Research

Epicatechin

77 peer-reviewed studies curated from PubMed and Semantic Scholar.

1
Meta-analyses
3
Systematic reviews
54
RCTs
19
Other studies
Meta-analyses (1%)
Systematic reviews (4%)
RCTs (70%)
Observational (1%)

Studies

Sorted by quality and recency

2025·Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research·Carolyn J Crandall, Sharon Chou, Eunjung Kim, et al

Effects of cocoa extract supplementation and multivitamin/multimineral supplements on self-reported fractures in the Cocoa Supplement and Multivitamins Outcomes Study randomized clinical trial.

RCTn = 21,442Joint Bone Health -

RCT of 21,442 older adults in the COSMOS study examining the effects of cocoa extract and multivitamin/multimineral (MVM) supplements on self-reported fractures. Neither cocoa extract nor MVM supplementation significantly reduced the risk of clinical fractures, including hip and nonvertebral fractures.

PubMedRead on PubMed
2025·JAMA ophthalmology·William G Christen, Pamela M Rist, M Vinayaga Moorthy, et al

Cocoa Flavanol Supplementation and Risk of Age-Related Macular Degeneration: An Ancillary Study of the COSMOS Randomized Clinical Trial.

RCTn = 21,442

This ancillary study of the COSMOS randomized clinical trial examined the effect of cocoa extract supplementation on age-related macular degeneration (AMD) in older adults. Over a median period of 3.6 years, cocoa extract showed no overall effect on AMD occurrence, though a modest treatment effect was suggested early in the trial.

PubMedRead on PubMed
2025·Age and ageing·Sidong Li, Rikuta Hamaya, Haidong Zhu, et al

Effects of 2-year cocoa extract supplementation on inflammaging biomarkers in older US adults: findings from the COcoa Supplement and Multivitamin Outcomes Study randomised clinical trial.

RCTn = 598Inflammation Heart Health

The COSMOS trial examined the effects of cocoa extract supplementation on inflammaging biomarkers in older adults. Cocoa extract significantly decreased hsCRP levels and increased IFN-γ, suggesting a role in modulating chronic inflammation and potential cardio-protective effects, including a reduction in cardiovascular disease death.

PubMedRead on PubMed
2025·Journal of agricultural and food chemistry·Young Cheol Yoon, Young Jin Min, Hendra Mahakam Putra, et al

Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis.

Meta-analysisBrain Health Mental Clarity

This systematic review and meta-analysis evaluated the efficacy of epicatechin in mitigating oxidative stress-induced cognitive impairment in animal models. Epicatechin significantly improved cognitive performance in rodents, enhancing spatial learning, memory retention, and memory precision. It also increased antioxidant defense and modulated neuroinflammation at the molecular level.

PubMedRead on PubMed
2024·Nutrients·Iris Jasmin Santos German, Karina Torres Pomini, Jesus Carlos Andreo, et al

New Trends to Treat Muscular Atrophy: A Systematic Review of Epicatechin.

Systematic reviewPhysical Performance

Systematic review investigating the molecular mechanism and clinical protocol of epicatechin in muscle atrophy. Epicatechin inhibits myostatin expression and atrogenes, stimulates myogenic factors, and improves skeletal muscle performance, especially with exercise. However, there is no standard protocol or sufficient clinical evidence for therapeutic implementation.

PubMedRead on PubMed
2023·Diabetes care·Jie Li, Howard D Sesso, Eunjung Kim, et al

Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial.

RCTn = 18,381Nutrition -

The COSMOS RCT evaluated the effect of cocoa extract supplementation on the risk of type 2 diabetes in 18,381 U.S. adults over a median follow-up of 3.5 years. The study found that cocoa extract supplementation did not reduce the risk of incident type 2 diabetes compared to placebo.

PubMedRead on PubMed
2023·The American journal of clinical nutrition·Chirag M Vyas, JoAnn E Manson, Howard D Sesso, et al

Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.

RCTn = 573Brain Health -

The COSMOS trial tested the effects of daily cocoa extract supplementation on cognitive function in 573 older adults over 2 years. The study found no significant effects of cocoa extract on global cognition, episodic memory, or executive function/attention compared to placebo. Subgroup analyses suggested potential cognitive benefits among those with poorer baseline diet quality, warranting further study.

PubMedRead on PubMed
2022·The American Journal of Clinical Nutrition·H. Sesso, J. Manson, A. Aragaki, et al

Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial

RCTn = 21,442Heart Health

RCT of 21,442 US adults examining cocoa extract supplementation (500 mg flavanols/d) for prevention of cardiovascular disease events. Cocoa extract did not significantly reduce total cardiovascular events but reduced CVD death by 27%. Per-protocol analyses suggested potential reductions in total cardiovascular events.

Semantic ScholarRead on Semantic Scholar
2022·Nutrients·Lisa Dicks, Zeina Haddad, Stefanie Deisling, et al

Effect of an (-)-Epicatechin Intake on Cardiometabolic Parameters-A Systematic Review of Randomized Controlled Trials.

Systematic reviewHeart Health Inflammation -Nutrition -

Systematic review of RCTs evaluating the impact of (-)-epicatechin (EC) intake on cardiometabolic biomarkers. EC intake may improve endothelial function in healthy young adults, but effects on other parameters like glucose/lipid metabolism, oxidative stress, inflammation, appetite sensations, and body weight were not observed. Further unbiased RCTs are needed.

PubMedRead on PubMed
2020·Plant foods for human nutrition (Dordrecht, Netherlands)·Paloma K Barrera-Reyes, Josué Cortés-Fernández de Lara, Melissa González-Soto, et al

Effects of Cocoa-Derived Polyphenols on Cognitive Function in Humans. Systematic Review and Analysis of Methodological Aspects.

Systematic reviewMental Clarity Brain Health

Systematic review analyzing the effects of cocoa-derived polyphenols on cognitive functions in humans. The review found positive effects on memory and executive function, particularly with intermediate doses of cocoa flavanols. However, methodological diversity across studies was noted.

PubMedRead on PubMed
2025·Molecular nutrition & food research·Janina Weigant, Anuschka Afchar, Meike Barzen, et al

Cardiometabolic Impact of Encapsulated Cocoa Powder and Pure Cocoa Ingredients Supplementation: A Comparative Placebo-Controlled RCT in Adults.

RCTn = 75Heart Health -

RCT comparing the effects of flavanol-rich cocoa powder, epicatechin, methylxanthines, and their combination on vascular function and serum lipid levels in 75 healthy young adults. No statistically significant differences in vascular function or lipid profiles were observed between groups after 4 weeks of supplementation.

PubMedRead on PubMed
2024·American journal of physiology. Cell physiology·Ahmed Ismaeel, Mary M McDermott, Jai K Joshi, et al

Cocoa flavanols, Nrf2 activation, and oxidative stress in peripheral artery disease: mechanistic findings in muscle based on outcomes from a randomized trial.

RCTPhysical Performance

A phase II randomized trial investigated the effects of cocoa flavanols on walking performance in people with peripheral artery disease (PAD). The study found that cocoa flavanols improved walking performance and enhanced antioxidant capacity via Nrf2 activation, protecting against skeletal muscle damage and increasing mitochondrial protein abundance.

PubMedRead on PubMed
2022·Alzheimer's & Dementia·Laura D. Baker, J. Manson, S. Rapp, et al

Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial

RCTBrain Health

COSMOS‐Mind tested the effects of daily cocoa extract (500 mg/day flavanols) and a commercial multivitamin‐mineral (MVM) versus placebo on cognition in older adults. The study aimed to assess cognitive protection from these dietary supplements.

Semantic ScholarRead on Semantic Scholar
2021·Food research international (Ottawa, Ont.)·Aldo Leyva-Soto, Rocío Alejandra Chavez-Santoscoy, Omar Porras, et al

Epicatechin and quercetin exhibit in vitro antioxidant effect, improve biochemical parameters related to metabolic syndrome, and decrease cellular genotoxicity in humans.

RCTn = 156Heart Health Inflammation Longevity

A randomized placebo-controlled study with 156 participants examined the effects of consuming bread enriched with a 1:1 mixture of (-)-epicatechin and quercetin. Results showed significant decreases in total cholesterol, LDL-cholesterol, total triglycerides, and fasting plasma glucose after three months. Nuclear abnormalities in buccal epithelium cells also decreased, indicating a genoprotective effect.

PubMedRead on PubMed
2025·Food & function·Irene Sánchez Gavilán, Sidong Li, Michael G Sweet, et al

A pilot and feasibility analysis of serum TMAO and choline in a randomized sample from the COSMOS trial.

RCTn = 37

Pilot study from the COSMOS trial examining the impact of cocoa extract (CE) supplementation on serum TMAO and choline levels over 1 year in 37 older adults. The study found trends toward lower TMAO and higher choline levels in the CE group compared to placebo, but differences were not statistically significant.

PubMedRead on PubMed
2025·Clinical and translational science·Cameron K Ormiston, Aryana Pazargadi, Ashley Rosander, et al

Enhancement of Statin Effects on Lipid Lowering and Reduction of Cardiovascular Risk Score by (-)-Epicatechin in Proof-of-Concept Pilot Study.

RCTn = 19Heart Health

This randomized, double-blind placebo-controlled trial explored the capacity of (-)-Epicatechin to augment statin's effects on lipid profile and ASCVD risk parameters in patients with metabolic syndrome. The statin + Epi group showed significant improvements in total cholesterol, non-HDL cholesterol, HDL, LDL particle number, and ASCVD risk compared to statin-only.

PubMedRead on PubMed
2024·Food & function·Rosalind Baynham, Jet J C S Veldhuijzen van Zanten, Catarina Rendeiro

Cocoa flavanols rescue stress-induced declines in endothelial function after a high-fat meal, but do not affect cerebral oxygenation during stress in young, healthy adults.

RCTn = 23Heart Health

This randomized, double-blinded, crossover study examined the effects of high-flavanol cocoa on endothelial function after a high-fat meal in young, healthy adults. High-flavanol cocoa attenuated impairments in flow-mediated dilatation post-stress, suggesting a protective effect on vascular health, but did not affect cerebral oxygenation during stress.

PubMedRead on PubMed
2023·Free radical biology & medicine·Javier I Ottaviani, Reedmond Y Fong, Gina Borges, et al

Flavan-3-ol-methylxanthine interactions: Modulation of flavan-3-ol bioavailability in volunteers with a functional colon and an ileostomy.

RCTn = 20

This study investigated the interactions between flavan-3-ols and methylxanthines, specifically theobromine and caffeine, on flavan-3-ol bioavailability in humans. In a randomized, controlled, triple cross-over study with volunteers having a functional colon, co-ingestion of flavan-3-ols and cocoa methylxanthines increased peak circulatory levels of flavan-3-ol metabolites. However, caffeine did not significantly affect flavan-3-ol bioavailability. In ileostomists, cocoa methylxanthines did not affect circulatory levels of flavan-3-ol metabolites.

PubMedRead on PubMed
2021·Nutrients·Rosalind Baynham, Jet J C S Veldhuijzen van Zanten, Paul W Johns, et al

Cocoa Flavanols Improve Vascular Responses to Acute Mental Stress in Young Healthy Adults.

RCTn = 30Heart Health

RCT examining the effects of acute cocoa flavanol intake on stress-induced vascular function changes in 30 healthy men. High-flavanol cocoa attenuated the decline in endothelial function post-stress and increased forearm blood flow at rest and during stress compared to low-flavanol cocoa.

