title: Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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)].
  
  
  CONCLUSIONS
  These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston 02120, MA, USA. ldjousse@rics.bwh.harvard.edu
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.forename: Paul N
authors.initials: PN
authors.lastname: Hopkins
authors.forename: Kari E
authors.initials: KE
authors.lastname: North
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: R Curtis
authors.initials: RC
authors.lastname: Ellison
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002099:Cacao / Q000737:chemistry*; D003327:Coronary Disease / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005419:Flavonoids / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054555:National Heart, Lung, and Blood Institute (U.S.); D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D005419:Flavonoids