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Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri

Yıl 2017, Cilt: 6 Sayı: 4, 234 - 246, 31.12.2017

Öz

Kardiyovasküler hastalıklar dünyadaki
ölüm nedenleri arasında ön sıralarda yer almakta olup, insanlar, sağlık
kuruluşları ve tüm toplumun üzerinde büyük bir yük oluşturmaktadır. Diyet;
kardiyometabolik bozuklukların oluşumu, önlenmesi ve kontrol edilmesinde
anahtar yaşam tarzı faktörlerinden biridir. Kardiyovasküler hastalıkların
gelişiminin önlenmesinde çikolatanın yüksek miktarda içerdiği polifenoller ve
flavonoidler önemli rol oynamaktadır. Kakao ve kakao ürünü olan çikolata bu
bileşikleri yüksek miktarda içerir. Özellikle bitter çikolatanın güvenle kullanılabilecek
bir besin olması ve lezzeti onu kardiyovasküler sağlığın gelişiminde
tüketilebilecek bir besin olarak kabul edilmesini sağlamaktadır. Eskiden
medikal ilaç tedavisinde de kullanılan kakaonun günümüzde yapılan çalışmalarda
endotel fonksiyon, kan basıncı, insülin direnci ve trombosit fonksiyonu
üzerinde olumlu etkileri olduğu belirtilmiştir. Kakao
içeren ürünlerin günde 2 gram tüketilmesi kardiyovasküler hastalıklardan
korunmayı sağlayabilmektedir Bu derlemenin amacı kakao ve çikolatanın
beslenmedeki önemini, kardiyovasküler etkilerini
belirlemek ve kakaonun tüketimi ile ilişkili klinik çalışmaları özetlemektir. 

Kaynakça

  • World Health Organization. The global burden of disease: 2008, update. Genova.
  • American Heart Association. Heart Disease and Stroke Statistics- 2015, Update. United States.
  • World Health Organization. Cardiovascular diseases Fact sheet 2015; 317.
  • Rayner M, Allender S, Scarborough P. Cardiovascular disease in Europe. Eur J Cardiovasc Prev Rehabil, 2009; 43-47.
  • Buitrago-Lopez A. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ, 2011; 343(4488), 1-8.
  • Ünal B. Kalp ve Damar Hastalıkları. Türkiye Kronik Hastalıklar ve Risk Faktörleri Sıklığı Çalışması ). Ankara, Türkiye: Sağlık Bakanlığı Yayın No:909. 2013; 191-206.
  • Hobbs F, Jukema J, Da Silva P, McCormack T, Catapano, A. Barriers to cardiovascular disease risk scoring and primary prevention in Europe. Q J Med, 2010; 03: 727-739.
  • Stampfer MJ, Hu FB, Joann ME, Rimm EB, Willet WC. Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle. The New England Journal of Medicine 2000; 343: 16-22.
  • Http://www.worldcocoafoundation.Org/about-cocoa/cocoa-value-chain Erişim tarihi: 08.06.2016.
  • Frank HB, Walter WC. Optimal Diets for Prevention of Coronary Heart Disease. The Journal of the American Medical Association 2002; 288(20): 2569-2578.
  • Ding EL, Hutfless SM, Ding X, Girotra S. Chocolate and Prevention of Cardiovascular Disease: A Systematic Review. Nutrition & Metabolism 2006.
  • Waterhouse A, Shirley J, Donovon J. Antioxidant in chocolate. Lancet 1996; 348, 834.
  • Mostofsky, E., Levitan, E. B., Wolk, A., & Mittleman, M. A. Chocolate Intake and Incidence of Heart Failure: A PopulationBased,. American Heart Association. Circulation 2010; 3(5): 612-616.
  • Buijsse B, Weikert C, Drogan D, Bergmann M, Boeing H. Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults. European Heart Journal 2010; 31(13): 1616-1623.
