Chocolate flavanols and skin photoprotection: a parallel, double-blind, randomized clinical trial

Jaime Andres Mogollon, Catherine Boivin, Simone Lemieux, Claudine Blanchet, Joël Claveau, Sylvie Dodin, Jaime Andres Mogollon, Catherine Boivin, Simone Lemieux, Claudine Blanchet, Joël Claveau, Sylvie Dodin

Abstract

Background: Solar ultraviolet (UV) radiation has deleterious effects on the skin, including sunburn, photoaging and cancer. Chocolate flavanols are naturally-occurring antioxidant and anti-inflammatory molecules that could play a role in preventing cutaneous UV damage. We investigated the influence of 12-week high-flavanol chocolate (HFC) consumption on skin sensitivity to UV radiation, measured by minimal erythema dose (MED). We also evaluated skin elasticity and hydration.

Methods: In this 2-group, parallel, double-blind, randomized controlled trial, 74 women aged 20-65 years and Fitzpatrick skin phototypes I or II were recruited from the general community in Quebec City, for randomization to either HFC (n = 33) or low-flavanol chocolate (LFC) (n = 41). A blocked randomisation (4), considering date of entry, skin type and age as factors, generated a sequentially-numbered allocation list. Study participants and research assistants were blinded. Totally, 30 g of chocolate were consumed daily for 12 weeks, followed by a 3-week washout period. MED was assessed at baseline and at 6, 9, 12 and 15 weeks. Main outcome was changes in MED at week 12.

Results: 33 participants in the HFC group and 41 in the LFC group were analyzed with 15 weeks of follow-up. Both groups showed similarly-increased MED at 12 weeks (HFC: 0.0252 ± 0.1099 J/cm2 [mean ± standard deviation (SD)]; LFC: 0.0151 ± 0.1118; mean difference (MD): 0.0100 J/cm2; 95% confidence interval (CI): -0.0417 to 0.0618). However, after 3-week washout, the HFC group presented decreased MED (-0.0248 ± 0.1145) whereas no effect was seen in the LFC group (0.0168 ± 0.1698) (MD: -0.0417; 95% CI: -0.1106 to 0.0272). Net temple elasticity increased slightly but significantly by 0.09 ± 0.12 mm in the HFC group at 12 weeks compared to 0.02 ± 0.12 mm in the LFC group (MD: 0.06; 95% CI: 0.01 to 0.12 ). No significant adverse events were reported.

Conclusion: Our study failed to demonstrate a statistically-significant protective effect of HFC vs. LFC consumption on skin sensitivity to UV radiation as measured by MED.

Trial registration: ClinicalTrials.gov identifier: NCT01444625.

Figures

Figure 1
Figure 1
Flow diagram of study participation. *1 participant withdrew voluntarily from the study at week 9, but accepted to return at week 12.
Figure 2
Figure 2
Mean MED differences within treatments. *Changes in MED corresponded to differences between the endpoints evaluated (6, 9, 12 and 15 weeks) and baseline (J/cm2).

