title: Chocolate consumption and bone density in older women.
abstract: BACKGROUND
  Nutrition is important for the development and maintenance of bone structure and for the prevention of osteoporosis and fracture. The relation of chocolate intake with bone has yet to be investigated.
  
  
  OBJECTIVE
  We investigated the relation of chocolate consumption with measurements of whole-body and regional bone density and strength.
  
  
  METHODS
  Randomly selected women aged 70-85 y (n=1460) were recruited from the general population to a randomized controlled trial of calcium supplementation and fracture risk. We present here a cross-sectional analysis of 1001 of these women. Bone density and strength were measured with the use of dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and quantitative ultrasonography. Frequency of chocolate intake was assessed with the use of a questionnaire and condensed into 3 categories: <1 time/wk, 1-6 times/wk, >or=1 time/d.
  
  
  RESULTS
  Higher frequency of chocolate consumption was linearly related to lower bone density and strength (P<0.05). Daily (>or=1 times/d) consumption of chocolate, in comparison to <1 time/wk, was associated with a 3.1% lower whole-body bone density; with similarly lower bone density of the total hip, femoral neck, tibia, and heel; and with lower bone strength in the tibia and the heel (P<0.05, for all). Adjustment for covariates did not influence interpretation of the results.
  
  
  CONCLUSIONS
  Older women who consume chocolate daily had lower bone density and strength. Additional cross-sectional and longitudinal studies are needed to confirm these observations. Confirmation of these findings could have important implications for prevention of osteoporotic fracture.
authors.affiliation: Royal Perth Hospital Unit, the University of Western Australia School of Medicine and Pharmacology, Perth, Australia. jonathan.hodgson@uwa.edu.au
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Hodgson
authors.forename: Amanda
authors.initials: A
authors.lastname: Devine
authors.forename: Valerie
authors.initials: V
authors.lastname: Burke
authors.forename: Ian M
authors.initials: IM
authors.lastname: Dick
authors.forename: Richard L
authors.initials: RL
authors.lastname: Prince
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002099:Cacao / Q000009:adverse effects; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002182:Candy / Q000009:adverse effects; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D016014:Linear Models; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary