Foods such as tea, grapes or apples are rich in flavan-3-ols, a plant compound that protects our heart health.
We are constantly told to “eat healthy” – but what does that really mean? Even doctors sometimes have difficulty offering clear, practical advice about what specific foods contribute to health, why they work and what real benefits people can expect.
A growing body of research is beginning to offer some answers. A new researched whether a group of plant compounds called flavan-3-ols could help reduce blood pressure and improve blood vessel function. The results suggest that these everyday compounds may have real potential to protect heart health.
Flavan-3-ols – sometimes called flavonols or catechins – are natural plant compounds that belong to the flavonoid family. They are part of what gives color to plants and help protect them from sunlight and pests.
For us, they appear in some of the most familiar foods: cocoa, green and black tea, grapes, apples and even some red fruits. That slightly acidic or bitter note you hear in dark chocolate or strong tea? This is flavan-3-ols in action.
Scientists have long been interested in its effects on health. In 2022, the Cosmos (Cocoa Supplement and Multivitamin Outcomes Study), which followed more than 21,000 people, found that cocoa flavanols, but not multivitamin supplements, reduced deaths from cardiovascular diseases by 27%. The new study delved even deeper, focusing specifically on its effects on blood pressure and endothelial function (the way blood vessels dilate and respond to blood flow).
Data from 145 randomized clinical trials involving more than 5200 participants were analyzed. These studies tested a variety of flavonoid-rich foods and supplements, including cocoa, tea, grapes, apples and isolated compounds such as epicatechin, and measured their effects on two important cardiovascular markers: blood pressure and dilation flow-mediated (FMD): a measure of the function of the inner lining of blood vessels.
Studies ranged from short-term interventions (single dose) to long-term interventions lasting weeks or months. On average, participants consumed near 586 mg of flavan-3-ois; approximately the amount found in two to three cups of tea, one to two servings of dark chocolate, two tablespoons of cocoa powder or a few apples.
Regular consumption of flavan-3-ols led to an average drop in blood pressure of 2.8 mmHg systolic (the top number) and 2.0 mmHg diastolic (the bottom number).
But for people who started out with high blood pressure or diagnosed hypertension, the benefits were even greaterwith reductions of up to 6–7 mmHg systolic and 4 mmHg diastolic. This is comparable to the effects of some prescription blood pressure medications and can significantly reduce the risk of heart attacks and strokes.
Flavan-3-ols were also found to improve endothelial function, with an average 1.7% increase in FMD after sustained intake. This benefit was observed even in participants whose blood pressure was already normal, suggesting that these compounds may help protect blood vessels through multiple pathways.
Side effects were uncommon and generally mild, generally limited to minor digestive issues, suggesting that adding flavan-3-ol-rich foods to the diet is generally safe.
Supporting cardiovascular health
Although the benefits were more pronounced in people with high blood pressure, even people with normal values showed an improvement in vascular function. This suggests that flavan-3-ols may help to prevent cardiovascular problems before they install themselves.
Arterial hypertension is one of the main causes of heart disease throughout the world, even at levels that do not qualify as high blood pressure (140/90 mmHg or higher). Recent guidelines from the European Society of Cardiology now recognize that even “high” blood pressure (120–139 systolic and 70–89 diastolic) presents an increased risk.
Lifestyle changes, particularly diet and exercise, are recommended by doctors as first-line strategies. But patients and even healthcare professionals often lack clear and specific guidance on which foods really make a difference. The new discoveries help to fill this gapshowing that increasing flavan-3-ol intake through everyday foods may offer a simple, evidence-based way to support cardiovascular health.
What about supplements?
Some studies tested supplements or isolated flavan-3-ol compounds, but these generally showed smaller effects than whole foodslike tea or cocoa. This may occur because other beneficial compounds in whole foods work together, increasing absorption and effectiveness.
Currently, it appears safer and more effective to focus on obtaining flavan-3-ols from foods rather than high-dose supplements, especially for people taking medications, as the interactions are not fully understood.
The studies reviewed suggest that 500 to 600 mg of flavan-3-ois per day may be sufficient to observe benefits. You can achieve this by combining two to three cups of green or black tea, one to two servings (about 56 g) of dark chocolate or two to three tablespoons of cocoa powder, two to three apples and other fruits rich in flavan-3-ols, such as grapes, pears and berries.
Small daily exchanges, such as swap a sugary snack for an apple and a piece of dark chocolate or adding an extra cup of tea can gradually improve your heart health over time. As flavan-3-ol content can vary between foods, monitoring your blood pressure at home can help you see if it’s making a difference for you.
More research is needed, especially in people with diabetes, where results were less consistent. We also need to better understand how flavan-3-ols interact with medications and whether even greater benefits can be achieved when combined with other healthy habits.
But the evidence is now strong enough to recommend foods rich in flavan-3-ols as part of a heart-healthy diet. As doctors look for practical and accessible lifestyle strategies for patients, these discoveries bring us closer to the idea of using food as medicine.
It is clear that flavan-3-ols are not a magic solution. They will not replace medication for everyone. But combined with other healthy habits, they can offer a significant – and delicious – boost to your cardiovascular health. And unlike many health fads, it’s not about exotic superfoods or expensive powdered supplements. These are foods that many of us already enjoy, used with a little more care.
