Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular
disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies
have demonstrated blood pressure lowering effects of dark chocolate. However, limited
data are available on the association of chocolate consumption and the risk of coronary
heart disease (CHD). We sought to examine the association between chocolate consumption
and prevalent CHD.
We studied in a cross-sectional design 4970 participants aged 25-93 years who participated
in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate
intake was assessed through a semi-quantitative food frequency questionnaire. We used
generalized estimating equations to estimate adjusted odds ratios.
Compared to subjects who did not report any chocolate intake, odds ratios (95% CI)
for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects
consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for
trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education,
non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise,
and fruit and vegetables. Consumption of non-chocolate candy was associated with a
49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)].
These data suggest that consumption of chocolate is inversely related with prevalent
CHD in a general United States population.
Published by Elsevier Ltd.