Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial
Primary result · Incident T2DResult — go to the resultAdjusted hazard ratio 1.04 95% CI 0.91–1.20Authors' conclusion
Middle-aged and older adults taking a cocoa extract supplement for a median of 3.5 years did not reduce their risk of incident T2D. Further studies of cocoa extract supplementation beginning earlier in adulthood and in populations with different background diets are warranted.
Study context
- Population
- US adults free of cardiovascular disease (CVD) and recent cancer (women aged ≥65 years, men aged ≥60 years) without diabetes at enrollmentwithout diabetes
- Participants
- 18,381 adults
- Comparison
- Cocoa extract vs placebo
- Primary endpoint
- Incident self-reported T2D
- Follow-up
- Median 3.5 years
Methodological details2 × 2 factorial, June 2015 to December 2020
- 2 × 2 factorial
- June 2015 to December 2020
Primary result
Incident T2D · median 3.5 years
Adjusted hazard ratio
1.04
95% CI 0.91–1.20
P = 0.58
Cocoa extractvs Placebo
aHR 1.04 (95% CI 0.91–1.20); P = 0.58
As reported in the abstract
- Incident T2D cases overall
- 801
Further findings
Effect modification (sex, race, BMI, smoking, physical activity, dietary quality, baseline flavanol status, multivitamin assignment)
- Effect of cocoa extract not significantly modified by any stratification factor
Original publication
Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial. Diabetes Care. Published 10 October 2023. doi:10.
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