• Data from a prospective study of 67,640 Swedish adults and from a meta-analysis of six prospective studies (including the prospective Swedish study) were used to examine the association between chocolate consumption and ischemic heart disease. In the Swedish study, chocolate consumption of three or more servings per week was found to reduce the risk of myocardial infarction compared with no consumption (RR, 0.87). A similar risk reduction for ischemic heart disease was noted in the highest compared with the lowest category of chocolate consumption in the meta-analysis (RR, 0.90).
• Chocolate consumption appears to be associated with a lower risk for myocardial infarction and ischemic heart disease.

Abstract

OBJECTIVE

To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data.

METHODS AND RESULTS

The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease.

RESULTS

The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%).

CONCLUSIONS

Chocolate consumption is associated with lower risk of MI and ischaemic heart disease.

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