title: Chocolate consumption and risk of heart failure in the Physicians' Health Study.
abstract: OBJECTIVE
  To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure (HF).
  
  
  RESULTS
  We prospectively studied 20 278 men from the Physicians' Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self-administered food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF. During a mean follow-up of 9.3 years there were 876 new cases of HF. The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios [95% confidence intervals (CI)] for HF were 1.0 (ref), 0.86 (0.72-1.03), 0.80 (0.66-0.98), 0.92 (0.74-1.13), and 0.82 (0.63-1.07), for chocolate consumption of less than 1/month, 1-3/week, 2-4/week, and 5+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation (P for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was <25 kg/m(2) [HR (95% CI) = 0.59 (0.37-0.94) for consumption of 5+ servings/week, P for linear trend = 0.03) but not in those with BMI of 25+ kg/m(2) [HR (95% CI) = 1.01 (0.73-1.39), P for linear trend = 0.42, P for interaction = 0.17).
  
  
  CONCLUSIONS
  Our data suggest that moderate consumption of chocolate might be associated with a lower risk of HF in male physicians.
authors.affiliation: Division of Aging and the Department of Preventive Medicine, Brigham and Women's Hospital, 1620 Tremont St. 3rd floor, Boston, MA, 02120, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) and Geriatric Research (GRECC), Boston, MA, USA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Petrone
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002099:Cacao; D002182:Candy; D015331:Cohort Studies; D004034:Diet Surveys; D004311:Double-Blind Method; D005419:Flavonoids / Q000008:administration & dosage; D006333:Heart Failure / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D005419:Flavonoids; D001241:Aspirin
keywords: Epidemiology; Heart failure; Nutrition; Risk factors