PubMedRead on PubMed
2021·Nutrients·Paloma K Barrera-Reyes, Josué Cortés-Fernández de Lara, Laure Poquet, et al

Circulating Structurally Related (-)-Epicatechin Metabolite Species and Levels after Sustained Intake of a Cocoa Powder High in Polyphenols Are Comparable to Those Achieved after a Single Dose.

RCTn = 20

A randomized, controlled crossover clinical trial evaluated the metabolic profile of structurally related (-)-epicatechin metabolites (SREMs) after single-dose and sustained intake of polyphenol-rich cocoa powder in 20 healthy young adults. SREMs concentrations were similar after both single-dose and 28-day supplementation, with no change in plasma antioxidant capacity.

PubMedRead on PubMed
2020·Nutrients·Sabine Ellinger, Andreas Reusch, Lisa Henckes, et al

Low Plasma Appearance of (+)-Catechin and (-)-Catechin Compared with Epicatechin after Consumption of Beverages Prepared from Nonalkalized or Alkalized Cocoa-A Randomized, Double-Blind Trial.

RCTn = 12

Randomized, double-blind trial comparing plasma appearance of flavan-3-ol stereoisomers after consumption of nonalkalized vs. alkalized cocoa beverages in 12 healthy nonsmokers. Epicatechin was the main monomeric flavan-3-ol detected in plasma, with differences in total area under the curve between treatments, but not in incremental values.

PubMedRead on PubMed
2020·Journal of inherited metabolic disease·Muhammad Yasir Qureshi, Marc C Patterson, Vicki Clark, et al

Safety and efficacy of (+)-epicatechin in subjects with Friedreich's ataxia: A phase II, open-label, prospective study.

RCTn = 10Heart Health Physical Performance

Phase II, open-label trial of (+)-epicatechin in 10 pediatric subjects with Friedreich's ataxia. The study found improvement in cardiac structure and function, with nonstatistically significant changes in neurological outcomes. (+)-Epicatechin was well tolerated over 24 weeks.

PubMedRead on PubMed
2019·Journal of aging and physical activity·Farnoosh Mafi, Soheil Biglari, Alireza Ghardashi Afousi, et al

Improvement in Skeletal Muscle Strength and Plasma Levels of Follistatin and Myostatin Induced by an 8-Week Resistance Training and Epicatechin Supplementation in Sarcopenic Older Adults.

RCTn = 62Physical Performance Joint Bone Health

RCT of 62 sarcopenic older adults comparing resistance training, epicatechin supplementation, and their combination over 8 weeks. The RT+EP group showed the greatest improvements in muscle strength, follistatin levels, and muscle growth factors, with significant decreases in myostatin.

PubMedRead on PubMed
2018·Food & function·Aldo Moreno-Ulloa, Nayelli Nájera-García, Marcela Hernández, et al

A pilot study on clinical pharmacokinetics and preclinical pharmacodynamics of (+)-epicatechin on cardiometabolic endpoints.

RCTHeart Health Inflammation

Pilot study on the pharmacokinetics and pharmacodynamics of (+)-epicatechin in healthy and pre-diabetic subjects. Incremental doses increased the half-life of blood metabolites, and the compound was well tolerated. In pre-diabetic subjects, 7-day dosing showed tendencies for reductions in inflammatory markers. In a mouse model, (+)-epicatechin improved metabolism-related endpoints, unlike (+)-catechin.

PubMedRead on PubMed
2017·Nutrition journal·Maria Saarenhovi, Pia Salo, Mika Scheinin, et al

The effect of an apple polyphenol extract rich in epicatechin and flavan-3-ol oligomers on brachial artery flow-mediated vasodilatory function in volunteers with elevated blood pressure.

RCTn = 60Heart Health -

This double-blind, placebo-controlled, crossover study tested the effect of an apple polyphenol extract rich in epicatechin and flavan-3-ol oligomers on brachial artery flow-mediated vasodilatation (FMD) in 60 volunteers with borderline or mild hypertension. While a significant acute improvement in FMD% was observed with apple extract, it was not statistically significant compared to placebo. No significant differences were found for endothelium-independent nitrate-mediated vasodilatation (NMD).

PubMedRead on PubMed
2016·Food & function·Idoia Ibero-Baraibar, Ana Romo-Hualde, Carlos J Gonzalez-Navarro, et al

The urinary metabolomic profile following the intake of meals supplemented with a cocoa extract in middle-aged obese subjects.

RCTn = 50

This study analyzed the effect of consuming meals supplemented with cocoa extract on urinary metabolomic changes in middle-aged obese subjects. A 4-week randomized, parallel, and double-blind study was conducted with 50 volunteers. The cocoa group showed distinct metabolomic profiles, indicating the bioavailability of cocoa compounds.

PubMedRead on PubMed
2016·International journal of cardiology·Gabriela Gutiérrez-Salmeán, Eduardo Meaney, Miguel A Lanaspa, et al

A randomized, placebo-controlled, double-blind study on the effects of (-)-epicatechin on the triglyceride/HDLc ratio and cardiometabolic profile of subjects with hypertriglyceridemia: Unique in vitro effects.

RCTHeart Health Inflammation Nutrition

This randomized, placebo-controlled, double-blind study evaluated the effects of (-)-epicatechin (EPI) on the triglyceride/HDLc ratio and cardiometabolic profile in subjects with hypertriglyceridemia. EPI treatment showed favorable effects on glycemia homeostasis, lipid profile, and systemic inflammation, suggesting benefits beyond antioxidant potential.

PubMedRead on PubMed
2015·Mutagenesis·Idoia Ibero-Baraibar, Amaya Azqueta, Adela Lopez de Cerain, et al

Assessment of DNA damage using comet assay in middle-aged overweight/obese subjects after following a hypocaloric diet supplemented with cocoa extract.

RCTn = 50Inflammation -

This double-blind, randomised, placebo-controlled trial assessed the effect of cocoa extract supplementation on oxidative stress in DNA among 50 overweight/obese subjects on a hypocaloric diet. The study found no significant changes in oxidative status of DNA with cocoa extract supplementation, though some inverse associations between oxidised bases and cocoa-derived metabolites were noted.