References

    1. Svobodova A, Vostalova J. Solar radiation induced skin damage: review of protective and preventive options. Int J Radiat Biol. 2010;86(12):999–1030.
    1. Nichols JA, Katiyar SK. Skin photoprotection by natural polyphenols: anti-inflammatory, antioxidant and DNA repair mechanisms. Arch Dermatol Res. 2010;302(2):71–83.
    1. Caldwell MM, Bornman JF, Ballare CL, Flint SD, Kulandaivelu G. Terrestrial ecosystems, increased solar ultraviolet radiation, and interactions with other climate change factors. Photochem Photobiol Sci. 2007;6(3):252–266.
    1. Brian D. Climate change, ozone depletion and the impact on ultraviolet exposure of human skin. Phys Med Biol. 2004;49(1):R1.
    1. de Gruijl FR, Longstreth J, Norval M, Cullen AP, Slaper H, Kripke ML, Takizawa Y, van der Leun JC. Health effects from stratospheric ozone depletion and interactions with climate change. Photochem Photobiol Sci. 2003;2(1):16–28.
    1. Diffey B. Climate change, ozone depletion and the impact on ultraviolet exposure of human skin. Phys Med Biol. 2004;49(1):R1–R11.
    1. Dinkova-Kostova AT. Phytochemicals as protectors against ultraviolet radiation: versatility of effects and mechanisms. Planta Med. 2008;74(13):1548–1559.
    1. Purdue MP. Predictors of sun protection in Canadian adults. Can J Public Health. 2002;93(6):470–474.
    1. Zussman J, Ahdout J, Kim J. Vitamins and photoaging: do scientific data support their use? J Am Acad Dermatol. 2010;63(3):507–525.
    1. Katiyar SK, Fau AN, Mukhtar H, Mukhtar H. Green tea and skin. Arch Dermatol. 2000;136(8):989–994.
    1. Katiyar SK, Elmets CA. Green tea polyphenolic antioxidants and skin photoprotection (Review) Int J Oncol. 2001;18(6):1307–1313.
    1. Katiyar SK, Bergamo Bm F, Vyalil PK, Vyalil Pk F, Elmets CA, Elmets CA. Green tea polyphenols: DNA photodamage and photoimmunology. J Photochem Photobiol B. 2001;65(2-3):109–114.
    1. Katiyar SK, Mukhtar H. Tea antioxidants in cancer chemoprevention. J Cell Biochem Suppl. 1997;27:59–67.
    1. Yang CS, Wang Z-Y. Tea and cancer. J Natl Cancer Inst. 1993;85(13):1038–1049.
    1. Elmets CA, Fau SD, Tubesing K, Fau TK, Matsui M, Fau MM, Katiyar S, Fau KS, Mukhtar H, Mukhtar H. Cutaneous photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad Dermatol. 2001;44(3):425–432.
    1. Katiyar SK, Fau CA, McCormick TS, McCormick Ts F, Cooper KD, Cooper Kd F, Mukhtar H, Mukhtar H. Prevention of UVB-induced immunosuppression in mice by the green tea polyphenol (-)-epigallocatechin-3-gallate may be associated with alterations in IL-10 and IL-12 production. Carcinogenesis. 1999;20(11):2117–2124.
    1. Katiyar SK, Elmets Ca F, Agarwal R, Fau AR, Mukhtar H, Mukhtar H. Protection against ultraviolet-B radiation-induced local and systemic suppression of contact hypersensitivity and edema responses in C3H/HeN mice by green tea polyphenols. Photochem Photobiol. 1995;62(5):855–861.
    1. Katiyar SK, Matsui Ms F, Elmets CA, Elmets Ca F, Mukhtar H, Mukhtar H. Polyphenolic antioxidant (-)-epigallocatechin-3-gallate from green tea reduces UVB-induced inflammatory responses and infiltration of leukocytes in human skin. Photochem Photobiol. 1999;69(2):148–153.
    1. Katiyar SK, Mukhtar H. Green tea polyphenol (-)-epigallocatechin-3-gallate treatment to mouse skin prevents UVB-induced infiltration of leukocytes, depletion of antigen-presenting cells, and oxidative stress. J Leukoc Biol. 2001;69(5):719–726.
    1. Meeran SM, Fau AS, Katiyar SK, Katiyar SK. Inhibition of UVB-induced skin tumor development by drinking green tea polyphenols is mediated through DNA repair and subsequent inhibition of inflammation. J Invest Dermatol. 2009;129(5):1258–1270.
    1. Heinrich U, Neukam K, Tronnier H, Sies H, Stahl W. Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women. J Nutr. 2006;136(6):1565–1569.
    1. Gasser P, Lati E, Peno-Mazzarino L, Bouzoud D, Allegaert L, Bernaert H. Cocoa polyphenols and their influence on parameters involved in ex vivo skin restructuring. Int J Cosmet Sci. 2008;30(5):339–345.
    1. Williams S, Tamburic S, Lally C. Eating chocolate can significantly protect the skin from UV light. J Cosmet Dermatol. 2009;8(3):169–173.
    1. Neukam K, Stahl W, Tronnier H, Sies H, Heinrich U. Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin. Eur J Nutr. 2007;46(1):53–56.
    1. Roberts WE. Skin type classification systems old and new. Dermatol Clin. 2009;27(4):529–533. viii.
