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This study investigates the effects of 85% dark chocolate supplementation on vascular function and nitric oxide (NO) levels during high-intensity resistance exercise in healthy women across menstrual phases. Using a randomized crossover design, 31 women consumed either dark chocolate or milk chocolate before exercising during the early follicular and mid-luteal phases. Vascular markers, including pulse wave velocity (ftPWV), arterial stiffness, blood pressure, and plasma NO levels, were measured at multiple time points.
Background:
Dark chocolate, rich in flavanols, may support vascular health by reducing arterial stiffness and blood pressure across menstrual phases. This study examined the effects of 85% dark chocolate on nitric oxide (NO) levels and vascular function during high-intensity resistance exercise in healthy women across the early follicular and mid-luteal phases.
Methods:
Thirty-one healthy women (aged 20-30 years) with regular menstrual cycles completed a randomized, crossover study (conducted at National Chung Cheng University, Sep-Dec 2023). Participants consumed either 85% dark chocolate or milk chocolate (1g/kg body weight) before high-intensity resistance exercise during the early follicular (days 2-5) and mid-luteal (days 18-24) phases of two menstrual cycles. Finger-toe pulse wave velocity (ftPWV), arterial stiffness, blood pressure, and plasma NO levels were measured at rest, 2 hours after chocolate consumption (baseline), immediately post-exercise (T0), and at 60 (T60) and 120 (T120) minutes post-exercise.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Early Follicular | Experimental | Participants consumed either 85% dark chocolate or milk chocolate (1g/kg body weight) before high-intensity resistance exercise during the early follicular (days 2-5) phases of two menstrual cycles. |
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| Mid-Luteal | Active Comparator | Participants consumed either 85% dark chocolate or milk chocolate (1g/kg body weight) before high-intensity resistance exercise during the mid-luteal (days 18-24) phases of two menstrual cycles. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| dark chocolate | Dietary Supplement | Participants consumed 85% dark chocolate (1g/kg body weight) before high-intensity resistance exercise during the early follicular (days 2-5) and mid-luteal (days 18-24) phases of two menstrual cycles. Finger-toe pulse wave velocity (ftPWV), arterial stiffness, blood pressure, and plasma NO levels were measured at rest, 2 hours after chocolate consumption (baseline), immediately post-exercise (T0), and at 60 (T60) and 120 (T120) minutes post-exercise. |
| Measure | Description | Time Frame |
|---|---|---|
| Finger-Toe Pulse Wave Velocity (ftPWV) | Measurements at other time points are taken while participants are resting in the laboratory. Firstly, sensors for photoplethysmography (PPG) were placed on the right index finger and right big toe of the participants. These sensors were marked with an oily pen to ensure consistent placement throughout the experiment. The signals were then amplified using a Biopec MP150 (MP150, Biopac Systems Inc., Goleta, CA, USA), with each physiological signal collected for at least 150 seconds. The signals were analyzed using MATLAB to calculate the time difference between the two pulse waves. The length of the participant's body segments ( sternum to the right index finger, and sternum to the big toe of the right foot) was measured, and this value was divided by the average difference between 10 pulse waves (in the stable interval of 150 seconds) to calculate the ftPWV value (m/s). | Finger-toe pulse wave velocity (ftPWV) were measured at rest, 2 hours after chocolate consumption (baseline), immediately post-exercise (T0), and at 60 (T60) and 120 (T120) minutes post-exercise. |
| Measure | Description | Time Frame |
|---|---|---|
| Arterial Index | The arterial pressure volume index (API) and arterial velocity pulse index (AVI) are measured using the PASESA AVE-2000 (PASESA, Tokyo, Japan) with a wrapped around the right upper arm of seated participants. The API reflected the stiffness of peripheral arteries by assessing the pressure-volume relationship of the artery, while the AVI primarily reflected the stiffness of central arteries by analyzing the ratio of forward and reflected pressure waves. Each measurement was taken three times, and the average of the three readings was recorded. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cheng-Shiun He Professor | National Chung Cheng University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Chung Cheng University | Chiayi County, Taiwan | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35852625 | Result | Gaynor-Metzinger SHA, Triplett NT, Meucci M, Fasczewski KS, Flinchum DH, Collier SR. Central arterial stiffness, wave reflection, and heart rate variability following 4-week high-intensity resistance training intervention in young active women. Eur J Appl Physiol. 2022 Oct;122(10):2283-2293. doi: 10.1007/s00421-022-05003-4. Epub 2022 Jul 19. | |
| 40249472 |
| Label | URL |
|---|---|
| National Chung Cheng University Human Research Ethics Center | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| CCUREC111122101 | Informed Consent Form | View IPD |
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EF-MC: early follicular-milk chocolate EF-DC: early follicular-dark chocolate ML-MC: Mid Luteal-milk chocolate ML-DC: Mid Luteal-dark chocolate
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Double-blind
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| milk chocolate | Dietary Supplement | Participants consumed milk chocolate (1g/kg body weight) before high-intensity resistance exercise during the early follicular (days 2-5) and mid-luteal (days 18-24) phases of two menstrual cycles. Finger-toe pulse wave velocity (ftPWV), arterial stiffness, blood pressure, and plasma NO levels were measured at rest, 2 hours after chocolate consumption (baseline), immediately post-exercise (T0), and at 60 (T60) and 120 (T120) minutes post-exercise. |
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| high-intensity resistance exercise | Behavioral | Participants performed high-intensity resistance exercise during the early follicular (days 2-5) and mid-luteal (days 18-24) phases of two menstrual cycles. |
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| Arterial index (API and AVI) were measured at rest, 2 hours after chocolate consumption (baseline), immediately post-exercise (T0), and at 60 (T60) and 120 (T120) minutes post-exercise. |
| Wang CW, Fang SH, Yu TA, Chen LY, Wang CK, Wang SC, He CS. The Cardiovascular Benefits of Dark Chocolate Supplementation before High-Intensity Resistance Exercise in the Early Follicular and Mid-Luteal Phases of the Menstrual Cycle. Sports Med Open. 2025 Apr 18;11(1):39. doi: 10.1186/s40798-025-00850-9. |
National Chung Cheng University Human Research Ethics Center |