PubMedRead on PubMed
2015·Molecular nutrition & food research·Stefanie Wiese, Tuba Esatbeyoglu, Peter Winterhalter, et al

Comparative biokinetics and metabolism of pure monomeric, dimeric, and polymeric flavan-3-ols: a randomized cross-over study in humans.

RCT

Randomized cross-over study investigating the metabolic fate of (-)-epicatechin, procyanidin B1, and polymeric procyanidins in humans. The study identified various metabolites in plasma, urine, and feces, with significant individual variation in metabolite formation. No correlation was found between flavan-3-ol intake and phenolic acid occurrence in blood and urine.

PubMedRead on PubMed
2013·Molecular nutrition & food research·Wendy J Hollands, David J Hart, Jack R Dainty, et al

Bioavailability of epicatechin and effects on nitric oxide metabolites of an apple flavanol-rich extract supplemented beverage compared to a whole apple puree: a randomized, placebo-controlled, crossover trial.

RCT

Randomized, placebo-controlled, crossover trial comparing bioavailability and effects on nitric oxide metabolites of epicatechin from an apple extract and apple puree. Epicatechin bioavailability was higher from the extract drinks compared to puree, with increased NO metabolite excretion, especially at higher doses.

PubMedRead on PubMed
2013·International journal of cardiology·Israel Ramirez-Sanchez, Pam R Taub, Theodore P Ciaraldi, et al

(-)-Epicatechin rich cocoa mediated modulation of oxidative stress regulators in skeletal muscle of heart failure and type 2 diabetes patients.

RCTHeart Health Inflammation

The study examined oxidative stress alterations in skeletal muscle of type 2 diabetes and heart failure patients, and evaluated the effects of three-month treatment with (-)-epicatechin rich cocoa. Treatment induced recovery in glutathione levels and decreased protein nitrotyrosilation and carbonylation. In insulin resistant mice, pure epicatechin replicated the beneficial effects observed in humans.

PubMedRead on PubMed
2010·Free radical biology & medicine·Javier I Ottaviani, Tony Y Momma, Christian Heiss, et al

The stereochemical configuration of flavanols influences the level and metabolism of flavanols in humans and their biological activity in vivo.

RCTHeart Health

This study investigated the influence of the stereochemical configuration of flavanols on their absorption, metabolism, and biological activity in healthy adult males. The study found that (-)-epicatechin was the only stereoisomer capable of mediating a significant arterial dilation response, indicating that the health benefits of flavanol-containing foods depend on the stereochemical configuration of the flavanols ingested.

PubMedRead on PubMed
2006·The Journal of nutrition·Ulrike Heinrich, Karin Neukam, Hagen Tronnier, et al

Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.

RCTSkin Hair Health

RCT with two groups of women consuming high or low flavanol cocoa for 12 weeks. The high flavanol group showed decreased UV-induced erythema, improved skin density, hydration, and reduced skin roughness and scaling. No changes were observed in the low flavanol group.

PubMedRead on PubMed
2001·The Journal of nutrition·B A Warden, L S Smith, G R Beecher, et al

Catechins are bioavailable in men and women drinking black tea throughout the day.

RCT

This study assessed the bioavailability of catechins from black tea in humans consuming tea throughout the day. Plasma concentrations of EGC, EC, and EGCG increased significantly, with peaks at 5 hours, while ECG peaked at 24 hours. Urinary and fecal excretion of catechins increased relative to baseline, indicating bioavailability.

PubMedRead on PubMed
2000·The Journal of nutrition·D Rein, S Lotito, R R Holt, et al

Epicatechin in human plasma: in vivo determination and effect of chocolate consumption on plasma oxidation status.

RCTInflammation

The study developed a method to determine physiological levels of epicatechin in plasma and evaluated its absorption from an 80-g semisweet chocolate bolus. There was a 12-fold increase in plasma epicatechin and a significant increase in plasma total antioxidant capacity, along with a decrease in plasma oxidation products, 2 hours after ingestion.

PubMedRead on PubMed
2000·The Journal of nutrition·J F Wang, D D Schramm, R R Holt, et al

A dose-response effect from chocolate consumption on plasma epicatechin and oxidative damage.

RCTHeart Health

RCT demonstrating that consumption of procyanidin-rich chocolate increases plasma levels of epicatechin, with dose-response effects on plasma antioxidant capacity and lipid oxidation. Suggests cardioprotective effects due to free radical scavenging and inhibition of lipid peroxidation.

PubMedRead on PubMed
2022·Journal of Pharmacy & Pharmacognosy Research·Audrey G. Riwu, J. Nugraha, D. Purwanto, et al

In silico analysis of anti-dengue activity of faloak (Sterculia quadrifida R. Br) stem bark compounds

Study

In silico analysis of Sterculia quadrifida stem bark compounds, specifically epicatechin and scopoletin, for their antiviral potential against dengue. The study found these compounds have low affinity bonds and noncovalent interactions with dengue envelope protein and NS5 RdRp, similar to the reference control ribavirin.

Semantic ScholarRead on Semantic Scholar
2019·Clinical nutrition (Edinburgh, Scotland)·M E Alañón, S M Castle, G Serra, et al

Acute study of dose-dependent effects of (-)-epicatechin on vascular function in healthy male volunteers: A randomized controlled trial.

RCTn = 20Heart Health

A randomized controlled trial examined the dose-dependent effects of (-)-epicatechin on vascular function in 20 healthy male volunteers. Significant increases in flow-mediated dilatation (FMD) were observed at 1 and 2 hours following intake of 1 mg/kg BW, and at 2 hours for 0.5 mg/kg BW intake, indicating acute improvements in vascular function.

