TABLE 1.

Observational human studies published over the past 6 years investigating flavonoid consumption and cognitive outcomes.

Title, reference	Cohort information	Study design	Flavonoids investigated	Outcome measure(s)	Main finding(s)
Long-term dietary flavonoid intake and change in cognitive function in the Framingham Offspring Cohort (Shishtar et al., 2020)	N = 1779 Age: ≥45 Cognitively normal Framingham, MA, United States	Prospective cohort study Median 11.8-year follow-up	Total flavonoids, flavanones, flavan-3-ols, flavonoid polymers, flavonols, flavones, and anthocyanins	Verbal memory, visual memory, verbal learning, attention and concentration, abstract reasoning, language, visuoperceptual organization, and global function	Nominally significant trends observed between slower decline in global function, verbal and visual memory with higher flavonol and flavan-3-ol intakes; slower decline in visual memory with higher total flavonoid and flavonoid polymer intake; and slower decline in verbal learning with higher flavanol intake
The efficacy of cocoa polyphenols in the treatment of mild cognitive impairment: a retrospective study (Calabro et al., 2019)	N = 55 Age: 56–75 Amnestic MCI Messina, Italy	Retrospective cohort study over 1 year	Mexenion® composed of cocoa polyphenols (240 mg/sachet)	MMSE	Participants were divided into two groups depending on change in MMSE score at 1-year follow-up: Group 1 = stable or improved, Group 2 = decreased by at least three points. Group 1 had a significantly higher rate of Mexenion® intake than Group 2
Chocolate intake is associated with better cognitive function: The Main Syracuse Longitudinal Study (Crichton et al., 2016)	N = 968 Age: 23–98 Syracuse, NY, United States	Cross-sectional study	Chocolate intake divided into categories: less than once a week, once per week, more than once per week	Maine-Syracuse Longitudinal Study neuropsychological test battery: Composite domains global, visual-spatial memory and organization, scanning and tracking, verbal episodic memory, and working memory. Wechsler Adult Intelligence Scale Similarities Test MMSE	Chocolate consumption was significantly and positively associated with the global composite, visual-spatial memory and organization, scanning and tracking, verbal episodic memory, working memory, Wechsler Adult Intelligence Scale Similarities Test, and MMSE

MCI, Mild Cognitive Impairment; MMSE, Mini-Mental State Examination.