  • Djousse L, Hopkins PN., Arnett DK, Pankow JS, Borecki I, North KE, Chocolate Consumption is Inversely Associated with Calcified Atherosclerotic Plaque in the Coronary Arteries: The NHLBI Family Heart Study. Clinical Nutrition 2011; 30(1): 38-43.
  • Djousse L, Hopkins PN, North KE, Pankow JS, Arnett DK, Ellison RC. Chocolate Consumption is Inversely Associated with Prevalent. Clinical Nutrition 2011; 30(2): 182-187.
  • Kwok SC, Boekholdt SM, Lentjes MA, Loke YK, Luben RN, Yeong JK. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart 2015; 101(16): 1279-1287.
  • Coe SD, Coe MD. The True History of Chocolate (Kindle edition b.). 1996; London, UK: Thames & Hudson.
  • Fernandez-Murga L, Tarin J, Garcia-Perez M, Cano A. The Impact of Chocolate on Cardiovascular Health. Maturitas 2011; 69: 312-321.
  • Lee K W, Kim YJ, Lee HJ, Lee CY. Cocoa has more phenolic phytochemicals and a higher antioxidant capacity than teas and red wine. Journal of Agricultural and Food Chemistry 2003; 51(25): 7292-7295.
  • Borchers AT, Keen CL, Hannum SM, Gershwin ME. Cocoa and Chocolate: Composition, Bioavailability, and Health Implications. Journal of Medicinal Food 2004; 3(2): 77-105.
  • Aremu C, Agiang M, Ayatse J. Nutrient and antinutrient profiles of raw and fermented cocoa beans. Plant Foods for Human Nutrition 1995; 48(3): 217-223.
  • Bracco U. Effect of triglyceride structure on fat absorption. The American Journal of Clinical Nutrition 1994; 60(6): 1002-1009.
  • Grundy, S. M. (1994). Influence of stearic acid on cholesterol metabolism relative to other long-chain fatty acids. The American Journal of Clinical Nutrition 1994; 60(6): 986-990.
  • Lairon D. Dietary fatty acids and arteriosclerosis. Biomed Pharmacotherapy 1997; 51(8): 333-336.
  • Ascherio A, Rimm EB, Giovannucci EL, Spiegelman D, Stampfer M, Willet WC. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. British Medical Journal 1996; 313(7049): 85-90.
  • Bonanome A, Grundy SM. Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels. The New England Journal of Medicine 1988; 318(19): 1244-1248.
  • Tholstrup T, Marckmann P, Jespersen J, Sandström B. Fat high in stearic acid favorably affects blood lipids and factor VII coagulant activity in comparison with fats high in palmitic acid or high in myristic and lauric acids. The american Journal of Clinical Nutrition 1994; 59(2): 371-377.
  • Kritchevsky D. Stearic acid metabolism and atherogenesis: history. The American Journal of Clinical Nutrition 1994; 60(6): 997-1001.
  • Maki K, Davidson M, Umporowicz D, Schaefer E, Dicklin M, Ingram, K. Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet. The American Journal of Clinical Nutrition 2001; 74(1): 33-43.
  • Staphylakis K, Gegiou D. Free, esterified and glucosidic sterols in cocoa butter. Springer Link 1985; 20(11): 723-728.
  • Steinberg F, Bearden M, Keen C. Cocoa and chocolate flavonoids: implications for cardiovascular health. The Journal of American Dietetic Association 2003; 103(2): 215-223.
  • Davidsson L, Walczyk T, Morris A, Hurrel R. Influence of ascorbic acid on iron absorption from an iron-fortified, chocolate-flavored milk drink in Jamaican children. The American Journal of Clinical Nutrition 1998; 67(5): 873-877.
  • Jenkins D, Kendall C, Vuksan V, Vidgen E, Wong E, Augustin L. Effect of cocoa bran on low-density lipoprotein oxidation and fecal bulking. American Medical Association's journal of internal medicine 2000; 160(15): 2374-2379.
