The age-related decline in mass, strength and performance of skeletal muscle is associated with loss of independence, falls risk, disability, institutionalization and death.

To determine whether a cocoa supplement enriched in flavonoids can improve plasma markers of oxidative stress and inflammation, physical performance and frailty in middle and older age subjects, we conducted a two-phase, randomized, double blind, clinical trial. The initial study included 60 subjects (55-70 year-old) allocated into placebo (P), highly alkalinized (no-flavonoid; NF) or flavonoid rich natural cocoa (F) beverage groups. The follow-up study included 74 older subjects (65-90 year-old) randomly distributed into NF or F groups. Subjects were instructed to consume the beverages once/day for up to 12-weeks. A comprehensive (aging relevant) set of endpoints were assessed which included mean change in blood plasma metabolic and oxidative stress indicators, in physical performance tests and quality of life (QoL).

In the initial study, the F group showed improved glycemia, triglyceridemia (TG), c-HDL, c-LDL, the TG/HDL index, and oxidative markers. Performance on the Up & Go test, skeletal muscle index, and QoL also improved. In the follow-up study, F treatment was associated with significant improvements in metabolic, oxidative stress and inflammatory endpoints and positive effects on physical performance, frailty indicators and QoL (F vs. NF group).