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The idea that “we are what we eat” has motivated numerous ever-changing food fads, diet books and dietary guidelines over the past 200 years, often in the absence of firm scientific evidence to support potential health benefits. In addition, some foods, such as chocolate, are often suspected of being bad for us, probably because they taste so good.
In this edition of Heart, Kwok and colleagues (see page 1279) examined the association between chocolate consumption and risk of cardiovascular disease (CVD) based on dietary histories in over 20 thousand men and women in the European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk) study. At a median followup of 11.9 years, coronary heart disease was present in 9.7% of patients in the highest, compared to 13.8% of patients in the lowest, quintile of chocolate consumption Similarly, the rate for stroke was 3.1% in the highest, compared to 5.4% in the lowest quintile. With multivariate adjustment, the hazard ratio was 0.88 (95% CI 0.77 to 1.01) for those in the top quintile of chocolate consumption (16–99 g/day) versus those who ate no chocolate. This trend was confirmed in a propensity score matched analysis and in a meta-analysis of nine previous publications (figure 1).
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