PubMedRead on PubMed
2018·The American journal of clinical nutrition·Natalie Kirch, Lea Berk, Yvonne Liegl, et al

A nutritive dose of pure (-)-epicatechin does not beneficially affect increased cardiometabolic risk factors in overweight-to-obese adults-a randomized, placebo-controlled, double-blind crossover study.

RCTn = 48

RCT with 48 overweight or obese adults evaluating the effects of 25 mg of pure (-)-epicatechin on cardiometabolic risk factors. The study found that (-)-epicatechin supplementation did not significantly affect blood pressure, glucose, insulin, lipid profiles, or oxidized LDL levels.

PubMedRead on PubMed
2018·The American journal of clinical nutrition·Ana Rodriguez-Mateos, Timon Weber, Simon S Skene, et al

Assessing the respective contributions of dietary flavanol monomers and procyanidins in mediating cardiovascular effects in humans: randomized, controlled, double-masked intervention trial.

RCTn = 45Heart Health

RCT with 45 healthy men assessing the effects of cocoa flavanols, specifically (-)-epicatechin and procyanidins, on vascular function. DP1-10 cocoa extract significantly improved flow-mediated vasodilation and reduced pulse wave velocity and blood pressure, while both DP1-10 and DP2-10 reduced total cholesterol compared to control.

PubMedRead on PubMed
2018·The American journal of clinical nutrition·Wendy J Hollands, Henri Tapp, Marianne Defernez, et al

Lack of acute or chronic effects of epicatechin-rich and procyanidin-rich apple extracts on blood pressure and cardiometabolic biomarkers in adults with moderately elevated blood pressure: a randomized, placebo-controlled crossover trial.

RCTn = 42Heart Health -

RCT with 42 adults with moderately elevated blood pressure testing the effects of epicatechin-rich and procyanidin-rich apple extracts on blood pressure and cardiometabolic biomarkers. The study found no significant changes in blood pressure, lipid profiles, endothelial function, or glucose control after 4 weeks of intervention.

PubMedRead on PubMed
2018·European journal of nutrition·P K Barrera-Reyes, N Hernández-Ramírez, J Cortés, et al

Gene expression changes by high-polyphenols cocoa powder intake: a randomized crossover clinical study.

RCTn = 20Inflammation

A randomized, controlled, double-blind, cross-over clinical trial assessed the effect of high-polyphenols cocoa intake on gene expression in PBMCs and plasma metabolites in 20 healthy adults. Cocoa intake led to significant changes in gene expression related to decreased production of reactive oxygen species and leukocyte activation, suggesting anti-inflammatory effects.

PubMedRead on PubMed
2016·The American journal of clinical nutrition·Roberto Sansone, Javier I Ottaviani, Ana Rodriguez-Mateos, et al

Methylxanthines enhance the effects of cocoa flavanols on cardiovascular function: randomized, double-masked controlled studies.

RCTn = 47Heart Health

Randomized, double-masked controlled studies investigated the interaction between cocoa flavanols and methylxanthines on cardiovascular function in 47 healthy volunteers. Cocoa flavanol intake increased flow-mediated vasodilation (FMD), decreased brachial pulse wave velocity (bPWV) and diastolic blood pressure, and increased circulating angiogenic cells (CACs). These effects were enhanced when cocoa flavanols were consumed with methylxanthines, which increased the plasma concentration of (-)-epicatechin metabolites.

PubMedRead on PubMed
2016·The American journal of clinical nutrition·James A Greenberg, Ryan O'Donnell, Miriam Shurpin, et al

Epicatechin, procyanidins, cocoa, and appetite: a randomized controlled trial.

RCTn = 28Nutrition

A 4-way randomized, crossover, placebo-controlled trial in 28 healthy young-adult men tested the effects of nonalkalized cocoa mixture, epicatechin, and procyanidins on appetite. The nonalkalized cocoa mixture with 1.6 mg epicatechin/kg body weight significantly decreased pizza intake by 18.7%.

PubMedRead on PubMed
2016·Molecular nutrition & food research·James I Dower, Johanna M Geleijnse, Paul A Kroon, et al

Does epicatechin contribute to the acute vascular function effects of dark chocolate? A randomized, crossover study.

RCTn = 20Heart Health

Randomized crossover study in 20 healthy men comparing the effects of pure epicatechin and dark chocolate on vascular function. Pure epicatechin did not significantly improve flow-mediated dilation or augmentation index compared to placebo, while dark chocolate did. The bioavailability of epicatechin was similar between pure epicatechin and dark chocolate.

PubMedRead on PubMed
2016·Food & function·Pam R Taub, Israel Ramirez-Sanchez, Minal Patel, et al

Beneficial effects of dark chocolate on exercise capacity in sedentary subjects: underlying mechanisms. A double blind, randomized, placebo controlled trial.

RCTn = 17Physical Performance Heart Health

Double-blind, randomized, placebo-controlled trial in 20 sedentary subjects (~50 years old) consuming 20g dark chocolate for 3 months. The dark chocolate group showed a 17% increase in VO2 max and improved maximum work achieved. Increases in HDL levels and decreases in triglycerides were observed, along with enhanced skeletal muscle mitochondrial efficiency.

PubMedRead on PubMed
2015·Molecular nutrition & food research·Ana Rodriguez-Mateos, Tania Cifuentes-Gomez, Isidro Gonzalez-Salvador, et al

Influence of age on the absorption, metabolism, and excretion of cocoa flavanols in healthy subjects.

RCTn = 40

The study compared the absorption, metabolism, and excretion of cocoa flavanols in 20 young and 20 elderly healthy male subjects. It found that cocoa flavanols are absorbed, metabolized, and excreted with relatively small differences between the two age groups.

PubMedRead on PubMed
2015·The American journal of clinical nutrition·James I Dower, Johanna M Geleijnse, Lieke Gijsbers, et al

Effects of the pure flavonoids epicatechin and quercetin on vascular function and cardiometabolic health: a randomized, double-blind, placebo-controlled, crossover trial.

