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This study analyzes the effects on body composition and variables related to metabolic syndrome of two coffees with different degree of roasting and phenolic content. Sixty participants with body mass index between 25 and 35 kg/m2 and a median age of 51.0 years (Interquartile range 46.3–56) were recruited. The study was a controlled, randomized, single-blind crossover trial consisting in drinking three cups/day of roasted coffee (RC) or lightly roasted coffee (LRC) during 12 weeks with 2-week wash-out stages before each coffee intervention. LRC contained ≈400 mg of hydroxycinnamic acids and ≈130 mg of caffeine per 200 mL/cup while RC contained ≈150 mg of hydroxycinnamic acids and ≈70 mg of caffeine per 200 mL/cup. Along the study, in each of the six visits, blood pressure, body composition by bioimpedance, anthropometric measurements, and blood biochemistry were analyzed. The mean differences and p values were calculated using a linear mixed model (JASP.v.0.18.0.3). A total of 38 participants completed the study. After the consumption of both coffees, fat mass and body fat percentage (LRC: −1.4%, p < 0.001; RC: −1.0%, p = 0.005) were reduced, whereas muscle mass and muscle mass percentage slightly increased (LRC: 0.8%, p < 0.001; RC: 0.7%, p = 0.002). The decrease in fat percentage was greater with LRC compared to RC (−0.8%; p = 0.029). There were no significant changes in metabolic syndrome variables or in body weight. In conclusion, LRC was slightly superior at inducing changes in body composition.

Obesity is a worldwide epidemic, making it crucial to understand how it can be effectively prevented/treated. Considering that obesity is a multifactorial condition, this article carried out a baseline cross-sectional study of the variables involved in the disorder. Eighty-four subjects with overweight/obesity were recruited. Dietary baseline information was obtained by analysing three 24 h recalls. Resting metabolic rate was measured using indirect calorimetry, physical activity was measured through accelerometry, cardiometabolic parameters were determined in blood samples and body composition via anthropometry and bioimpedance. A univariant and multivariate exploratory approach was carried out using principal component analysis (PCA). Large inter-individual variability was observed in dietetic, biochemical, and physical activity measurements (coefficient of variation ≥ 30%), but body composition was more uniform. Volunteers had an unbalanced diet and low levels of physical activity. PCA reduced the 26 analysed variables to 4 factors, accounting for 65.4% of the total data variance. The main factor was the “dietetic factor”, responsible for 24.0% of the total variance and mainly related to energy intake, lipids, and saturated fatty acids. The second was the “cardiometabolic factor” (explaining 16.8% of the variability), the third was the “adiposity factor” (15.2%), and the last was the “serum cholesterol factor” (9.4%).

Obesity is coupled with an altered redox state and low-level inflammation. Oxidative stress may increase pre-adipocyte proliferation, adipocyte differentiation and mature adipocyte size. Regarding inflammation, the dysregulation of cytokine production by adipose tissue takes place in obesity, which is promoted by oxidative stress. Polyphenols may exert a positive effect on obesity, not only by modulating the redox state, but also due to their anti-inflammatory activity. Coffee, which is one of the most consumed beverages, is very rich in phenolic compounds. Bioavailability studies on coffee phenols have shown that the most abundant group of metabolites in plasma and urine are dihydrocaffeic (DHCA), dihydroferulic (DHFA), and hydroxyhippuric (HHA) acids, the three acids of colonic origin. To better understand the antioxidant and anti-inflammatory properties of DHCA, DHFA, and HHA, an inflammation/oxidation model was set up in the pre-adipocyte 3T3-L1 cell line using tumor necrosis factor-α (TNF-α). After the exposure of 3T3-L1 cells to 0.5, 1, 5, and 10 µM of TNF-α at different times, the cell viability, interleukin (IL)-6 secretion, and the production of reactive oxygen species (ROS) and glutathione (GSH) were determined. Using the TNF-α prooxidant and proinflammatory conditions established (10 µM, 24 h), it was observed that the physiological concentrations (0.5, 1, 5, and 10 µM) of DHCA, DHFA, and HHA induced dose-dependent antioxidant effects according to the ROS, GSH, and antioxidant enzyme (glutathione peroxidase) results. In addition, reductions in the IL-1β, IL-6, and monocyte chemoattractant protein-1 (MCP-1) concentrations were observed to different extents depending on the metabolite (DHFA, HHA, or DHCA) and the concentration used. In conclusion, the main colonic metabolites from coffee chlorogenic acids may counteract TNF-α-induced inflammation and oxidative stress in the 3T3-L1 cell line, and thus, they present antiobesity potential.