  • Fernandez M. Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk. Current Opinion in Lipidology 2001; 12(1): 35-40.
  • Harland B, Oberleas D. Phytate and Zinc Contents of Coffees, Cocoas, and Teas. Journal of Food Science 1985; 50(3): 832-833.
  • Aremu C, Abara A. Hydrocyanate, oxalate, phytate, calcium and zinc in selected brands of Nigerian cocoa beverage. Plant Foods for Human Nutrition 1992; 42(3): 231-237.
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Comment in JAMA, 2001;285(19): 2508-9.
  • Crozier, A., Yokota T, Jaganath IB, Saltmarsh M, Clifford MN. Plant Secondary Metabolites: Occurunce, Structure and Role in the Human Diet Oxford: Blackwell Publishing 2006; 208-302.
  • Kim H, Keeney P.Epicatechin Content in Fermented and Unfermented Cocoa Beans. Journal of Food Science 1984; 49(4): 1090-1092.
  • Del Rio D, Rodriguez-Mateos A, Spencer JP, Tognolini M, Borges G, Crozier A. Dietary (Poly)phenolics in Human Health: Structures, Bioavailability, and Evidence of Protective Effects Against Chronic Diseases. Antioxidants & Redox Signaling 2013; 18(14): 1818-1892.
  • Zumbe A. Polyphenols in cocoa: are there health benefits Nutrition Bulletin, 1998; 23(1): 94-102.
  • Osakabe N, Yamagishi M, Sanbongi C, Natsume M, Takizawa T, Osawa T. The antioxidative substances in cocoa liquor. Journal of Nutritional Science and Vitaminology 1998; 44(2): 313-321.
  • Porter L, Ma Z, Chan B. Cacao procynadins: Major flavanoids and identification of some minor metabolites. Phytochemistry 1991; 30(5): 1657-1663.
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  • Rein D, Lotito S, Holt RR, Keen CL, Schmitz HH, Fraga CG. Epicatechin in Human Plasma: In Vivo Determination and Effect of Chocolate Consumption on Plasma Oxidation Status. The Journal of Nutrition 2000; 130(8): 2109-2114.
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  • Persson I, Persson K, Hagg S, Andersson R. Effects of Cocoa Extract and Dark Chocolate on Angiotensin-converting Enzyme and Nitric Oxide in Human Endothelial Cells and Healthy Volunteers–A Nutrigenomics Perspective. Journal of Cardiovascular Pharmacology 2011; 57(1): 44-50.
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Yıl 2017, Cilt: 6 Sayı: 4, 234 - 246, 31.12.2017

Öz

Kaynakça

  • World Health Organization. The global burden of disease: 2008, update. Genova.
  • American Heart Association. Heart Disease and Stroke Statistics- 2015, Update. United States.
  • World Health Organization. Cardiovascular diseases Fact sheet 2015; 317.
  • Rayner M, Allender S, Scarborough P. Cardiovascular disease in Europe. Eur J Cardiovasc Prev Rehabil, 2009; 43-47.
  • Buitrago-Lopez A. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ, 2011; 343(4488), 1-8.
  • Ünal B. Kalp ve Damar Hastalıkları. Türkiye Kronik Hastalıklar ve Risk Faktörleri Sıklığı Çalışması ). Ankara, Türkiye: Sağlık Bakanlığı Yayın No:909. 2013; 191-206.
  • Hobbs F, Jukema J, Da Silva P, McCormack T, Catapano, A. Barriers to cardiovascular disease risk scoring and primary prevention in Europe. Q J Med, 2010; 03: 727-739.
  • Stampfer MJ, Hu FB, Joann ME, Rimm EB, Willet WC. Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle. The New England Journal of Medicine 2000; 343: 16-22.
  • Http://www.worldcocoafoundation.Org/about-cocoa/cocoa-value-chain Erişim tarihi: 08.06.2016.