RCTn = 37Heart Health Nutrition

RCT of 37 healthy adults aged 40-80 years investigating the effects of epicatechin and quercetin supplementation on vascular function and cardiometabolic health. Epicatechin improved insulin resistance but did not significantly change flow-mediated dilation or other cardiovascular risk factors. Quercetin had no significant effects.

PubMedRead on PubMed
2015·The Journal of nutrition·James I Dower, Johanna M Geleijnse, Lieke Gijsbers, et al

Supplementation of the Pure Flavonoids Epicatechin and Quercetin Affects Some Biomarkers of Endothelial Dysfunction and Inflammation in (Pre)Hypertensive Adults: A Randomized Double-Blind, Placebo-Controlled, Crossover Trial.

RCTn = 37Heart Health Inflammation

A randomized, double-blind, placebo-controlled crossover trial with 37 (pre)hypertensive adults studied the effects of epicatechin and quercetin supplementation on biomarkers of endothelial dysfunction and inflammation. Epicatechin improved endothelial function, while quercetin improved endothelial function and reduced inflammation.

PubMedRead on PubMed
2015·Food & function·Christopher F Barnett, Aldo Moreno-Ulloa, Sruti Shiva, et al

Pharmacokinetic, partial pharmacodynamic and initial safety analysis of (-)-epicatechin in healthy volunteers.

RCTn = 17

Phase I open-label study assessing the safety, tolerability, pharmacokinetics, and pharmacodynamics of purified (-)-epicatechin in healthy volunteers. The study found that (-)-epicatechin was well tolerated and absorbed, with significant increases in plasma nitrite, mitochondrial enzyme function, and plasma follistatin levels, suggesting potential beneficial effects.

PubMedRead on PubMed
2014·Archives of biochemistry and biophysics·Amy Gasper, Wendy Hollands, Amelie Casgrain, et al

Consumption of both low and high (-)-epicatechin apple puree attenuates platelet reactivity and increases plasma concentrations of nitric oxide metabolites: a randomized controlled trial.

RCTn = 25

RCT with 25 subjects consuming apple puree containing 25mg and 100mg epicatechin to assess effects on platelet activity and nitric oxide metabolite levels. Both low and high flavanol apple purees attenuated integrin-β3 and P-selectin expression and increased plasma nitric oxide metabolite concentration, but the high flavanol puree did not enhance the effect.

PubMedRead on PubMed
2013·The American journal of clinical nutrition·Lucas Actis-Goretta, Antoine Lévèques, Maarit Rein, et al

Intestinal absorption, metabolism, and excretion of (-)-epicatechin in healthy humans assessed by using an intestinal perfusion technique.

RCTn = 8

A single-center, randomized, open, controlled study in 8 healthy volunteers investigated the jejunal absorption, systemic availability, metabolism, and excretion of 50 mg purified (-)-epicatechin. Approximately 46% of the dose was absorbed, with conjugates predominantly as sulfates in the intestinal perfusate and glucuronides in plasma, bile, and urine.

PubMedRead on PubMed
2010·Nutrition (Burbank, Los Angeles County, Calif.)·Daniele Del Rio, Luca Calani, Chiara Cordero, et al

Bioavailability and catabolism of green tea flavan-3-ols in humans.

RCTn = 20Nutrition

A feeding study in 20 healthy human volunteers investigated the bioavailability and catabolism of green tea flavan-3-ols. The study found that green tea catechins are more bioavailable than previously thought, with significant variability in urinary excretion of colonic metabolites among participants.

PubMedRead on PubMed
2009·The American journal of clinical nutrition·William Mullen, Gina Borges, Jennifer L Donovan, et al

Milk decreases urinary excretion but not plasma pharmacokinetics of cocoa flavan-3-ol metabolites in humans.

RCTn = 9

RCT with 9 human volunteers examining the effect of milk on the bioavailability of cocoa flavan-3-ol metabolites. Milk significantly lowered the excretion of 4 urinary flavan-3-ol metabolites but had minor effects on plasma pharmacokinetics.

PubMedRead on PubMed
2009·Journal of agricultural and food chemistry·Andrew P Neilson, Judy C George, Elsa M Janle, et al

Influence of chocolate matrix composition on cocoa flavan-3-ol bioaccessibility in vitro and bioavailability in humans.

RCTn = 6

This study assessed the bioavailability of epicatechin (EC) from different chocolate matrices and cocoa beverages in humans and in vitro. Six subjects consumed various products in a randomized crossover design, with serum EC concentrations monitored over 6 hours. The study found that EC bioavailability was similar among chocolate matrices, but significantly increased for certain cocoa beverages compared to chocolate confections. The physical form and sucrose content influenced peak serum concentrations and time to peak concentration.

PubMedRead on PubMed
2008·The British journal of nutrition·Elena Roura, Cristina Andrés-Lacueva, Ramon Estruch, et al

The effects of milk as a food matrix for polyphenols on the excretion profile of cocoa (-)-epicatechin metabolites in healthy human subjects.

RCTn = 21

RCT with 21 volunteers evaluating the effect of milk as a food matrix on the excretion of (2)-epicatechin metabolites from cocoa powder. The study found that milk does not significantly affect the total amount of metabolites excreted in urine, but differences in metabolite excretion profiles were observed.

PubMedRead on PubMed
2006·European journal of nutrition·Karin Neukam, Wilhelm Stahl, Hagen Tronnier, et al

Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin.

RCTn = 10Skin Hair Health

Crossover study with 10 healthy women investigating the acute effects of flavanol-rich cocoa on dermal microcirculation. High flavanol cocoa significantly increased dermal blood flow and oxygen saturation, while low flavanol cocoa did not show significant changes.

PubMedRead on PubMed
2005·European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·John Lekakis, Loukianos S Rallidis, Ioanna Andreadou, et al

Polyphenolic compounds from red grapes acutely improve endothelial function in patients with coronary heart disease.