Obesity has reached pandemic proportions and has become a major health concern worldwide. Therefore, it is necessary to find new strategies against this condition and its associated comorbidities. Green coffee polyphenols (GCP) and oat beta-glucans (BGs) have proven their hypolipidaemic and hypoglycaemic effects. This study aimed to examine the effects of the long-term consumption of supplements containing GCP, BG or the novel GCP/BG combination on lipid and glucose metabolism biomarkers in overweight/obese subjects who maintained their dietary habits and physical activity, hence addressing the difficulty that this population faces in adapting to lifestyle changes. A randomised, crossover, blind trial was carried out in 29 volunteers who consumed either GCP (300 mg), BG (2.5 g) or GCP/BG (300 mg + 2.5 g) twice a day for 8 weeks. Blood samples were collected, and blood pressure and body composition were measured at the beginning and end of each intervention. Total cholesterol, triglycerides, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), very low-density lipoprotein (VLDL-C) cholesterol, glycated haemoglobin, fasting glucose, insulin, aspartate transaminase, alanine transaminase and different hormones and adipokines were analysed. Only VLDL-C (p = 0.01) and diastolic blood pressure (p = 0.027) decreased after the intervention, especially with the BG supplement. There were no other significant changes in the analysed biomarkers. In conclusion, the regular intake of GCP, BG and GCP/BG without lifestyle changes is not an efficient strategy to improve lipid and glucose homeostasis in overweight/obese subjects.

Background: Cytokine profile in patients with primary open-angle glaucoma (POAG) differs from that in healthy controls. Due to the different pathophysiological mechanisms involved in the genesis of primary congenital glaucoma (PCG) and POAG, it is possible that the cytokine profile could also differ. The main objective of this study was to compare the concentrations of cytokines in the aqueous humor of patients with PCG with those of POAG patients and a control group. Methods: A cross-sectional study was conducted. Aqueous humor samples were taken from PCG and POAG patients eligible for glaucoma or cataract surgery and from patients undergoing cataract surgery. Twenty-seven cytokines were analyzed using the Human Cytokine 27-Plex Immunoassay Kit (Bio-Rad Laboratories, Hercules, CA, USA). Results: A total of 107 subjects were included: patients with PCG (n = 19), patients with POAG (n = 54), and a control group (CG) of patients undergoing cataract surgery (n = 34). Most cytokines measured in aqueous humor in PCG presented decreased values compared with POAG and controls. A statistically significant difference was observed in IL-1ra, IL-2, IL-5, IL-7, IL-8, IL-10, IL-12, IL-15, IL-17A, Eotaxin, FGF basic, G-CSF, GM-CSF, IFN-γ, MIP-1α, PDGF-bb, MIP-1β, RANTES, TNF-α, and VEGF. Conclusion: PCG patients have a cytokine profile in aqueous humor different from POAG patients and patients without glaucoma, characterized by lower concentrations of multiple cytokines.

Vegetarian foods are plant-based (PB) foods, often perceived as healthier foods than animal-based (AB) foods. The objective of this study was to analyze the nutritional quality of a set of PB foods (meat, milk and dairy products) marketed in Spain, and to compare their nutrient profiles with respect to some AB counterparts. Nutritional information per 100 g or mL, ingredients, and nutritional declarations, as well as the Nutri-Score, NOVA, and Eco-Score of each food were collected from Open Food Facts. Differences in the nutrient compositions between PB foods and their counterparts, and between the different groups of PB foods, were assessed at a 5% significance level. A total of 544 PB foods and 373 AB foods were identified. Overall, PB foods had a higher median content of fiber and carbohydrates, but a lower amount of proteins (except PB “meat” analogues: 14 g) and saturated fats (except PB “cheese alternatives”: 12.5 g), than the AB counterparts (p < 0.05). PB “milk alternatives”, particularly oat “milk”, showed a higher median content of total carbohydrates (8 g) and sugars (5.5 g) compared to cow milks (4.7 g carbohydrates/sugars, on average; p < 0.001). PB “meat alternatives” also had a significantly higher value of carbohydrates (9 g) than AB meats (2 g, on average; p < 0.001). PB foods were mostly classified as Nutri-Score A and B (86%). However, more than half of them were of NOVA groups 3 and 4. Thus, there is a great diversity of PB meat and milk/dairy product alternatives on the Spanish market. Despite being products of good nutritional quality compared to AB foods, they also carry drawbacks that could have an impact on nutritional health.

