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Chocolate consumption may lower risk for MI, ischemic heart disease
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Eating a serving of chocolate several times a week may lower risk for MI and ischemic heart disease, according to data published in Heart.
Researchers in Sweden conducted a prospective study and meta-analysis to investigate the relationship between chocolate consumption and ischemic heart disease. Susanna Larsson, MD, from the unit of nutritional epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden, and colleagues collected food frequency questionnaire data from 67,640 women and men aged 45 to 83 years from the Cohort of Swedish Men and the Swedish Mammography Cohort in 1997. Then they used the Swedish National Patient Register and the Swedish Cause of Death Register at the National Board of Health and Welfare to determine which participants experienced incident MI during the follow-up period between 1998 and 2010.
By 2010, 4,417 incidents of MI (3,067 in men; 1,350 in women) had occurred. The researchers observed an inverse relationship between chocolate consumption and risk for MI.
Participants were grouped by frequency of chocolate consumption (never, 1-3 servings/month, 1-2 servings/week and 3 or more servings/week). Those who ate three or more servings a week of chocolate had a 13% lower risk for MI (RR = 0.87; 95% CI, 0.77-0.98; P = .04 for trend) compared with participants who never ate chocolate. This association remained significant even after adjusting for potential confounders such as BMI, diabetes, hypertension and hypercholesterolemia (P > .25 for interaction), according to the researchers.
Participants in the highest category of chocolate consumption tended to be university-educated with fewer comorbidities such as obesity, diabetes, hypertension and hypercholesterolemia. They also were less likely to be smokers. However, they ate more processed meat.
The researchers acknowledged limitations of the study, including that there was only one question on the food frequency questionnaire about chocolate consumption and that responses did not specify type of chocolate.
For the meta-analysis, the researchers searched PubMed and Embase databases for other prospective studies that assessed the relationship between chocolate and risk for ischemic heart disease. In total, the current study and five other prospective studies from Sweden, Germany, the United Kingdom and the United States were included in the meta-analysis. Type of chocolate was only specified in two of these studies.
Combined, the six studies reported 6,851 incidents of ischemic heart disease and an RR of 0.9 (95% CI, 0.82-0.97) for those with the highest consumption of chocolate vs. those with the lowest consumption (heterogeneity [I2] = 24.3%). According to the data, those who ate the most chocolate had a 10% lower risk for ischemic heart disease. In a dose-response meta-analysis of the four studies that included three or more categories of chocolate consumption, the RR per 50 g/week increment of chocolate consumption was 0.95 (95% CI, 0.92-0.98).
Larsson and colleagues concluded that although “chocolate consumption may lower the risk for ischemic heart disease, chocolate should be consumed in moderation because it is high in sugar, calories and saturated fat.” – by Tracey Romero
Disclosure: The researchers report no relevant financial disclosures.
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