RCTn = 30Heart Health

RCT with 30 male patients with coronary heart disease, testing the effect of red grape polyphenol extract on endothelial function. The extract significantly improved flow-mediated dilatation compared to placebo, suggesting a positive effect on endothelial function.

PubMedRead on PubMed
2005·Clinical & developmental immunology·Qin Yan Zhu, Derek D Schramm, Heidrun B Gross, et al

Influence of cocoa flavanols and procyanidins on free radical-induced human erythrocyte hemolysis.

RCTn = 8Immunity

The study investigated the effect of a flavonoid-rich cocoa beverage on human erythrocyte resistance to oxidative stress. Consumption of the beverage reduced susceptibility to free radical-induced hemolysis and increased the lag time for erythrocyte hemolysis, indicating enhanced antioxidant capacity.

PubMedRead on PubMed
2020·Molecules·Fernando Pereyra-Vergara, I. Olivares-Corichi, Adriana Guadalupe Perez-Ruiz, et al

Apoptosis Induced by (−)-Epicatechin in Human Breast Cancer Cells is Mediated by Reactive Oxygen Species

In vitro

The study investigates the anticancer effects of (−)-epicatechin in breast cancer cells, showing that it decreases cell viability and induces apoptosis through increased ROS production and modulation of pro-apoptotic proteins. The mechanism involves both death receptor pathways and intrinsic pathways depending on the cell type.

Semantic ScholarRead on Semantic Scholar
2012·Pharmacological research·S Saha, W Hollands, P W Needs, et al

Human O-sulfated metabolites of (-)-epicatechin and methyl-(-)-epicatechin are poor substrates for commercial aryl-sulfatases: implications for studies concerned with quantifying epicatechin bioavailability.

Study

The study investigates the hydrolysis of epicatechin and methylepicatechin sulfates using commercial sulfatases, finding that these metabolites are poor substrates for the enzymes. This suggests that previous studies may have underestimated epicatechin bioavailability due to incomplete hydrolysis of its conjugates.

PubMedRead on PubMed
2020·Molecules (Basel, Switzerland)·Xinyu Zhao, Ruyi Chen, Yueyue Shi, et al

Antioxidant and Anti-Inflammatory Activities of Six Flavonoids fromRoxb.

In vitroInflammation

In vitro study isolating and evaluating six flavonoids from a standardized flavonoid extract for antioxidant and anti-inflammatory activities. (-)-Epicatechin, astilbin, neoastilbin, isoastilbin, and neoisoastilbin showed strong antioxidant activities, and all six flavonoids significantly inhibited cytokine secretion and NF-κB expression in LPS-stimulated RAW264.7 cells.

PubMedRead on PubMed
2020·Critical Reviews in Food Science and Nutrition·Zhihao Qu, Ailing Liu, Penghui Li, et al

Advances in physiological functions and mechanisms of (−)-epicatechin

ReviewInflammation Physical Performance Heart Health Brain Health Longevity

This narrative review discusses the physiological functions and mechanisms of (−)-epicatechin (EC), highlighting its anti-oxidant and anti-inflammatory activities, enhancement of muscle performance, improvement of cardiovascular and cerebrovascular symptoms, diabetes prevention, and nervous system protection. It provides a theoretical basis for future research on EC.

Semantic ScholarRead on Semantic Scholar
2019·Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie·S. Shariati, H. Kalantar, M. Pashmforoosh, et al

Epicatechin protective effects on bleomycin-induced pulmonary oxidative stress and fibrosis in mice.

Animal studyInflammation

Animal study evaluating the effect of epicatechin on oxidative stress, inflammation, and pulmonary fibrosis induced by bleomycin in mice. Epicatechin showed protective effects against pulmonary injury in a dose-dependent manner, reducing oxidative stress and inflammation.

Semantic ScholarRead on Semantic Scholar
2019·Heliyon·O. Afolabi, F. A. Aderibigbe, Dasola Teslim Folarin, et al

Oxidative stress and inflammation following sub-lethal oral exposure of cypermethrin in rats: mitigating potential of epicatechin

Animal studyInflammation

The study evaluated the protective efficacy of epicatechin against oxidative stress and inflammation induced by cypermethrin exposure in rats. Epicatechin administration mitigated the oxidative and inflammatory effects caused by cypermethrin, suggesting its potential to attenuate toxic effects.

Semantic ScholarRead on Semantic Scholar
2017·Redox Biology·E. Cremonini, Ziwei Wang, Ahmed Bettaieb, et al

(-)-Epicatechin protects the intestinal barrier from high fat diet-induced permeabilization: Implications for steatosis and insulin resistance

Animal studyGut Health Inflammation Nutrition

The study investigated the effects of dietary (-)-epicatechin supplementation on intestinal barrier protection against high fat diet-induced permeabilization and endotoxemia in male C57BL/6J mice. Epicatechin supplementation mitigated adverse effects such as increased intestinal permeability, steatosis, and insulin resistance by modulating cell signals and gut hormone GLP-2, preventing NOX1/NOX4 upregulation, protein oxidation, and activation of redox-sensitive pathways.

Semantic ScholarRead on Semantic Scholar
2016·Scientific Reports·Javier I. Ottaviani, G. Borges, Tony Y. Momma, et al

The metabolome of [2-14C](−)-epicatechin in humans: implications for the assessment of efficacy, safety, and mechanisms of action of polyphenolic bioactives

Observationaln = 8

The study investigated the absorption, distribution, metabolism, and excretion (ADME) of [2-14C](−)-epicatechin in humans. It found that 82% of ingested epicatechin was absorbed, identified over 20 metabolites, and highlighted the gut microbiome's role in its metabolism. Species-dependent differences in metabolism were noted, impacting the assessment of epicatechin's safety and efficacy.