Coffee presents beneficial health properties, including antiobesity effects. However, its effects on inflammation are controversial. Hydroxycinnamic acids are the main coffee phenolic bioactive compounds. In human bioavailability studies carried out with coffee, among the most abundant compounds found in urine and plasma were the colonic metabolites, dihydrocaffeic (DHCA), dihydroferulic (DHFA), and hydroxyhippuric (HHA) acids. To understand the hepato-protective potential of these three compounds, we tested whether treatment with realistic concentrations (0.5–10 µM) were effective to counteract inflammatory process and oxidative status induced by tumor necrosis factor α (TNF-α). First, we established a novel model of inflammation/oxidation using TNF-α and HepG2 cells. Afterwards, we evaluated the activity of DHCA, DHFA, and HHA against the inflammatory/oxidative challenge through the determination of the inflammatory mediators, interleukins (IL)-6, and IL-8 and chemokines, monocyte chemoattractant protein-1, and macrophage inflammatory protein-1, as well as the levels of biomarkers of oxidative stress, such as reactive oxygen species, reduced glutathione, and the antioxidant enzymes glutathione peroxidase and reductase. Results showed that all three compounds have a potential hepato-protective effect against the induced inflammatory/oxidative insult.

Introducción. Este trabajo reúne información preliminar sobre un proyecto cuya hipótesis es que la inclusión de errores en algunos temas por parte del profesor induce a los alumnos a buscarlos, localizarlos, discutirlos y conocerlos, llevando a un mejor conocimiento de la asignatura y por tanto a adquirir las competencias que marca el Plan Bolonia. Métodos. El proyecto que se concibió para aplicar un método basado en el error, pero con potenciación mediante gamificación en cinco asignaturas de tres grados de la Universidad Complutense de Madrid. A causa de la pandemia COVID-19 se tuvieron que modificar algunos objetivos planificados al solicitar la concesión del proyecto, obteniéndose datos objetivos, muchos aun sin evaluar totalmente, de dos asignaturas. Un 10% de los temas explicados tenían errores. Se hicieron evaluaciones con la plataforma Kahoot! y mediante cuestionarios tipo test. Las preguntas tenían cuatro posibles respuestas, de las que solo una era cierta. Se realizaron además un examen parcial liberatorio y un examen final donde se ubicaron preguntas de los temas con errores y sin errores. Resultados. Aunque muchos datos están aún siendo evaluados estadísticamente para conocer el grado de contribución de los temas con errores respecto a sin errores, así como de la gamificación, los resultados sugieren una nota superior y del orden de un 8,2% en los temas con errores. Estas diferencias fueron mucho mayores en el caso de los alumnos de Farmacia (15%, p

Background: olive pomace oil (OPO) is a nutritionally relevant fat due to its high oleic acid content (C18:1) and the presence of a wide range of minor bioactive components. Although numerous in vitro and preclinical studies have been developed to study some of its characteristic components, the health effect of prolonged OPO consumption is unknown. Methods: a randomised, blinded, cross-over, controlled clinical trial was carried out in 31 normocholesterolemic and 37 hypercholesterolemic subjects. Participants consumed 45 g/day of OPO or sunflower oil (SO) for 4 weeks, each preceded by a 3-week run-in/wash-out phase with corn oil (CO). Results: regular consumption of OPO and SO had no statistically significant effect on any of the markers related to lipid profile, blood pressure, and endothelial function in both groups, except for eNOS levels, which were close to statistical significance due to the effect of oil (OPO and SO) (p = 0.083). A decrease in visceral fat (p = 0.028) in both groups was observed after OPO intake, accompanied by an increment of leptin (p = 0.017) in the hypercholesterolemic group. Conclusion: reducing visceral fat after prolonged OPO intake might contribute to improve cardiometabolic status, with a potentially positive effect on the vascular tone. Further clinical trials are needed to confirm the present results.

