FLAVIOLA addressed gaps in existing research including: absorption, metabolism, and excretion of flavanols; population-based data on flavanol intake; need for rigorous, large-scale clinical studies.

Clinical studies conducted as a part of the FLAVIOLA project were double-blinded, randomized control trials. These are considered the “gold standard” when it comes to experimental study designs. Using these rigorous study designs allows results to be translated into or contribute to the development of meaningful public health policies. Additionally, other elements of study design informed the implications on public health, these are outlined below.
The FLAVIOLA consortium also sets a precedent for collaborations between academia, industry, and government to achieve large-scale investigations.

FLAVIOLA investigators noted the need for continued research in many areas, notably these include: continued elucidation of the mechanism(s) of action by which flavanols elicit health effects, investigation into age-related differences in flavanol metabolism, and initiation of a larger-scale clinical trial.

In the EU and US, the percentage of elderly is rising, which can place a burden on health care systems, the economy, and families due to health conditions that are associated with aging.

New research, including results from FLAVIOLA, indicate that there may be ways to reduce the risk of some age-associated diseases and possibly maintain health with diet and nutrition through the aging process.

One of the key insights from the FLAVIOLA project was the study comparing the effects of cocoa flavanol intake in young and elderly adults. Intake of cocoa flavanols improved vascular health in young and elderly individuals. The endpoints measured included measures of arterial stiffness, which is known to be associated with aging.

Understanding the role of nutrition and diet in healthy aging, which refers to maintaining optimal health during the aging process, will contribute to better preventative health and lessen the social and economic burdens of compromised health.

Daily recommendations for nutrients, know as dietary reference values (DRVs) in the EU or dietary reference intake (DRIs) in the US, are used in government programs (such as school lunch requirements), on food labels, and by medical professionals when giving nutrition advice. Unlike vitamins and minerals, flavanols do not have specific dietary recommendations for daily intake, in part, due to a lack of sound, scientific evidence to indicate that flavanols are needed for optimal health.

FLAVIOLA project was designed to provide the sound, science-based knowledge and contribute to the body of evidence that may be used to determine if a daily recommendation for flavanols is necessary. The key elements from FLAVIOLA that will contribute to public health recommendations are:

• Establishing that there is little variability in the absorption of flavanols, which supports that a fixed, daily recommendation for flavanol intake is reasonable.
• Gaining knowledge on current, typical intake of flavanols in the EU population and development of food databases that can be used to assess flavanol intake in other populations.
• For the first time, FLAVIOLA studied the effects of flavanol intake on cardiovascular function in healthy people. This is a requirement to determine a daily intake recommendation.
• Lastly, one of the clinical trials within the FLAVIOLA project examined the effects of cocoa flavanols over a one month (30 day) period, this time-frame is crucial as it is the time-frame considered by EFSA to be relevant in the food-claims regulatory framework related to cardiovascular health benefits.