title: Chocolate consumption and prevalence of metabolic syndrome in the NHLBI Family Heart Study.
abstract: OBJECTIVE
  Previous studies have suggested that cocoa products, which are rich sources of flavonoids, may lower blood pressure, serum cholesterol, fasting blood glucose and improve endothelial function. However, it is unclear whether consumption of cocoa products including chocolate influences the risk of metabolic syndrome (MetS). In a cross-sectional design, we sought to examine the association between chocolate consumption and the prevalence of MetS.
  
  
  METHODS
  We studied 4098 participants from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study aged 25-93 years. Chocolate consumption was assessed using a semi-quantitative food-frequency questionnaire. MetS was defined using the NCEP III criteria. Generalized estimating equations were used to estimate prevalence odds ratios of MetS according to frequency of chocolate intake.
  
  
  RESULTS
  Of the 4098 participants (mean age 51.7 y) included in the analyses, 2206 (53.8%) were female. The prevalence of metabolic syndrome in our population was 30.2%. Compared with those who did not consume any chocolate, multivariate adjusted odds ratios (95% CI) for MetS were 1.26 (0.94, 1.69), 1.15 (0.85, 1.55), and 0.99 (0.66, 1.51) among women who reported chocolate consumption of 1-3 times/ month, 1-4 times/week, and 5+ times/week, respectively. Corresponding values for men were: 1.13 (0.82, 1.57), 1.02 (0.74, 1.39), and 1.21 (0.79, 1.85).
  
  
  CONCLUSIONS
  These data do not support an association between chocolate intake and the prevalence of MetS in US adult men and women.
authors.affiliation: Division of Aging, OBC, 3rd floor, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont St., Boston, MA 02120-1613, USA.
authors.forename: Oluwabunmi A
authors.initials: OA
authors.lastname: Tokede
authors.affiliation: Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Curtis R
authors.initials: CR
authors.lastname: Ellison
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.affiliation: Department of Epidemiology, University of North Carolina and Carolina Center for Genome Sciences, Chapel Hill, NC, USA.
authors.forename: Kari E
authors.initials: KE
authors.lastname: North
authors.affiliation: Division of Cardiovascular Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hunt
authors.affiliation: Division of Statistical Genomics, Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Aldi T
authors.initials: AT
authors.lastname: Kraja
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.affiliation: Division of Aging, OBC, 3rd floor, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont St., Boston, MA 02120-1613, USA ; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA, USA ; Harvard Medical School, Boston, MA, USA.
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
keywords: Cardiovascular disease risk; Chocolate; Metabolic syndrome