Olive pomace oil (OPO) is mainly a source of monounsaturated fat together with a wide variety of bioactive compounds, such as triterpenic acids and dialcohols, squalene, tocopherols, sterols and aliphatic fatty alcohols. To date, two long-term intervention studies have evaluated OPO’s health effects in comparison with high oleic sunflower oil (HOSO, study-1) and sunflower oil (SO, study-2) in healthy and cardiovascular risk subjects. The present study integrates the health effects observed with the three oils. Two randomized, blinded, cross-over controlled clinical trials were carried out in 65 normocholesterolemic and 67 moderately hypercholesterolemic subjects. Each study lasted fourteen weeks, with two four-week intervention phases (OPO versus HOSO or SO), each preceded by a three-week run-in or washout period. Regular OPO consumption reduced total cholesterol (p = 0.017) and LDL cholesterol (p = 0.018) levels as well as waist circumference (p = 0.026), and only within the healthy group did malondialdehyde (p = 0.004) levels decrease after OPO intake versus HOSO. Contrarily, after the SO intervention, apolipoprotein (Apo) B (p < 0.001) and Apo B/Apo A ratio (p < 0.001) increased, and to a lower extent Apo B increased with OPO. There were no differences between the study groups. OPO intake may improve cardiometabolic risk, particularly through reducing cholesterol-related parameters and waist circumference in healthy and hypercholesterolemic subjects.

Knowledge on the bioavailability of coffee (poly)phenols mostly come from single dose postprandial studies. This study aimed at investigating the effects of regularly consuming a green coffee phenolic extract (GCPE) on the bioavailability and metabolism of (poly)phenols. Volunteers with overweight/obesity consumed a decaffeinated GCPE nutraceutical containing 300 mg hydroxycinnamates twice daily for two months. Plasma and urinary pharmacokinetics, and fecal excretion of phenolic metabolites were characterized by LC-MS-QToF at weeks 0 and 8. Fifty-four metabolites were identified in biological fluids. Regular consumption of the nutraceutical produced certain changes: reduced forms of caffeic, ferulic and coumaric acids in urine or 3-(3′-hydroxypenyl)propanoic, and 3,4-dihydroxybenzoic acids in feces significantly increased (p < 0.05) after 8 weeks; in contrast, coumaroylquinic and dihydrocoumaroylquinic acids in urine decreased (p < 0.05) compared to baseline excretion. The sum of intestinal and colonic metabolites increased after sustained consumption of GCPE, without reaching statistical significance, suggesting a small overall effect on (poly)phenols’ bioavailability.

Many in vitro and in vivo studies support that green coffee polyphenols (GCP) and beta-glucans (BG) present important hypolipidaemic and hypoglycaemic effects. However, their weight-management/-reducing properties are less clear. Considering that these compounds act on different metabolic pathways, their combination could increase their beneficial health effects. The aim of the present study was to investigate the effects of regularly consuming supplements containing GCP, BG or the novel GCP/BG combination on body composition in overweight/obese subjects without changing their dietary and physical activity habits, hence addressing the difficulty to adapt to lifestyle changes. A randomised, cross-over, blind trial was carried out in 29 volunteers who consumed GCP (300 mg), BG (2.5 g) or GCP/BG (300 mg + 2.5 g) twice a day for 8 weeks. At the beginning and end of each of the interventions, body weight, body mass index, body fat%, intracellular and extracellular water, skinfolds (tricipital, bicipital, subscapularis, suprailiac, leg and thigh) and body circumferences (waist, hip, thigh, calf, branchial) were measured. Along the study, volunteers filled out 72 h dietary records, and physical activity was measured using accelerometers. The results show that dietary intake and physical activity were unchanged throughout the study; however, there were no changes in any of the body composition parameters analysed with any of the food supplements. In conclusion, the regular intake of GCP, BG and GCP/BG, without changes in diet and physical activity, is not an efficient strategy to lose weight or induce other positive changes in body composition, although results should be taken with caution as the study was underpowered.

