Cocoa-flavanols enhance moderate-intensity pulmonary V̇O2 kinetics but not exercise tolerance in sedentary middle-aged adults: A randomised controlled trial

Background: Cocoa flavanols (CF) may exert health benefits through their potent vasodilatory effects which are perpetuated by elevations in nitric oxide (NO) bioavailability. These vasodilatory effects may contribute to improved delivery of blood and oxygen to exercising muscle.Objective: Therefore, the objective of this study was to examine how CF supplementation impacts pulmonary oxygen uptake (V̇O2) kinetics and exercise tolerance in sedentary middle-aged adults.Methods: We employed a double-blind cross-over, placebo-controlled design whereby 17 participants (11 male, 6 female; mean±SD, 45±6 years) randomly received either 7 days of daily CF (400 mg) or placebo (PL) supplementation. On day 7, participants completed a series of ‘step’ moderate- and severe-intensity exercise tests for the determination of oxygen uptake kinetics.Results: During moderate-intensity exercise, the time constant of the fundamental phase of V̇O2 kinetics (τV̇O2) was decreased by 15% in CF as compared to PL (mean±SD; PL: 40±12 vs. CF: 34±9 s, P=0.019), with no differences in the amplitude of V̇O2 (AV̇O2; PL: 0.77±0.32 vs. CF: 0.79±0.34 l min−1, P=0.263). However, during severe-intensity exercise, τV̇O2,the amplitude of the slow component (SCV̇O2) and exercise tolerance (PL: 435±58 vs. CF: 424±47 s, P=0.480) were unchanged between conditions.Conclusions: Our data show that acute CF supplementation enhanced oxygen uptake kinetics during moderate-, but not severe-intensity exercise in middle-aged participants. These novel effects of CFs, in this demographic, may contribute to improved tolerance of moderate-activity physical activities, which appear commonly present in daily life.Registered under ClinicalTrials.gov Identifier no. NCT04370353