Kwok, CS, Loke, Y, Welch, AA, Luben, RN, Lentjes, M, Boekholt, M, Pfister, R, Mamas, MA, wareham, N, Khaw, K 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). pp. 722-734. ISSN 0939-4753

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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 1,101 developed heart failure during the follow up (mean 12.5±2.7 years, total person years 262,291 years). After adjusting lifestyle and dietary factors, we found 19% relative reduction in heart failure incidence in the top (up to 100g/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 accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at 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)
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 01 Feb 2016 10:10
Last Modified: 22 Jun 2018 15:05

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