Tomato Extract Views
Flavanol-rich chocolate and lycopene-rich tomato extract have attracted interest as potential alternative treatment options for hypertension, a known risk factor for cardiovascular morbidity and mortality. Treatment of prehypertension (SBP 120>–139/DBP 80o–89 mmHg) may forestall progression to hypertension. However, there has been only limited research into non-pharmacological treatment options for prehypertension. We investigated the effect of dark chocolate or tomato extract on blood pressure, and their acceptability as an ongoing treatment option in a prehypertensive population.
Our trial consisted of two phases: a randomised controlled three-group-parallel trial over 12 weeks (phase 1) followed by a crossover of the two active treatment arms over an additional 12-week period (phase 2). Group 1 received a 50 g daily dose of dark chocolate with 70% cocoa containing 750 mg polyphenols, group 2 were allocated one tomato extract capsule containing 15 mg lycopene per day, and group 3 received one placebo capsule daily over 8 weeks followed by a 4-week washout period. In phase 2 the active treatment groups were crossed over to receive the alternative treatment. Median blood pressure, weight, and abdominal circumference were measured 4-weekly, and other characteristics including physical activity, general health, energy, mood, and acceptability of treatment were assessed by questionnaire at 0, 8 and 20 weeks. We analysed changes over time using a linear mixed model, and one time point differences using Kruskal-Wallis, Fisher's-Exact, or t-tests.
Lifestyle modifications including dietary approaches have been recommended for the management of prehypertension [1,7]. Because alternative and complementary treatment options for blood pressure have become increasingly popular [8,9], we investigated whether dark chocolate or tomato extract would be effective or acceptable treatment options for prehypertension.
Polyphenols, in particular flavanols, in chocolate have been associated with the formation of endothelial nitric oxide leading to vasodilation and lowering of blood pressure [10-12], whereas the blood pressure lowering effect of tomato extract has been linked to its high antioxidant content, in particular the carotenoid lycopene, and its free radical scavenging properties [13,14].
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