Study design, participants, follow-up and outcomes for studies evaluating chocolate consumption and CVD
| Study ID | Dietary exposures | Study design | No in analysis | Characteristics | Follow-up (years) | Outcome measures | Measures of association |
|---|---|---|---|---|---|---|---|
| Buijsse et al5 | Cocoa intake | Prospective cohort, Netherlands | 470 | White men with mean age 72 years | 15 | Cardiovascular mortality at 15 years | RR: 0.50 (0.32–0.78) for >2.25 g/day vs <0.5 g/day (top vs bottom tertile) |
| Buijsse et al20 | Chocolate consumption | Prospective cohort, Germany | 19 357 | Men and women with mean age of 49 years, 38% were men with no history of myocardial infarction and stroke and not using blood pressure drugs | 10 | Incident MI, stroke and composite of both at mean of 8.1 years follow-up | RR: MI 0.73 (0.47–1.18), stroke 0.52 (0.30–0.89), composite 0.61 (0.44–0.87) for 4th quartile vs 1st quartile energy-adjusted chocolate consumption |
| Djousse et al19 | Chocolate consumption | Cross-sectional, USA | 4970 | Men and women with mean age of 52 years (range 25–93 years), 45% were men and 5% were of African-American origin | NA | Prevalent coronary heart disease (MI or coronary revascularisation) | OR: 0.43 (0.27–0.68) for >5 times a week vs no consumption (based on some degree of post-hoc categorisation of collected data). |
| Janszky et al21 | Chocolate consumption | Prospective cohort, Sweden | 1169 | Men (71%) and women who survived an acute myocardial infarction with mean age of 59 years | 8 | Cardiovascular mortality, recurrent MI, stroke and congestive heart failure | HR: Cardiovascular mortality 0.34 (0.17–0.70), recurrent MI 0.86 (0.54–1.37), stroke 0.62 (0.33–1.16) for <2× week vs never (based on some degree of post-hoc categorisation of collected data) |
| Larsson et al6 | Chocolate consumption | Prospective cohort, Sweden | 33 372 | Women with no history of stroke, age range 49–83 years | 10.4 | Incident stroke | RR: 0.80 (0.66–0.99) >45 g/week vs <8.9 g/week (top vs bottom quartile) |
| Larsson et al7 | Chocolate consumption | Prospective cohort, Sweden | 37 103 | Men with mean age mean of 59 years and no history of stroke | 10.2 | Incident stroke | RR: 0.83 (0.70–0.99) for >51.6 g/week vs <12 g/week (top vs bottom quartile) |
| Lewis et al8 | Chocolate consumption | Post-hoc analysis of a randomised trial of calcium supplementation in women, Australia | 1216 | Women, mean age 75 years | 9.5 | Atherosclerotic vascular disease and ischaemic heart disease | HR: Ischaemic heart disease 0.65 (0.46–0.94) for <1 serving/week vs >1 serving/week (based on some degree of post-hoc categorisation of collected data) |
| Mink et al9 | Chocolate consumption | Prospective cohort, USA | 34 489 | Women with mean age 62 years with no history of heart disease | 16 | CHD mortality and stroke mortality | Rate ratio: CHD mortality 0.98 (0.88–1.10), stroke mortality 0.85 (0.70–1.03) for <1 per week vs >1 per week (based on some degree of post-hoc categorisation of collected data) |
| Current study | Chocolate consumption | Cohort | 25 663 | 55% women, 99.6% white Caucasians, mean age 59 years with no history of heart disease or stroke | 11.8 | Incident CHD, stroke and composite of the two, defined as CVD | HR: CHD 0.88 (0.77–1.01), stroke 0.77 (0.62–0.96), CVD 0.86 (0.76–0.97) (top quintile vs bottom quintile) |
CHD, coronary heart disease; CVD, cardiovascular disease; MI, myocardial infarction.