Cocoa Flavanols in Healthy Aging: Mechanistic Insights and Clinical Evidence

Abstract: Cocoa flavanols have increasingly been investigated as potential modulators of biological processes related to aging. This review critically appraises the current experimental and clinical evidence on the role of cocoa polyphenols in regulating oxidative stress, vascular function, and inflammation. Modest improvements in endothelial function and some inflammatory biomarkers were demonstrated in randomized controlled trials, but clinical importance remains unclear given heterogeneity in study design, dosage, and outcome measures. Mechanistically, cocoa flavanols are associated with nitric oxide signalling, mitochondrial function, and redoxsensitive pathways, but most of this evidence is derived from preclinical studies. Furthermore, variability in flavanol composition, short study duration, and reliance on surrogate endpoints limit translational applicability. Overall, cocoa flavanols demonstrate promising biological activity, but solid, standardized, and long-term clinical studies are needed to define their role in healthy aging.