RT Journal Article
SR Electronic
T1 Chocolate consumption and risk of cardiovascular diseases: a meta-analysis of prospective studies
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 49
OP 55
DO 10.1136/heartjnl-2018-313131
VO 105
IS 1
A1 Ren, Yongcheng
A1 Liu, Yu
A1 Sun, Xi-Zhuo
A1 Wang, Bing-Yuan
A1 Zhao, Yang
A1 Liu, De-Chen
A1 Zhang, Dong-Dong
A1 Liu, Xue-Jiao
A1 Zhang, Rui-Yuan
A1 Sun, Hao-Hang
A1 Liu, Fei-Yan
A1 Chen, Xu
A1 Cheng, Cheng
A1 Liu, Lei-Lei
A1 Zhou, Qiong-Gui
A1 Zhang, Ming
A1 Hu, Dong-Sheng
YR 2019
UL http://heart.bmj.com/content/105/1/49.abstract
AB Objective Studies investigating the impact of chocolate consumption on cardiovascular disease (CVD) have reached inconsistent conclusions. As such, a quantitative assessment of the dose–response association between chocolate consumption and incident CVD has not been reported. We performed a systematic review and meta-analysis of studies assessing the risk of CVD with chocolate consumption.Methods PubMed and EMBASE databases were searched for articles published up to 6 June 2018. Restricted cubic splines were used to model the dose–response association.Results Fourteen publications (23 studies including 405 304 participants and 35 093 cases of CVD) were included in the meta-analysis. The summary of relative risk (RR) per 20 g/week increase in chocolate consumption was 0.982 (95% CI 0.972 to 0.992, I2=50.4%, n=18) for CVD (heart failure: 0.995 (0.981 to 1.010, I2=36.3%, n=5); total stroke: 0.956 (0.932 to 0.980, I2=25.5%, n=7); cerebral infarction: 0.952 (0.917 to 0.988, I2=0.0%, n=4); haemorrhagic stroke: 0.931 (0.871 to 0.994, I2=0.0%, n=4); myocardial infarction: 0.981 (0.964 to 0.997, I2=0.0%, n=3); coronary heart disease: 0.986 (0.973 to 0.999, n=1)). A non-linear dose–response (pnon-linearity=0.001) indicated that the most appropriate dose of chocolate consumption for reducing risk of CVD was 45 g/week (RR 0.890;95%CI 0.849 to 0.932).Conclusions Chocolate consumption may be associated with reduced risk of CVD at <100 g/week consumption. Higher levels may negate the health benefits and induce adverse effects associated with high sugar consumption.