSMOS. Under contracts 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005, the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, provides funding for the Women’s Health Initiative (WHI) program. Pfizer Consumer Healthcare and Mars Edge did not contribute to the data analysis, result interpretation,or manuscript development.