Background In many cocoa intervention studies, health outcomes are related to cocoa components without taking into account the bioavailability of the main bioactive components: phenolic compounds and methylxanthines. Methods The present work associates the results of bioavailability and randomised controlled crossover studies in humans carried out with similar cocoa products, so that the main phenol and methylxanthine metabolites observed in plasma and urine are associated to the health effects observed in the chronic studies. We outstand that doses of cocoa and consumption rate used are realistic. In the bioavailability study, a conventional (CC) and a methylxanthine-polyphenol rich (MPC) cocoa product were used, whereas in the chronic study a dietary fibre-rich (DFC) and a polyphenol-rich (PC) product were studied in healthy and cardiovascular risk subjects. Results and Discussion The main phenolic metabolites formed after CC and MPC intake, 5-(4′-hydroxyphenyl)-γ-valerolactone-3′-sulfate, 3′-methyl-epicatechin-5-sulfate, 4-hydroxy-5-(4′-hydroxyphenyl)valeric acid-sulfate, 5-phenyl-γ-valerolactone--sulfate and 5-(4′-hydroxyphenyl)-γ-valerolactone-3′-glucuronide, may contribute to the changes in cholesterol (and indirectly HDL-cholesterol) observed after the regular intake of both DFC and PC, in healthy and cardiovascular risk subjects, whereas 7-methylxanthine (the main cocoa methylxanthine metabolite) and theobromine, together with its content in insoluble dietary fibre, may be responsible for the decrease of IL-1β and hypoglycemic effects observed with DFC. With both phenolic and methylxanthine metabolites a strong dose–response effect was observed. Conclusion After the regular consumption of both DFC and PC, positive changes were observed in volunteer’s lipid profile, which may be related to the long-lasting presence of colonic phenolic metabolites in blood. In contrast, the anti-inflammatory and hypoglycemic effects were only observed with DFC, and these may be related to methylxanthine metabolites, and it is likely that insoluble dietary fibre may have also played a role.

Green coffee has weight management properties, yet its effects on appetite and satiety remain unclear as few, mainly acute, studies perform objective measurements. Therefore, the influence on appetite/satiety of acute and regular consumption of two nutraceuticals, a decaffeinated green coffee phenolic extract (GC) alone or combined with oat β-glucans (GC/BG), with known satiating properties, has been analysed subjectively using visual analog scales (VAS) and objectively measuring actual food intake and postprandial appetite and satiety hormones. A randomised, cross-over, blind trial was carried out in 29 overweight volunteers who consumed GC or GC/BG twice a day for 8 weeks. After acute (day = 0) and regular consumption (day = 56) of the nutraceuticals, satiety was measured at 30, 60, 90, 150, and 210 min, as well as food intake at breakfast (30 min) and lunch (300 min). Additionally, in a subgroup of participants (n = 9), cholecystokinin, peptide-YY, glucagon-like-peptide-1, ghrelin and leptin concentrations were analysed in blood samples taken at the same time-points. According to VAS results, GC/BG reduced hunger more efficiently than GC. However, there were no statistically significant differences in food intake. Comparing the effects of the acute consumption of GC/BG and GC, leptin concentration at 150 min was higher after GC/BG intake vs. GC. Moreover, when comparing the effects of regularly consuming the two nutraceuticals, maximum ghrelin level decreased with GC/BG vs. GC. In conclusion, acute and regular effects of the nutraceuticals on appetite/satiety differed, and subjective and objective results partially agreed; GC/BG may reduce hunger more efficiently than GC.

In previous studies, after regularly consuming a green/roasted coffee blend, body weight, body fat%, glucose, plasminogen activator inhibitor-1 (PAI-1), resistin, leptin, ghrelin, diastolic (DBP) and systolic blood pressure (SBP) significantly changed in healthy and hypercholesterolemic subjects. However, glucagon, total-cholesterol (T-C), triglycerides (TG), LDL-cholesterol (LDL-C) and Homeostasis Model Assessment index to estimate insulin resistance (HOMA-IR) only changed in the hypercholesterolemics. This work looks into the antiobesity effects of coffee blend and into the relationship of antiobesity with the aforementioned cardiometabolic modifications in hypercholesterolemics. (1) Methods: Tricipital and subscapular skinfolds, hip, thigh, arm and waist circumference (WC) were measured in normocholesterolemic and hypercholesterolemics. To understand the relationship between cardiometabolic and antiobesity results in hypercholesterolemics, factor analysis was carried out using baseline values of the variables that changed. (2) Results: WC, WC/hip and WC/height showed significant coffee×group interaction, and in hypercholesterolemics tended to decrease. After factor analysis, three factors emerged, accounting for 29.46, 13.13 and 11.79% of variance. Only factor 1 (main loadings: WC, DBP and SBP, body weight, WC/hip and WC/height ratios, TG and ghrelin, inversely) decreased after coffee intake. (3) Conclusion: Regularly consuming green/roasted coffee may help to control body weight, and in hypercholesterolemics, may reduce cardiovascular risk by reducing abdominal adiposity and blood pressure.

