title: Chocolate consumption and risk of stroke: a prospective cohort of men and meta-analysis.
abstract: OBJECTIVE
  To investigate the association between chocolate consumption and risk of stroke in men and conduct a meta-analysis to summarize available evidence from prospective studies of chocolate consumption and stroke.
  
  
  METHODS
  We prospectively followed 37,103 men in the Cohort of Swedish Men. Chocolate consumption was assessed at baseline using a food-frequency questionnaire. Cases of first stroke were ascertained from the Swedish Hospital Discharge Registry. For the meta-analysis, pertinent studies were identified by searching the PubMed and EMBASE databases through January 13, 2012. Study-specific results were combined using a random-effects model.
  
  
  RESULTS
  During 10.2 years of follow-up, we ascertained 1,995 incident stroke cases, including 1,511 cerebral infarctions, 321 hemorrhagic strokes, and 163 unspecified strokes. High chocolate consumption was associated with a lower risk of stroke. The multivariable relative risk of stroke comparing the highest quartile of chocolate consumption (median 62.9 g/week) with the lowest quartile (median 0 g/week) was 0.83 (95 % CI 0.70-0.99). The association did not differ by stroke subtypes. In a meta-analysis of 5 studies, with a total of 4,260 stroke cases, the overall relative risk of stroke for the highest vs lowest category of chocolate consumption was 0.81 (95% CI 0.73-0.90), without heterogeneity among studies (p = 0.47).
  
  
  CONCLUSIONS
  These findings suggest that moderate chocolate consumption may lower the risk of stroke.
authors.affiliation: Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. susanna.larsson@ki.se
authors.forename: Susanna C
authors.initials: SC
authors.lastname: Larsson
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
mesh_terms: D000328:Adult; D002099:Cacao; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires