(-)-Epicatechin and the comorbidities of obesity

Arch Biochem Biophys. 2020 Sep 15;690:108505. doi: 10.1016/j.abb.2020.108505. Epub 2020 Jul 14.


Obesity has major adverse consequences on human health contributing to the development of, among others, insulin resistance and type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, altered behavior and cognition, and cancer. Changes in dietary habits and lifestyle could contribute to mitigate the development and/or progression of these pathologies. This review will discuss current evidence on the beneficial actions of the flavan-3-ol (-)-epicatechin (EC) on obesity-associated comorbidities. These benefits can be in part explained through EC's capacity to mitigate several common events underlying the development of these pathologies, including: i) high circulating levels of glucose, lipids and endotoxins; ii) chronic systemic inflammation; iii) tissue endoplasmic reticulum and oxidative stress; iv) insulin resistance; v) mitochondria dysfunction and vi) dysbiosis. The currently known underlying mechanisms and cellular targets of EC's beneficial effects are discussed. While, there is limited evidence from human studies supplementing with pure EC, other studies involving cocoa supplementation in humans, pure EC in rodents and in vitro studies, support a potential beneficial action of EC on obesity-associated comorbidities. This evidence also stresses the need of further research in the field, which would contribute to the development of human dietary strategies to mitigate the adverse consequences of obesity.

Keywords: Dyslipidemia; Epicatechin; Inflammation; Insulin resistance; Intestine; Obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Blood Glucose / drug effects
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy
  • Catechin / pharmacology*
  • Comorbidity
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Dysbiosis / metabolism
  • Dyslipidemias / metabolism
  • Endoplasmic Reticulum / metabolism
  • Endotoxins / metabolism
  • Flavonoids / pharmacology
  • Humans
  • Inflammation / metabolism
  • Insulin Resistance
  • Lipid Metabolism
  • Mental Disorders / complications
  • Mental Disorders / drug therapy
  • Mitochondria / metabolism
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / drug therapy
  • Obesity / drug therapy*
  • Oxidative Stress


  • Blood Glucose
  • Endotoxins
  • Flavonoids
  • flavan-3-ol
  • Catechin