  • Frank HB, Walter WC. Optimal Diets for Prevention of Coronary Heart Disease. The Journal of the American Medical Association 2002; 288(20): 2569-2578.
  • Ding EL, Hutfless SM, Ding X, Girotra S. Chocolate and Prevention of Cardiovascular Disease: A Systematic Review. Nutrition & Metabolism 2006.
  • Waterhouse A, Shirley J, Donovon J. Antioxidant in chocolate. Lancet 1996; 348, 834.
  • Mostofsky, E., Levitan, E. B., Wolk, A., & Mittleman, M. A. Chocolate Intake and Incidence of Heart Failure: A PopulationBased,. American Heart Association. Circulation 2010; 3(5): 612-616.
  • Buijsse B, Weikert C, Drogan D, Bergmann M, Boeing H. Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults. European Heart Journal 2010; 31(13): 1616-1623.
  • Djousse L, Hopkins PN., Arnett DK, Pankow JS, Borecki I, North KE, Chocolate Consumption is Inversely Associated with Calcified Atherosclerotic Plaque in the Coronary Arteries: The NHLBI Family Heart Study. Clinical Nutrition 2011; 30(1): 38-43.
  • Djousse L, Hopkins PN, North KE, Pankow JS, Arnett DK, Ellison RC. Chocolate Consumption is Inversely Associated with Prevalent. Clinical Nutrition 2011; 30(2): 182-187.
  • Kwok SC, Boekholdt SM, Lentjes MA, Loke YK, Luben RN, Yeong JK. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart 2015; 101(16): 1279-1287.
  • Coe SD, Coe MD. The True History of Chocolate (Kindle edition b.). 1996; London, UK: Thames & Hudson.
  • Fernandez-Murga L, Tarin J, Garcia-Perez M, Cano A. The Impact of Chocolate on Cardiovascular Health. Maturitas 2011; 69: 312-321.
  • Lee K W, Kim YJ, Lee HJ, Lee CY. Cocoa has more phenolic phytochemicals and a higher antioxidant capacity than teas and red wine. Journal of Agricultural and Food Chemistry 2003; 51(25): 7292-7295.
  • Borchers AT, Keen CL, Hannum SM, Gershwin ME. Cocoa and Chocolate: Composition, Bioavailability, and Health Implications. Journal of Medicinal Food 2004; 3(2): 77-105.
  • Aremu C, Agiang M, Ayatse J. Nutrient and antinutrient profiles of raw and fermented cocoa beans. Plant Foods for Human Nutrition 1995; 48(3): 217-223.
  • Bracco U. Effect of triglyceride structure on fat absorption. The American Journal of Clinical Nutrition 1994; 60(6): 1002-1009.
  • Grundy, S. M. (1994). Influence of stearic acid on cholesterol metabolism relative to other long-chain fatty acids. The American Journal of Clinical Nutrition 1994; 60(6): 986-990.
  • Lairon D. Dietary fatty acids and arteriosclerosis. Biomed Pharmacotherapy 1997; 51(8): 333-336.
  • Ascherio A, Rimm EB, Giovannucci EL, Spiegelman D, Stampfer M, Willet WC. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. British Medical Journal 1996; 313(7049): 85-90.
  • Bonanome A, Grundy SM. Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels. The New England Journal of Medicine 1988; 318(19): 1244-1248.
  • Tholstrup T, Marckmann P, Jespersen J, Sandström B. Fat high in stearic acid favorably affects blood lipids and factor VII coagulant activity in comparison with fats high in palmitic acid or high in myristic and lauric acids. The american Journal of Clinical Nutrition 1994; 59(2): 371-377.
  • Kritchevsky D. Stearic acid metabolism and atherogenesis: history. The American Journal of Clinical Nutrition 1994; 60(6): 997-1001.
  • Maki K, Davidson M, Umporowicz D, Schaefer E, Dicklin M, Ingram, K. Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet. The American Journal of Clinical Nutrition 2001; 74(1): 33-43.
