Effects of Cocoa (Theobroma cacao) Powder

to Lipid Profile of Normocholesterolemic

and Borderline Hypercholesterolemic
Residents of Barangay 19-B
Poblacion, Davao City:
A Pilot Study

Group 5 - NMD 1A

Chapter 1
INTRODUCTION

Background of the Study

In May 2014, the World Health Organization on their official site, published and updated
that Ischemic heart disease and stroke are the two leading causes of mortality in the world.
Likewise, the Department of Health said that diseases of the heart and diseases of the vascular
system are the first and second leading causes of mortality, respectively, in the Philippines as of
2009. And the Davao City Health Office, health status for the year 2011 showed that among the
estimated 1,511,300 residents of Davao City, the top ten leading causes of mortality for all ages
are cerebrovascular accident, senile atherosclerosis and diseases of the heart. (WHO, 2014).
The top ten leading causes of mortality , for all ages in the world as stated by the world
health organization, namely, Cerebrovascular accident, senile atherosclerosis, diseases of the
heart, diseases of the vascular system, ischemic heart disease and stroke have a common risk
factor which is hypercholesterolemia, when, if not treated and given much attention, will
eventually lead to death. In a study entitled,"Relation of High density lipoprotein cholesterol and
triglycerides to incidence of atherosclerotic coronary artery disease" by Gerd Assmann MD,
hypercholesterolemia is a powerful coronary risk factor when excessive triglycerides coincide
with a high amount of plasma low-density lipoprotein cholesterol.

High cholesterol levels leads to a condition known as hypercholesterolemia which occurs

when there is too much cholesterol in the body. It increases the risk for heart disease, heart
attack, and stroke. When there is too much cholesterol circulating in the blood, it can create
sticky deposits called plaque along the artery walls when it undergoes oxidation and this will
eventually narrow or block the flow of blood to the brain, heart, and other organs. Blood cells
that get caught on the plaque form clots, which will later on cause heart attack or stroke. While
heredity may be a factor for some people, the main culprits are lack of exercise and diets high in
saturated fat. High cholesterol can be prevented, sometimes with lifestyle changes such as a
proper diet and exercise alone. If these do not work, certain medications to lower your
cholesterol levels are prescribed (Ehrlich,2013) , but, despite of the advancement and progress of
the health system and the presence of drugs in the market today, occurrence of it is still
undeniable.
A compound called Theobromine, 3,7 dimethyl xanthine, is a purine-derived that is
widely consumed in cocoa beverages. It has been used as a vasodilator and a diuretic but
recently, there has been considerable interest in the possible beneficial consumption of it in
human health (El Mohsen,2002).
Many studies have proven the efficiency of theobromine in treating high cholesterol
levels. According to a study entitled "Theobromine for incresing HDL cholesterol" by Richard
Draijer et. al., consumption of theobromine has lead to an increase in HDL and also an increase
in HDL:LDL ratio.
Another active consituent of cocoa is flavonoid. Flavonoids are polyphenolic compounds
that are ubiquitous in nature and are categorized, according to chemical structure, into flavonols,

flavones, flavanones, isoflavones, catechins, anthocyanidins and chalcones. Over 4,000

flavonoids have been identified, many of which occur in fruits, vegetables and beverages (tea,
coffee, beer, wine and fruit drinks). The flavonoids have many uses such as antiviral, antiallergic, antiplatelet, anti-inflammatory, antitumor and antioxidant activities, but recently, it
aroused considerable interest because of their potential beneficial effects on human health-they
have been reported to have powerful antioxidant property (Buhler, 2000). Flavonoids are potent
antioxidants that may affect initial steps in the development of atherosclerosis through the
prevention of LDL oxidation, blockage of LDL uptake by macrophages, and prevention of foam
cell formation (Gross, 2004).
Flavonoids and theobromine, with different mechanism of actions, are the two compunds
responsible for cocoa's cholesterol lowering effects but our study focuses more on flavonoids
that have the property of being a powerful antoxidant responible for the antihypercholesterolemic
effects of cocoa.
In reference to the presented facts, the researchers managed to pool their information
from alternative medicine, and ongoing researches in plant potentials, and realize the hidden
abilities of a common and abundant food found in Philippines, Cocoa. Cocoa beans, with its
scientific name Theobroma Cacao, which means "food from the Gods", are processed to form
cocoa powder that is widely used for chocolate in solid and liquid forms. It is considered as a
ceremonial food and a medicine plant. Cacao is rich in flavonodis and as stated earlier,
flavonoids have the property of being a powerful antioxidant that prevents low denisity
lipoproteins from undergoing oxidation and have the ability to increase high density lipoprotein.

