Cocoa beans in a cocoa pod.

Cocoa extract is showing promise in decreasing acute macular degeneration (AMD) risk, according to a US study published in JAMA Ophthalmology.

The cocoa supplement and multivitamin outcomes (COSMOS) study, conducted at the Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, found patients taking cocoa extract may have a decreased AMD event risk (developing AMD or progressing to advanced AMD) in the first two years of supplementation.

COSMOS assessed participants’ risk of developing heart disease, stroke, cancer and other health outcomes while taking daily cocoa extract supplements containing 500mg/day cocoa flavanols or a common multivitamin. It included 12,666 women aged ≥65 years and 8,776 men aged ≥60 years who were followed for an average of 3.6 years.

Although authors concluded cocoa supplementation had no effect overall on the occurrence of AMD, they could not rule out a possible modest treatment effect early in the trial. This warrants further investigation to clarify whether cocoa extract may help reduce AMD risk, they said.

COSMOS has already shown cardiovascular benefits with long-term use of cocoa extract supplements, including a significant 27% reduction in cardiovascular death. Researchers also said participants with comparatively lower levels of dietary flavanol intake may have greater cognitive benefits from a cocoa extract supplement compared with those taking placebo.