  • Staphylakis K, Gegiou D. Free, esterified and glucosidic sterols in cocoa butter. Springer Link 1985; 20(11): 723-728.
  • Steinberg F, Bearden M, Keen C. Cocoa and chocolate flavonoids: implications for cardiovascular health. The Journal of American Dietetic Association 2003; 103(2): 215-223.
  • Davidsson L, Walczyk T, Morris A, Hurrel R. Influence of ascorbic acid on iron absorption from an iron-fortified, chocolate-flavored milk drink in Jamaican children. The American Journal of Clinical Nutrition 1998; 67(5): 873-877.
  • Jenkins D, Kendall C, Vuksan V, Vidgen E, Wong E, Augustin L. Effect of cocoa bran on low-density lipoprotein oxidation and fecal bulking. American Medical Association's journal of internal medicine 2000; 160(15): 2374-2379.
  • Fernandez M. Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk. Current Opinion in Lipidology 2001; 12(1): 35-40.
  • Harland B, Oberleas D. Phytate and Zinc Contents of Coffees, Cocoas, and Teas. Journal of Food Science 1985; 50(3): 832-833.
  • Aremu C, Abara A. Hydrocyanate, oxalate, phytate, calcium and zinc in selected brands of Nigerian cocoa beverage. Plant Foods for Human Nutrition 1992; 42(3): 231-237.
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Comment in JAMA, 2001;285(19): 2508-9.
  • Crozier, A., Yokota T, Jaganath IB, Saltmarsh M, Clifford MN. Plant Secondary Metabolites: Occurunce, Structure and Role in the Human Diet Oxford: Blackwell Publishing 2006; 208-302.
  • Kim H, Keeney P.Epicatechin Content in Fermented and Unfermented Cocoa Beans. Journal of Food Science 1984; 49(4): 1090-1092.
  • Del Rio D, Rodriguez-Mateos A, Spencer JP, Tognolini M, Borges G, Crozier A. Dietary (Poly)phenolics in Human Health: Structures, Bioavailability, and Evidence of Protective Effects Against Chronic Diseases. Antioxidants & Redox Signaling 2013; 18(14): 1818-1892.
  • Zumbe A. Polyphenols in cocoa: are there health benefits Nutrition Bulletin, 1998; 23(1): 94-102.
  • Osakabe N, Yamagishi M, Sanbongi C, Natsume M, Takizawa T, Osawa T. The antioxidative substances in cocoa liquor. Journal of Nutritional Science and Vitaminology 1998; 44(2): 313-321.
  • Porter L, Ma Z, Chan B. Cacao procynadins: Major flavanoids and identification of some minor metabolites. Phytochemistry 1991; 30(5): 1657-1663.
  • Miller KB, Stuart DA, Smith NL, Lee CY, Mchale N, Flanagan JA.Antioxidant activity and polyphenol and procyanidin contents of selected commercially available cocoa-containing and chocolate products in the United States. Journal of Agricultural Food Chemistry 2006; 54(11): 4062-4068.
  • Holt RR, Lazarus SA, Sullards M C, Zhu QY, Schramm DD, Hammerstone JF. Procyanidin dimer B2 [epicatechin-(4β-8)-epicatechin] in human plasma after the consumption of a flavanol-rich cocoa. The American Journal of Clinical Nutrition 2002; 76(4): 798-804.
  • Schramm DD, Karim M, Schrader HR, Holt RR, Kirkpatric NJ, Polagruto JA. Food effects on the absorption and pharmacokinetics of cocoa flavanols. Life Science 2003; 73(7): 857-869.
  • Manach C, Scalbert A, Morand C, Remesy C, Jimenez L. Polyphenols: food sources and bioavailability. The American Journal of Clinical Nutrition 2004; 79(5): 727-747.