The study will focus on hypercholesterolemic volunteers from Barangay 19-B, Poblacion,
Davao city.

Objectives of the Study

To determine the effects of cocoa powder to lipid profiles of normocholesterolemic and
borderline hypercholesterolemic residents of Barangay 19-B Poblacion, Davao City.
Specifically, this study aims:
1. To determine the demographic profile of normocholesterolemic and borderline
hypercholesterolemic residents of Barangay 19-B Poblacion, Davao City according to:
a. Age
b. Sex
c. BMI
2. To determine the baseline lipid profile of the residents of Barangay 19-B Poblacion,
Davao City
3. To determine the lipid profile of the normocholesterolemic residents after two weeks of
taking the cocoa powder
4. To determine the lipid profile of the borderline hypercholesterolemic residents after two
weeks of taking the cocoa powder
5. To determine if there is a significant difference between the normocholesterolemic
participants lipid profile results before and after taking the cocoa powder every day for
one week

6. To determine

if

there

is

significant

difference

between

the

borderline

hypercholesterolemic participants lipid profile results before and after taking the cocoa
powder every day for one week
7. To determine if there is a significant difference between the normocholesterolemic
participants lipid profile results before and after taking the cocoa powder every day for
two weeks
8. To determine

if

there

is

significant

difference

between

the

borderline

hypercholesterolemic participants lipid profile results before and after taking the cocoa
powder every day for two weeks; and
9. To determine if there is a significant difference between the lipid profile of
normocholesterolemic and borderline hypercholesteromic participants.

Significance of the Study

Cocoa powder is dry solid remains of fermented, dried, and roasted cacao beans. The
popular use of cocoa powder is to give chocolate flavor to baked goods and drinks. Interestingly,
researchers gave attention to flavonoid content of cocoa. Flavonoids are phenolic substances that
are widely found in vegetables and fruits. Cocoa and cocoa products are important source of
flavonoids in our diet. In the observational study of Taubert, et. al. (2007), they suggested that
regular intake of cocoa-containing foods is linked to lower cardiovascular mortality.
Furthermore, the findings of the study made by Mennen, et. al. (2004) would support the study of
Taubert, that consumption of flavonoid-rich foods may prevent cardiovascular diseases.
Lowering blood cholesterol is an advised strategy to help reduce the risk of cardiovascular
diseases. Thus, in our study, we would like to add the current understanding by contributing
significant data on the effects of cocoa powder in normocholesterolemic and borderline
hypercholesterolemic respondents. Furthermore, our study would contribute about using cocoa
powder as a promising cost-efficient healthy alternative in lowering blood cholesterol.

Scope and Limitation

The study focused on the effects of cocoa powder intake on the lipid profile of
normocholesterolemic and borderline hypercholesterolemic residents in Brgy 19-B, Davao City.
The study was done among 13 volunteers Cardiovascular Disease Program database of Barangay
19-B Poblacion determined to be unmedicated . Participants are given one glass of 26 grams of

cocoa powder drink. The study utilized cocoa powder in obtaining experimental data. The study
was conducted for two weeks.

Definition of Terms
Cholesterol - a waxy substance found in the lipids of our blood and is vital for the functioning of
the body both good (HDL) and bad (LDL) cholesterol
Normocholesterolemia - having normal levels of blood cholesterol levels
Desirable levels - total cholesterol levels below 200 mg/dl or below 5.2 mmol/L (American Heart
Association)
Borderline/High risk - total cholesterol levels of 200-239 mg/dl or 5.2-6.2 mmol/L (American
Heart Association)
Hypercholesterolemia - also known as hyperlipidemia; a condition characterized by the presence
of high levels of blood cholesterol; can increase the risk of diseases of blood vessels including
Stroke and Cardiovascular disease; total cholesterol levels above 240 mg/dl or above 6.2 mmol/L
(American Heart Association)
Cocoa powder - a brown, unsweetened powder made from roasted cocoa beans (26 grams per
day)
Lipid profile - also known as lipoprotein profile; measures blood levels of total cholesterol, LDL
cholesterol, HDL cholesterol and triglycerides
Participants - unmedicated low risk hypercholesterolemic residents of Barangay 19-B Poblacion,
Davao City