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 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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 722-734 |
| Number of pages | 13 |
| Journal | Nutrition, Metabolism and Cardiovascular Diseases |
| Volume | 26 |
| Issue number | 8 |
| Early online date | 28 Jan 2016 |
| DOIs | |
| Publication status | Published - Aug 2016 |
Keywords
- heart failure
- chocolate
- cocoa
- epidemiology
- meta-analysis
