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Blood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trial

Jaime Andres Mogollon1, Emmanuel Bujold2, Simone Lemieux3, Mélodie Bourdages5, Claudine Blanchet1, Laurent Bazinet3, Charles Couillard3, Martin Noël4 and Sylvie Dodin16*

Author affiliations

1 St. François d’Assise Hospital, Centre hospitalier universitaire de Québec (CHUQ), Quebec, Canada

2 Reproductive Biology Research Center, Research Center, Centre hospitalier de l'Université Laval (CHUL)-CHUQ, Quebec, Canada

3 Department of Food Sciences and Nutrition, Institute of Nutraceuticals and Functional Foods (INAF), Université Laval, Quebec, Canada

4 Public Health Research Center, CHUQ, Quebec, Canada

5 Institute of Nutraceuticals and Functional Foods (INAF), Université Laval, Quebec, Canada

6 Department of Obstetrics and Gynecology, Research Center, St. François d’Assise Hospital (CHUQ), Université Laval, Québec, QC, G1L 3 L5, Canada

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Citation and License

Nutrition Journal 2013, 12:41  doi:10.1186/1475-2891-12-41

Published: 8 April 2013



Several randomized clinical trials (RCTs) indicate that flavanol-rich chocolate has beneficial effects on flow-mediated dilation (FMD) and blood pressure (BP). However, no RCTs have evaluated these outcomes in pregnant women. The objective of this 2-group, parallel, double-blind RCT was to examine the effects of flavanol-rich chocolate on FMD and BP in pregnant women with normal BP.


Forty-four healthy, pregnant women were randomized to the high-flavanol (n = 23) or low-flavanol (n = 21) chocolate consumption for 12 weeks. At randomization (0, 60, 120 and 180 min after a single 40-g dose of chocolate), 6 and 12 weeks after daily 20-g chocolate intake, we evaluated plasma concentrations of flavanols and theobromine, as well as the FMD and BP.


Plasma epicatechin was significantly increased (p < 0.001) 180 min after the consumption of 40-g high-flavanol chocolate compared to low-flavanol chocolate. Theobromine concentrations were significantly higher 180 min and 12 weeks after the intake of experimental chocolate or low-flavanol chocolate (p < 0.001). FMD was not different between the 2 groups at all pre-defined time periods. No other significant within-group or between-group changes were observed.


These results confirm the feasibility of a large-scale RCT comparing daily consumption of flavanol-rich chocolate to an equivalent placebo during pregnancy and demonstrate higher plasma epicatechin and theobromine concentration in the intervention group after acute ingestion

Trial registration Identifier: NCT01659060

Cacao; Chocolate; Theobromine; Flavanols; Pregnant women; Hypertension; Pregnancy-induced; Preeclampsia; Epicatechin