Keele Research Repository

Kwok, CS, Loke, YK, Welch, AA, Luben, RN, Lentjes, MA, Boekholdt, SM, Pfister, R, Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890, Wareham, NJ, Khaw, KT and Myint, PK (2016) Habitual chocolate consumption and the risk of incident heart failure among healthy men and women. Nutrition, Metabolism and Cardiovascular Diseases, 26 (8). 722 -734.

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Abstract

BACKGROUND: We aimed to examine the association between chocolate intake and the risk of incident heart failure in a UK general population. We conducted a systematic review and meta-analysis to quantify this association. METHODS AND RESULTS: We used data from a prospective population-based study, the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort. Chocolate intake was quantified based on a food frequency questionnaire obtained at baseline (1993-1997) and incident heart failure was ascertained up to March 2009. We supplemented the primary data with a systematic review and meta-analysis of studies which evaluated risk of incident heart failure with chocolate consumption. A total of 20,922 participants (53% women; mean age 58 ± 9 years) were included of whom 1101 developed heart failure during the follow up (mean 12.5 ± 2.7 years, total person years 262,291 years). After adjusting for lifestyle and dietary factors, we found 19% relative reduction in heart failure incidence in the top (up to 100 g/d) compared to the bottom quintile of chocolate consumption (HR 0.81 95%CI 0.66-0.98) but the results were no longer significant after controlling for comorbidities (HR 0.87 95%CI 0.71-1.06). Additional adjustment for potential mediators did not attenuate the results further. We identified five relevant studies including the current study (N = 75,408). The pooled results showed non-significant 19% relative risk reduction of heart failure incidence with higher chocolate consumption (HR 0.81 95%CI 0.66-1.01). CONCLUSIONS: Our results suggest that higher chocolate intake is not associated with subsequent incident heart failure.

Item Type:	Article
Additional Information:	This is the final published version of the article (version of record). It first appeared online via Elsevier at http://dx.doi.org/10.1016/j.numecd.2016.01.003 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords:	Heart failure; Chocolate; Cocoa; Epidemiology; Meta-analysis
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:	Author
Depositing User:	Symplectic
Date Deposited:	16 Sep 2016 13:23
Last Modified:	30 Mar 2021 13:57
URI:	https://eprints.keele.ac.uk/id/eprint/2202

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