EVEN those who regularly consume five portions of fruit and vegetables per day may be failing to hit the recommended flavanol intake to support cardiovascular health, new research has found.1
Flavanols
Flavanols are a group of food bioactives that have been shown to have a beneficial effect on heart health, improving, for example, flow-mediated dilation, systolic and diastolic blood pressure, total cholesterol, LDL and HDL cholesterol, triglycerides, haemoglobin A1c, and homeostasis model assessment of insulin resistance.2, 3
Higher levels of the antioxidants are found in certain foods, including green tea, apples, berries, and cocoa.4
Cocoa flavanols, in particular, have been shown to reduce cardiovascular disease risk.4
Context from the COSMOS Study
The COSMOS study found that a daily intake of 500 mg of flavanols significantly reduced the risk of dying from heart disease.4
Most people fall significantly short of that threshold, the new research found.1
Fewer than 25% of participants meeting current dietary guidelines consumed at least 500 mg of flavanols on a daily basis.
This included those who regularly ate five portions of fruit and vegetables per day.
Nutritional Implications
Findings have reportedly raised wider questions around the effectiveness of current official dietary guidelines.
Researchers have also called for the use of validated nutritional biomarkers in strengthening the impact of randomised controlled trials in nutrition, to increase scientific rigour in this field of study.5
References
1 Ottaviani JI et al. Adhering to dietary guidelines does not yield flavanol intake levels associated with beneficial cardiovascular effects. Food Funct. 2026;DOI:10.1039/D6FO00867D.
2 Raman G et al. Dietary intake of flavan-3-ols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies. Am J Clin Nutr. 2019;110:1067–1078.
3 Crowe-White K et al. Flavan-3-ols and cardiometabolic health: a guidelines recommendation by the Academy of Nutrition and Dietetics. Adv Nutr. 2022;13(6):2070–2083.
4 Sesso H et al. Group effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Am J Clin Nutr. 2022;115:1490–1500.
5 Ottaviani JI et al. The overlooked impact of background diet and adherence in nutrition trials. Food Funct. 2026;16(14):5733–5743.
Featured image: Nikolay on Adobe Stock