A series of alkyl nitrohydroxytyrosyl ether derivatives has been synthesized from free hydroxytyrosol (HT), the natural olive oil phenol, in order to increase the assortment of compounds with potential neuroprotective activity in Parkinson’s disease. In this work, the antioxidant activity of these novel compounds has been evaluated using Ferric Reducing Antioxidant Power (FRAP), 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), and Oxygen Radical Scavenging Capacity (ORAC) assays compared to that of nitrohydroxytyrosol (NO2HT) and free HT. New compounds showed variable antioxidant activity depending on the alkyl side chain length; compounds with short chains (2–4 carbon atoms) maintained or even improved the antioxidant activity compared to NO2HT and/or HT, whereas those with longer side chains (6–8 carbon atoms) showed lower activity than NO2HT but higher than HT.

Chronic inflammation has been identified as a necessary step to mediate atherosclerosis and cardiovascular disease and as a relevant stage in the onset and progression of several types of cancer. Considerable attention has recently been focused on the identification of dietary bioactive compounds with anti-inflammatory activities as an alternative natural source for prevention of inflammation-associated diseases. The remarkable capacity of cocoa flavanols as antioxidants, as well as to modulate signaling pathways involved in cellular processes, such as inflammation, metabolism and proliferation, has encouraged research on this type of polyphenols as useful bioactive compounds for nutritional prevention of cardiovascular disease and cancer. Data from numerous studies suggest that cocoa and cocoa-derived flavanols can effectively modify the inflammatory process, and thus potentially provide a benefit to individuals with elevated risk factors for atherosclerosis/cardiovascular pathology and cancer. The present overview will focus on the most recent findings about the effects of cocoa, its main constituents and cocoa derivatives on selected biomarkers of the inflammatory process in cell culture, animal models and human cohorts.

This review collects and critically examines data on the levels of tumour necrosis factor-alpha (TNF-α) in lean, overweight and obese subjects, and the effects of intervention with different foods and food products containing bioactive constituents in overweight/obese individuals. We additionally explore the influence of different single nucleotide polymorphisms (SNPs) on TNF-α levels and compare the response to food products with that to some anti-obesity drugs. Our aim was to provide an overview of the variability, consistency, and magnitude of the reported effects of dietary factors on TNF-α, and to envisage the reliability of measuring changes in the levels of this cytokine as a biomarker responsive to food intervention in association with the reduction in body weight. Regarding the circulating levels of TNF-α, we report: (i) a large intra-group variability, with most coefficients of variation (CV%) values being ≥30% and, in many cases, >100%; (ii) a large between-studies variability, with baseline TNF-α values ranging from

Cocoa has beneficial health effects partly due to its high flavanol content. This study was aimed at assessing the absorption and metabolism of polyphenols in two soluble cocoa products: a conventional (CC) and a flavanol-rich product (CC-PP). A crossover, randomized, blind study was performed in 13 healthy men and women. On two different days, after an overnight fast, volunteers consumed one serving of CC (15 g) or CC-PP (25 g) in 200 mL of semi-skimmed milk containing 19.80 mg and 68.25 mg of flavanols, respectively. Blood and urine samples were taken, before and after CC and CC-PP consumption, and analyzed by high-performance liquid chromatography coupled to electrospray ionisation and quadrupole time-of-flight mass spectrometry (HPLC-ESI-QToF-MS). Up to 10 and 30 metabolites were identified in plasma and urine, respectively. Phase II derivatives of epicatechin were identified with kinetics compatible with small intestine absorption, although the most abundant groups of metabolites were phase II derivatives of phenyl-γ-valerolactone and phenylvaleric acid, formed at colonic level. 5-(4′-Hydroxyphenyl)-γ-valerolactone-sulfate could be a sensitive biomarker of cocoa flavanol intake. CC and CC-PP flavanols showed a dose-dependent absorption with a recovery of 35%. In conclusion, cocoa flavanols are moderately bioavailable and extensively metabolized, mainly by the colonic microbiota.