    1. Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM. Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr. 2000;83(2):115–122.
    1. Goulet J, Nadeau G, Lapointe A, Lamarche B, Lemieux S. Validity and reproducibility of an interviewer-administered food frequency questionnaire for healthy French-Canadian men and women. Nutr J. 2004;3:13.
    1. Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, Manne S, O'Riordan DL, Heckman CJ, Hay J, Robinson JK. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008;144(2):217–222.
    1. Otman SG, Edwards C, Gambles B, Anstey AV. Validation of a semiautomated method of minimal erythema dose testing for narrowband ultraviolet B phototherapy. Br J Dermatol. 2006;155(2):416–421.
    1. Otman SG, Edwards C, Wyness K, Anstey AV. British photodermatology group: summaries of papers. Br J Dermatol. 2005;153:92–98.
    1. Huang M-W, Lo P-Y, Cheng K-S. Objective assessment of sunburn and minimal erythema doses: comparison of noninvasive in vivo measuring techniques after UVB irradiation. EURASIP J Adv Signal Process. 2010;2010(1):483562.
    1. Fullerton A, Fischer T, Lahti A, Wilhelm KP, Takiwaki H, Serup J. Guidelines for measurement skin colour and erythema: A report from the Standardization Group of the European Society of Contact Dermatitis*. Contact Dermatitis. 1996;35(1):1–10.
    1. Ollmar S, NyrÉN M, Nicander I, Emtestam L. Electrical impedance compared with other non-invasive bioengineering techniques and visual scoring for detection of irritation in human skin. Br J Dermatol. 1994;130(1):29–36.
    1. Fluhr JW, Kuss O, Diepgen T, Lazzerini S, Pelosi A, Gloor M, Berardesca E. Testing for irritation with a multifactorial approach: comparison of eight non-invasive measuring techniques on five different irritation types. Br J Dermatol. 2001;145(5):696–703.
    1. Radmilovi A, Bori Z, Naumovi T, Stamenkovi M, Mu?iki P. Shunt thrombosis prevention in hemodialysis patients--a double-blind, randomized study: pentoxifylline vs placebo. Angiology. 1987. pp. 499–506.
    1. Ahn S, Kim S, Lee H, Moon S, Chang I. Correlation between a Cutometer and quantitative evaluation using Moire topography in age-related skin elasticity. Skin Res Technol. 2007;13(3):280–284.
    1. Heinrich U, Koop U, Leneveu-Duchemin MC, Osterrieder K, Bielfeldt S, Chkarnat C, Degwert J, Hantschel D, Jaspers S, Nissen HP, Rohr M, Schneider G, Tronnier H. Multicentre comparison of skin hydration in terms of physical-, physiological- and product-dependent parameters by the capacitive method (Corneometer CM 825) Int J Cosmetic Sci. 2003;25(1–2):45–53.
    1. Baba S, Fau ON, Yasuda A, Fau YA, Natsume M, Fau NM, Takizawa T, Fau TT, Nakamura T, Fau NT, Terao J, Terao J. Bioavailability of (-)-epicatechin upon intake of chocolate and cocoa in human volunteers. Free Radic Res. 2000;33(5):635–641.
    1. Foenander T, Birkett DJ, Birkett Dj F, Miners JO, Miners Jo F, Wing LM, Wing LM. The simultaneous determination of theophylline, theobromine and caffeine in plasma by high performance liquid chromatography. Clin Biochem. 1980;13(3):132–134.
    1. Richelle M, Tavazzi I, Enslen M, Offord EA. Plasma kinetics in man of epicatechin from black chocolate. Eur J Clin Nutr. 1999;53(1):22–26.
    1. Lock-Andersen J, Wulf HC. Threshold level for measurement of UV sensitivity: reproducibility of phototest. Photodermatol Photoimmunol Photomed. 1996;12(4):154–161.
    1. Ettler K. Determination of the minimal erythema dosage and natural photoprotection of the skin in the population. Acta Medica (Hradec Kralove) Suppl. 1998;41(1):81–104.
    1. Sayre RM, Desrochers DL, Wilson CJ, Marlowe E. Skin type, minimal erythema dose (MED), and sunlight acclimatization. J Am Acad Dermatol. 1981;5(4):439–443.
    1. van den Bogaard B, Draijer R, Westerhof BE, van den Meiracker AH, van Montfrans GA, van den Born BJ. Effects on peripheral and central blood pressure of cocoa with natural or high-dose theobromine: a randomized, double-blind crossover trial. Hypertension. 2010;56(5):839–846.
    1. Kelly CJ. Effects of theobromine should be considered in future studies. Am J Clin Nutr. 2005;82(2):486–487.
    1. Chen L, Hu JY, Wang SQ. The role of antioxidants in photoprotection: a critical review. J Am Acad Dermatol. 2012;67(5):1013–1024.
    1. Mogollon JA, Bujold E, Lemieux S, Bourdages M, Blanchet C, Bazinet L, Couillard C, Noel M, Dodin S. Blood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trial. Nutr J. 2013;12(1):41.

Source: PubMed

Подписаться