Semantic ScholarRead on Semantic Scholar
2016·Redox Biology·P. Prince, Laura Fischerman, J. Toblli, et al

LPS-induced renal inflammation is prevented by (−)‐epicatechin in rats

Animal studyInflammation

This study investigated the ability of (−)-epicatechin to prevent renal damage induced by LPS in rats. Supplementation with (−)-epicatechin prevented adverse effects of LPS challenge by inhibiting TLR4 upregulation and NOX activation, reducing inflammation and oxidative stress markers.

Semantic ScholarRead on Semantic Scholar
2014·Arteriosclerosis, Thrombosis, and Vascular Biology·M. Morrison, J. W. V. Hoorn, R. Heijden, et al

Abstract 441: Epicatechin Attenuates Atherosclerosis and Exerts Anti-inflammatory Effects on Diet-Induced Human CRP and NfκB in vivo

Animal studyHeart Health Inflammation

The study investigated the effects of the flavanol epicatechin on diet-induced atherosclerosis in ApoE*3Leiden mice. Epicatechin reduced atherosclerotic lesion area by 27% and mitigated diet-induced increases in inflammatory markers such as plasma SAA and human-CRP. It also showed anti-inflammatory activity in the vessel wall, providing a rationale for its anti-atherogenic effects.

Semantic ScholarRead on Semantic Scholar
2008·Molecules·S. Nagarajan, R. Nagarajan, S. Braunhut, et al

Biocatalytically Oligomerized Epicatechin with Potent and Specific Anti-proliferative Activity for Human Breast Cancer Cells

In vitro

The study reports an enzymatic strategy for oligomerizing catechins, specifically epicatechin, to create stable, water-soluble oligomerized epicatechins with enhanced anti-proliferative activity against human breast cancer cells. The oligomerized epicatechins show greater specificity and efficacy compared to EGCG.

Semantic ScholarRead on Semantic Scholar
2006·Journal of cardiovascular pharmacology·Stan Heptinstall, Jane May, Sue Fox, et al

Cocoa flavanols and platelet and leukocyte function: recent in vitro and ex vivo studies in healthy adults.

In vitroHeart Health Inflammation

The paper summarizes two studies on the effects of cocoa flavanols on platelet and leukocyte function. In vitro, cocoa flavanols and their metabolites inhibited platelet aggregation and activation, similar to aspirin. Ex vivo, consumption of a flavanol-rich cocoa beverage by healthy adults also inhibited platelet and leukocyte activation, suggesting potential cardiovascular benefits.

PubMedRead on PubMed
2019·Journal of Functional Foods·M. Prakash, B. Basavaraj, K. Murthy

Biological functions of epicatechin: Plant cell to human cell health

Review

This narrative review discusses the biological functions of epicatechin, its therapeutic potential, and challenges related to its bioavailability and stability. It also explores the role of nanotechnology in enhancing the bioavailability and biological effects of epicatechin.

Semantic ScholarRead on Semantic Scholar
2018·Journal of Molecular Biomarkers & Diagnosis·Dr Oludare temitope Osuntokun, O. Omotuyi

Bacteriostatic and Bactericidal Mechanism of Novel Compound Isolated from Ethyl Acetate Stem Bark Extract of Spondias mombin Using Biomarker Repressor LexA gene on Escherichia coli and Bacillus subtilis

In vitro

The study investigates the bacteriostatic and bactericidal mechanisms of novel compounds isolated from Spondias mombin stem bark extract against E. coli and B. subtilis. The compounds showed bacteriostatic action on B. subtilis and bactericidal action on E. coli, disrupting the SOS regulon and leading to bacterial cell death.

Semantic ScholarRead on Semantic Scholar
2017·Veterinary World·Layth Abdulmajeed Abdulkhaleq, M. Assi, M. Noor, et al

Therapeutic uses of epicatechin in diabetes and cancer

ReviewNutrition Longevity

This narrative review discusses the therapeutic role of epicatechin, a natural flavonoid found in green tea, in managing diabetes and cancer. It highlights epicatechin's potential to reduce blood glucose levels in diabetic patients and its anticancer effects attributed to antioxidant properties, antiangiogenic activity, and direct cytotoxicity to cancer cells.

Semantic ScholarRead on Semantic Scholar
2016·PLoS ONE·S. Wein, B. Beyer, A. Gohlke, et al

Systemic Absorption of Catechins after Intraruminal or Intraduodenal Application of a Green Tea Extract in Cows

Animal studyn = 11

The study investigated the systemic absorption of catechins from green tea extract in cattle plasma after intraruminal and intraduodenal administration. Intraruminal application resulted in almost no catechins detected in plasma, while intraduodenal administration increased plasma concentrations of certain catechins in a dose-dependent manner.

Semantic ScholarRead on Semantic Scholar
2015·Phytotherapy Research·S. Stohs, D. Bagchi

Antioxidant, Anti‐inflammatory, and Chemoprotective Properties of Acacia catechu Heartwood Extracts

ReviewInflammation Gut Health

Narrative review of Acacia catechu heartwood extracts, highlighting their antioxidant, anti-inflammatory, tissue protectant, antineoplastic, and analgesic activities in animal and cell culture systems. The review notes the need for more human studies on efficacy and safety, despite some evidence of anti-inflammatory effects in osteoarthritis patients.

Semantic ScholarRead on Semantic Scholar
1995·The Journal of pharmacology and experimental therapeutics·Yutaka Matsuoka, H. Hasegawa, S. Okuda, et al

Ameliorative effects of tea catechins on active oxygen-related nerve cell injuries.

Animal studyBrain Health Inflammation

The study investigated the protective effects of tea catechins on nerve cell injuries induced by active oxygen species. Tea catechins, including catechin and epicatechin, protected mouse cerebral nerve cells from glucose oxidase-induced death and improved memory impairment in mice. Catechin and epicatechin also reduced carrageenin-induced edema in rats.

Semantic ScholarRead on Semantic Scholar