  • Sarda-Urpi M, Monogas M, Khan N, Lamuela-Raventos RM, Santos-Buelga C, Sacanella E. Epicatechin, procyanidins, and phenolic microbial metabolites after cocoa intake in humans and rats. Analytical and Bioanalytical Chemistry 2009; 394(6): 1545-1556.
  • Fogliano V, Corollaro LM, Vitaglione P, Napolitano A, Ferracane R, Travaglia F. In vitro bioaccessibility and gut biotransformation of polyphenols present in the water-insoluble cocoa fraction. Molecular Nutrition & Food Research 2011; 55(1): 44-55.
  • Cook N, Samman S. Flavonoids—Chemistry, metabolism, cardioprotective effects, and dietary sources. The Journal of Nutritional Biochemistry 1996; 7(2): 66-76.
  • Hertog MG, Hollman PC, Katan MB. Content of potentially anticarcinogenic flavonoids of 28 vegetables and 9 fruits commonly consumed in the Netherlands. Journal of Agricultural and Food Chemistry 1992; 40(12): 2379-2383.
  • Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliövaara M, Aromaa A. Antioxidant Vitamin Intake and Coronary Mortality in a Longitudinal Population Study. American Journal of Epidemiology 1994; 139(12): 1180-1189.
  • Bravo L. Polyphenols: Chemistry, Dietary Sources, Metabolism, and Nutritional Significance. Nutrition Reviews 1998; 56(11): 317-333.
  • Steinberg D, Parthasarathy S, Carew TE, Khoo JC,Witztum JL. Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. The New England Journal Of Medicine 1989; 320(14): 915-924.
  • Aviram M. Modified forms of low density lipoprotein and atherosclerosis. Atherosclerosis 1993;98(1): 1-9.
  • Hii CL, Law CL, Suzannah S, Cloke M, Cloke M. Polyphenols in cocoa. Asian Fournal of Food and Agro-Industry 2009; 702-722.
  • Bakan A, Eksi A. Gıdaların antioksidan kapasitesinin belirleme yöntemleri. Dünya Gıda Dergisi 2006.
  • Wang H, Cao G, Prior RL. Total Antioxidant Capacity of Fruits. Journal of Agricultural Food and Chemistry 1996; 44: 701-705.
  • Adamson GE, Lazarus SA, Mitchell AE, Prior RL, Cao G, Jacobs PH. HPLC Method for the Quantification of Procyanidins in Cocoa and Chocolate Samples and Correlation to Total Antioxidant Capacity. Journal of agricultural Food and Chemistry 1999; 47(10): 4184-4188.
  • Kalt W, Ryan DA, Duy JC, Prior RL, Ehlenfeldt MK, Kloet SV. Interspecific Variation in Anthocyanins, Phenolics, and Antioxidant Capacity among Genotypes of Highbush and Lowbush Blueberries (Vaccinium Section cyanococcus spp.). Journal of Agricultural Food and Chemistry 2001; 49(10): 4761-4767.
  • Othman A, Ghani NA, Adenan I. Antioxidant capacity and phenolic content of cocoa beans. Food Chemistry 2007; 100(4): 1523-1530.
  • Pannala AS, Chan TS, O'Brien PJ, Rice-Evans CA. Flavonoid B-Ring Chemistry and Antioxidant Activity: Fast Reaction Kinetics. Biochemical and Biophysical Research Communications 2001; 282(5): 1161-1168.
  • Arteel GE, Sies H. Protection against peroxynitrite by cocoa polyphenol. FEBS Letters 1999; 462 (1-2): 167-170.
  • Lotito SB, Actis-Goretta L, Renart ML, Caligiuri, M, Rein D, Schmitz HH, Influence of Oligomer Chain Length on the Antioxidant Activity of Procyanidins. Biochemical and Biophysical Resarch Communications 2000; 276(3): 945-951.
