Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.
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.
Djoussé
Luc
L
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston 02120, MA, USA. ldjousse@rics.bwh.harvard.edu
Hopkins
Paul N
PN
North
Kari E
KE
Pankow
James S
JS
Arnett
Donna K
DK
Ellison
R Curtis
RC
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
D005419:Flavonoids