title: Daily chocolate consumption is inversely associated with insulin resistance and liver enzymes in the Observation of Cardiovascular Risk Factors in Luxembourg study.
abstract: This study examined the association of chocolate consumption with insulin resistance and serum liver enzymes in a national sample of adults in Luxembourg. A random sample of 1153 individuals, aged 18-69 years, was recruited to participate in the cross-sectional Observation of Cardiovascular Risk Factors in Luxembourg study. Chocolate consumption (g/d) was obtained from a semi-quantitative FFQ. Blood glucose and insulin levels were used for the homoeostasis model assessment of insulin resistance (HOMA-IR). Hepatic biomarkers such as serum γ-glutamyl-transpeptidase (γ-GT), serum aspartate transaminase and serum alanine transaminase (ALT) (mg/l) were assessed using standard laboratory assays. Chocolate consumers (81·8 %) were more likely to be younger, physically active, affluent people with higher education levels and fewer chronic co-morbidities. After excluding subjects taking antidiabetic medications, higher chocolate consumption was associated with lower HOMA-IR (β=-0·16, P=0·004), serum insulin levels (β=-0·16, P=0·003) and γ-GT (β=-0·12, P=0·009) and ALT (β=-0·09, P=0·004), after adjustment for age, sex, education, lifestyle and dietary confounding factors, including intakes of fruits and vegetables, alcohol, polyphenol-rich coffee and tea. This study reports an independent inverse relationship between daily chocolate consumption and levels of insulin, HOMA-IR and liver enzymes in adults, suggesting that chocolate consumption may improve liver enzymes and protect against insulin resistance, a well-established risk factor for cardiometabolic disorders. Further observational prospective research and well-designed randomised-controlled studies are needed to confirm this cross-sectional relationship and to comprehend the role and mechanisms that different types of chocolate may play in insulin resistance and cardiometabolic disorders.
authors.affiliation: 1Luxembourg Institute of Health (LIH) (formerly CRP-Santé),Epidemiology and Public Health Research Unit,Strassen, L-1445,Grand-Duchy of Luxembourg.
authors.forename: Ala'a
authors.initials: A
authors.lastname: Alkerwi
authors.affiliation: 1Luxembourg Institute of Health (LIH) (formerly CRP-Santé),Epidemiology and Public Health Research Unit,Strassen, L-1445,Grand-Duchy of Luxembourg.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sauvageot
authors.affiliation: 1Luxembourg Institute of Health (LIH) (formerly CRP-Santé),Epidemiology and Public Health Research Unit,Strassen, L-1445,Grand-Duchy of Luxembourg.
authors.forename: Georgina E
authors.identifier: 0000-0002-6532-7931
authors.initials: GE
authors.lastname: Crichton
authors.affiliation: 3Department of Psychology,University of Maine,Orono,ME 04469,USA.
authors.forename: Merrill F
authors.initials: MF
authors.lastname: Elias
authors.affiliation: 1Luxembourg Institute of Health (LIH) (formerly CRP-Santé),Epidemiology and Public Health Research Unit,Strassen, L-1445,Grand-Duchy of Luxembourg.
authors.forename: Saverio
authors.initials: S
authors.lastname: Stranges
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002099:Cacao; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D000069956:Chocolate; D004032:Diet; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008189:Luxembourg; D008297:Male; D008875:Middle Aged; D028321:Plant Preparations / Q000494:pharmacology* / Q000627:therapeutic use; D012307:Risk Factors; D012639:Seeds; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D028321:Plant Preparations; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase
keywords: Chocolate consumption; FPG fasting plasma glucose; HOMA-IR homoeostasis model assessment of insulin resistance; Insulin resistance; Liver enzymes; ORISCAV-LUX Observation of Cardiovascular Risk Factors in Luxembourg