  • Rein D, Lotito S, Holt RR, Keen CL, Schmitz HH, Fraga CG. Epicatechin in Human Plasma: In Vivo Determination and Effect of Chocolate Consumption on Plasma Oxidation Status. The Journal of Nutrition 2000; 130(8): 2109-2114.
  • Wang JF, Schramm DD, Holt RR, Ensunsa JL, Fraga CG, Schmmitz HH. A Dose-Response Effect from Chocolate Consumption on Plasma Epicatechin and Oxidative Damage. The Journal of Nutrition 2000; 130(8): 2115-2119.
  • Miller KB, Hurst WJ, Payne MJ, Stuart DA, Apgar J, Sweigart DS. Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders. Journal of Agricultural and Food Chemistry 2008; 56(18): 8527-8533.
  • Türkiye İstatistik Kurumu. Ölüm Nedeni İstatistikleri, 2015. Türkiye İstatistik Kurumu 2016
  • Joannides R, Haefeli WE, Linder L, Richard V, Bakkali E, Thuillez C. Nitric Oxide Is Responsible for Flow-Dependent Dilatation of Human Peripheral Conduit Arteries In Vivo. American Heart Association. Circulation 1995; 91: 1314-1319.
  • Joannides R, Richard V, Haefeli WE, Linder L, Lüscher TF, Thuilez C. Role of Basal and Stimulated Release of Nitric Oxide in the Regulation of Radial Artery Caliber in Humans. American Heart Association. Hypertansion 1995; 26: 327-331.
  • Oemar BS, Tschudi MR, Godoy N, Brovkovich V, Malinski T, Lüscher TF. Reduced Endothelial Nitric Oxide Synthase Expression and Production in Human Atherosclerosis. American Heart Association. Circulation 1998; 97: 2494-2498.
  • Ross R. Atherosclerosis- An Inflammatory Disease. The New England Journal of Medicine 1999; 340: 115-126.
  • Fuster V, Moreno PR, Fayad ZA, Corti R, Badimon JJ. Atherothrombosis and High-Risk Plaque: Part I: Evolving Concepts. Journal of the American College of Cardiology 2005; 46(6): 937-954.
  • Keen CL, Holt RR., Oteiza PI, Fraga CG, Schimitz HH. Cocoa antioxidants and cardiovascular health. The American Journal of Clinical Nutrition2005; 81(1): 298-303.
  • Pearson DA, Paglieroni TG, Rein D, Wun T, Schramm DD, Wang JF. The effects of flavanol-rich cocoa and aspirin on ex vivo platelet function. The Journal of Emergency Medicine 2002; 106(4-5): 191-197.
  • Innes A, Kennedy G, Bancroft A, Belch J. Dark chocolate inhibits platelet aggregation in healthy volunteers. Platelets 2003; 14(5): 325-327.
  • Hermann F, Spieker LE, Ruschitzka F, Sudano I, Hermann M, Binggeli C. Dark chocolate improves endothelial and platelet function. Heart 2006; 92: 119-120.
  • Kelly F, Sinclair A, Mann N, Turner A, Abedin L, Li D. A stearic acid-rich diet improves thrombogenic and atherogenic risk factor profiles in healthy males. European Journal of Clinical Nutrition 2001; 55(2): 88-96.
  • Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study. Archives of Internal Medicine 2006; 166(4): 411-417.
  • Alonso A, Fuente C, Beunza JJ, Sanchez-Villegas A, Martinez-Gonzalez MA. Chocolate Consumption and Incidence of Hypertension. American Heart Association. Hypertension 2005; 46: 21-22.
  • Taubert D, Roesen R, Lehmann C, Jung N, Schömig E. Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide. The Journal of the American Medica Association 2007; 298(1): 49-60.
  • Foster MW, Pawloski JR, Stamler S, Stamler JS. Role of Circulating S-Nitrosothiols in Control of Blood Pressure. American Heart Association. Hypertension 2005; 45: 15-17.
