ArticleContemporary clinical trials2022
Design and baseline characteristics of participants in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).
Article in Contemporary clinical trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02422745 (COcoa Supplement and Multivitamin Outcomes Study), which is not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
COcoa Supplement and Multivitamin Outcomes Study
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Potato Consumption and Risk of Cardiovascular Disease in a Harmonized Analysis of Seven Prospective Cohorts.Nutrients · 2025Pooled it
- Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS.The American journal of clinical nutrition · 2024Pooled it
- Effects of daily multivitamin-multimineral supplementation on metabolomic profiles: 2-year findings from the COSMOS randomized clinical trial.GeroScience · 2026Trial
- Trial
- Effects of daily multivitamin-multimineral and cocoa extract supplementation on epigenetic aging clocks in the COSMOS randomized clinical trial.Nature medicine · 2026Trial
- Effects of 2-year cocoa extract supplementation on inflammaging biomarkers in older US adults: findings from the COcoa Supplement and Multivitamin Outcomes Study randomised clinical trial.Age and ageing · 2025Trial
- Effects of cocoa extract supplementation and multivitamin/multimineral supplements on self-reported fractures in the Cocoa Supplement and Multivitamins Outcomes Study randomized clinical trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Trial
- Prepandemic Physical Activity and Risk of COVID-19 Diagnosis and Hospitalization in Older Adults.JAMA network open · 2024Trial
- Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.The American journal of clinical nutrition · 2024Trial
- Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial.Diabetes care · 2023Trial
- Impact of multivitamin-mineral and cocoa extract on incidence of mild cognitive impairment and dementia: Results from the COcoa Supplement and Multivitamin Outcomes Study for the Mind (COSMOS-Mind).Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Trial
- Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial.The American journal of clinical nutrition · 2023Trial
- Dietary flavanols restore hippocampal-dependent memory in older adults with lower diet quality and lower habitual flavanol consumption.Proceedings of the National Academy of Sciences of the United States of America · 2023Trial
- Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Trial
- Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial.The American journal of clinical nutrition · 2022Trial
- Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial.The American journal of clinical nutrition · 2022Trial
- Combining external placebo-arm data in a prevention trial: effects of cocoa extract supplementation on cardiovascular disease.European journal of epidemiology · 2026Article
- Longitudinal changes in epigenetic measures over 2 years: methodological implications.GeroScience · 2026Article
- Adhering to dietary guidelines does not yield flavanol intake levels associated with beneficial cardiovascular effects.Food & function · 2026Article
- Effects of pistachio consumption on cognition, cardiometabolic risk factors, and life satisfaction in older adults: Protocol for a remote-based randomized controlled trial.Contemporary clinical trials · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 6 institutions in 2 countries.
Funding
Abstract
Background Cocoa extract and multivitamins have been proposed to reduce the risk of cardiovascular disease (CVD) and cancer, respectively. However, few randomized clinical trials have tested their long-term effects on these outcomes. Methods The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled, 2 × 2 factorial trial of a cocoa extract supplement and a multivitamin supplement to reduce the risk of CVD and cancer. Here we describe the pragmatic, hybrid design of the trial and baseline characteristics of the trial participants. Results The nationwide study population includes 21,442 U.S. women aged ≥65 years and men aged ≥60 years without baseline myocardial infarction (MI), stroke, or a recent (within the past 2 years) cancer diagnosis. Participants were randomized in a 2 × 2 factorial design to one of four groups: (1) cocoa extract (containing 500 mg/d flavanols, including 80 mg (-)-epicatechin) and a multivitamin (Centrum Silver©); (2) cocoa extract and multivitamin placebo; (3) multivitamin and cocoa extract placebo; or (4) both placebos. Randomization successfully distributed baseline demographic, clinical, behavioral, and dietary characteristics across treatment groups. Baseline biospecimens were collected from 6867 participants, with at least one follow-up biospecimen from 2142 participants. The primary outcome for the cocoa extract intervention is total CVD (a composite of MI, stroke, cardiovascular mortality, coronary revascularization, unstable angina requiring hospitalization, carotid artery surgery, and peripheral artery surgery); the primary outcome for the multivitamin intervention is total invasive cancer. Conclusion COSMOS will provide important information on the health effects of cocoa extract and multivitamin supplementation in older U.S. adults. Clinical Trials Registration: clinicaltrials.gov #NCT02422745.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.