Cocoa extract may slow aging, lower heart disease death risk in new study
Brigham and Women’s COSMOS trial finds declines in inflammatory marker hsCRP and a reduced cardiovascular death risk among cocoa supplement users
New results from Brigham and Women’s Hospital’s COSMOS trial suggest cocoa extract supplements may slow aging-related inflammation and trim the risk of death from cardiovascular disease, the leading cause of death in the United States. In a two-year analysis of 598 participants aged 60 and older, researchers found that levels of hsCRP, a protein linked to heart-disease risk, fell by 8.4% per year in those taking cocoa extract compared with a placebo. The improvement in this inflammatory marker could help explain the cardiovascular benefits observed in a larger COSMOS analysis, where cocoa extract users had about a 27% lower chance of dying from cardiovascular disease.
Three pro-inflammatory proteins, one anti-inflammatory protein and one immune-mediating protein were tracked in the study. By the end of the two-year follow-up, the scientists reported that hsCRP declined in cocoa users while other markers mostly held steady or rose only marginally.
In addition to hsCRP, researchers noted shifts in other inflammaging markers. Interferon-γ, an immune-related cytokine, rose over the period, a finding that raises new questions for future research. IL-6, another pro-inflammatory protein, declined in women but not in men, a pattern the team said warrants further study as it could point to sex-specific responses to cocoa components.
“This study calls for more attention to the advantage of plant-based foods for cardiovascular health, including cocoa products rich in flavanols,” said Dr. Howard Sesso, the study’s corresponding author and associate director of the Division of Preventive Medicine at Brigham and Women’s Hospital. “It reinforces the importance of a diverse, colorful, plant-based diet — especially in the context of inflammation.”
The COSMOS project aims to determine whether long-term cocoa extract supplementation can modulate inflammaging, the chronic, low-grade inflammation that accelerates aging and raises the risk of many chronic diseases. The current analysis represents one piece of a larger puzzle, with ongoing efforts to see whether cocoa extract regimens can curb more severe aging-related health issues and improve vascular function over time.
“While cocoa extract is not a replacement for a healthy lifestyle, these results are encouraging and highlight its potential role in modulating inflammation as we age,” said Dr. Yanbin Dong, senior author of the study and director of the Georgia Prevention Institute. The team plans to keep analyzing COSMOS data to understand whether cocoa extract can influence other aging-related health outcomes and to identify which populations might benefit most.
Cardiovascular disease remains the top cause of death in the United States. The American Heart Association notes that a heart-related death occurs in roughly 34 seconds, and in 2023, heart disease accounted for about one in three deaths nationwide, underscoring the continued public health importance of preventing and managing cardiovascular risk factors.
The COSMOS investigators emphasize that cocoa’s effects are likely part of a broader pattern linking plant-based foods and vascular health. Cocoa is rich in flavonoids, compounds that have been associated with anti-inflammatory and antioxidant effects in prior research. The current findings add to a growing body of evidence suggesting that dietary strategies centered on anti-inflammatory foods may complement medical care in aging populations.
As the study team continues to parse the data, researchers caution that cocoa extract should not be viewed as a stand-alone solution. Maintaining regular physical activity, controlling blood pressure and lipids, avoiding tobacco use and following a balanced diet remain central to reducing aging-related disease risk. The ongoing COSMOS work will aim to clarify how cocoa-derived flavanols interact with other lifestyle factors to influence inflammaging and heart health over longer periods.
In summarizing the implications, researchers stressed that benefits observed with cocoa extract need confirmation across diverse populations and settings, and they reiterated that the best approach to aging healthily combines a plant-forward diet with proven lifestyle measures. Future analyses will test whether cocoa supplementation can further reduce inflammaging biomarkers and translate into measurable reductions in other aging-related health outcomes across broader demographics.
References to the study indicate that inflamed pathways contribute to vascular stiffening and atherosclerosis, and the cocoa-derived modulation of these pathways could be a meaningful, if modest, component of cardiovascular risk management for older adults. The researchers are hopeful that continued investigation will illuminate how such dietary strategies can complement pharmacological interventions and public health efforts to reduce the burden of heart disease as the population ages.