  • Actis-Goretta L, Ottaviani JI, Fraga CG. Inhibition of Angiotensin Converting Enzyme Activity by Flavanol-Rich Foods. Journal of Agricultural and Food Chemistry 2006; 54(1): 229-234.
  • Persson I, Persson K, Hagg S, Andersson R. Effects of Cocoa Extract and Dark Chocolate on Angiotensin-converting Enzyme and Nitric Oxide in Human Endothelial Cells and Healthy Volunteers–A Nutrigenomics Perspective. Journal of Cardiovascular Pharmacology 2011; 57(1): 44-50.
  • Kelly CJ. Effects of theobromine should be considered in future studies. The American journal of Clinical Nutrition 2005; 82(2): 486-487.
  • Simon JA, Fong J, Bernert JT. Serum Fatty Acids and Blood Pressur. American Heart Association. Hypertension 1996; 27: 303-307.
  • Mensink RP, Zock PL, Kester AD. Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. The American Journal of Clinical Nutrition 2003; 77(5): 1146-1155.
  • Kris-Etherton P, Zock P, Kester A, Katan M. Effects of a milk chocolate bar per day substituted for a high-carbohydrate snack in young men on an NCEP/AHA Step 1 Diet. The American Journal of Clinical Nutrition 1994; 60(6): 1037-1042.
  • Jia L, Liu X, Bai YY, Hua Li S, Sun K, He C. Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition 2010; 92(1): 218-225.
  • Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. The American Journal of Clinical Nutrition2005; 81(3): 611-614.
  • Mursu J, Voutilainen S, Nurmi T, Rissanen TH, Virtanen JK, Kaikkonen. Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. Free Radical Biology and Medicine 2004; 37(9): 1351-1359.
  • Baba S, Osakabe N, Kato Y, Natsume M, Yasuda A, Kido T. Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. The American Journal of Clinicl Nutrition 2007; 709-717.
  • Corti R, Flammer AJ, Hollenberg NK, Lüscher TF. Cocoa and Cardiovascular Health. American Heart Association. Circulation 2009; 119: 1433-1441.
  • Zeng G, Nystrom FH., Ravichandran LV, Kirby M, Motowski H, Quon MJ. Roles for Insulin Receptor, PI3-Kinase, and Akt in Insulin-Signaling Pathways Related to Production of Nitric Oxide in Human Vascular Endothelial Cells. American Heart Association 2000; 101: 1539-1545.
  • Grassi D, Desideri G, Necozione S, Lippi C, Casale R, Properzi G. Blood Pressure Is Reduced and Insulin Sensitivity Increased in Glucose-Intolerant, Hypertensive Subjects after 15 Days of Consuming High-Polyphenol Dark Chocolate. The Journal of Nutrition 2008; 138(9): 1671-1676.
Toplam 96 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Dicle Kargın Bu kişi benim

Fatma Esra Güneş Bu kişi benim

Yayımlanma Tarihi 31 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 6 Sayı: 4

Kaynak Göster

APA Kargın, D., & Güneş, F. E. (2017). Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6(4), 234-246.
AMA Kargın D, Güneş FE. Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. Aralık 2017;6(4):234-246.
Chicago Kargın, Dicle, ve Fatma Esra Güneş. “Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 6, sy. 4 (Aralık 2017): 234-46.
EndNote Kargın D, Güneş FE (01 Aralık 2017) Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 6 4 234–246.
IEEE D. Kargın ve F. E. Güneş, “Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri”, Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 6, sy. 4, ss. 234–246, 2017.
ISNAD Kargın, Dicle - Güneş, Fatma Esra. “Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 6/4 (Aralık 2017), 234-246.
JAMA Kargın D, Güneş FE. Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2017;6:234–246.
MLA Kargın, Dicle ve Fatma Esra Güneş. “Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 6, sy. 4, 2017, ss. 234-46.
Vancouver Kargın D, Güneş FE. Çikolatanın Kardiyovasküler Sistem Üzerine Etkileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2017;6(4):234-46.