Effects of cocoa products intake on cardiometabolic biomarkers of type 2 diabetes patients: a systematic review and meta-analysis based on both long-term and short-term randomised controlled trials

Cocoa consumption as a diet has been shown to improve cardiometabolic biomarkers for T2D, but results were inconsistent. A comprehensive search from PubMed, Web of Science, Embase, and The Cochrane Library to identify the randomised controlled trials investigating the impacts of cocoa products consumption on cardiometabolic biomarkers in T2D was performed up to December 2020. Twelve trials involving 9 long-term and 3 short-term studies were included. The cocoa products significantly decreased low density lipoprotein-cholesterol (WMD: -9.955 mg/dL, 95% CI: -17.408, -2.501, p = 0.009), triglyceride (WMD: -15.364 mg/dL, 95% CI: -23.383, -7.346, p < 0.001), blood glucose (WMD: -9.105 mg/dL, 95% CI: -15.022, -3.189, p = 0.003), and C-reactive protein (WMD: -0.978 mg/L, 95% CI: -1.687, -0.269, p = 0.007) in long-term. The results indicated the beneficial long-term effects of cocoa products intake on cardiometabolic biomarkers for T2D, especially on blood glucose, lipid metabolism (LDL-C and TG), and inflammation (CRP).