Characteristics of prospective studies of chocolate consumption and risk of IHD
| Reference | Study name, country | Study population | Follow-up (years) | Number of cases | Category of chocolate intake | RR (95% CI) | Adjustments |
|---|---|---|---|---|---|---|---|
| Mink et al7 | Iowa Women's Health Study, USA | 34 489 CVD-free postmenopausal women, 55–69 years | 16 | 1329 fatal IHD cases | 0 >0 serving/week | 1.00 (reference) 0.98 (0.88 to 1.10) | Age, marital status, education, blood pressure, diabetes, BMI, waist-to-hip ratio, physical activity, smoking, oestrogen use and energy intake |
| Janszky et al8 | Stockholm Heart Epidemiology Program, Sweden | 1169 non-diabetic men and women with MI, 45–70 years | 8 | 250 recurrent non-fatal MI cases | Never <1 serving/month 1 serving/week ≥2 servings/week | 1.00 (reference) 0.95 (0.61 to 1.49) 1.02 (0.68 to 1.55) 0.86 (0.54 to 1.37) | Age, sex, education, smoking, obesity, physical inactivity, alcohol consumption, filtered coffee consumption and sweet score |
| Buijsse et al9 | EPIC-Potsdam, Germany | 19 357 CVD-free men and women not using antihypertensive medication, 35–65 years | 8.3 | 166 non-fatal and fatal MI cases | 11.9 g/week 13.3 g/week 23.1 g/week 52.5 g/week | 1.00 (reference) 0.65 (0.40 to 1.05) 1.02 (0.65 to 1.60) 0.73 (0.47 to 1.15) | Age, sex, employment status, education, smoking, BMI, waist circumference, prevalence of diabetes, occupational physical activity, sports, cycling and intakes of total energy, alcohol, coffee, tea, red meat, processed meat, dairy, fruits, vegetables and cereal fibre |
| Lewis et al10 | NA, Australia | 1216 women, NA | 9.5 | 153 non-fatal and fatal IHD cases | <1 serving/week ≥1 serving/week | 1.00 (reference) 0.65 (0.46 to 0.94) | Age, socioeconomic status, BMI and energy intake |
| Kwok et al11 | EPIC-Norfolk, UK | 20 952 CVD-free men and women, mean age 59 years | 11.9 | 2434 non-fatal and fatal IHD cases | 0 4.2–24.5 g/week 28.7–49.9 g/week 50.4–108.5 g/week ≥109.2 g/week | 1.00 (reference) 1.03 (0.91 to 1.15) 1.03 (0.91 to 1.17) 0.92 (0.81 to 1.05) 0.91 (0.80 to 1.04) | Age, sex, smoking, physical activity, BMI, diabetes, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and intake of energy and alcohol |
| Larsson et al, 2016 (current study) | Cohort of Swedish Men and Swedish Mammography Cohort, Sweden | 67 640 CVD-free men and women, 45–83 years | 13 | 4417 non-fatal and fatal MI cases | 0 1–3/month 1–2/week ≥3–4/week | 1.00 (reference) 0.91 (0.84 to 0.99) 0.89 (0.81 to 0.97) 0.87 (0.77 to 0.98) | Age, sex, education, family history of MI, smoking status and pack-years of smoking, aspirin use, walking/bicycling, exercise, BMI, history of diabetes, hypertension and hypercholesterolaemia, intakes of total energy, alcohol, processed meat and fruits and vegetables |
BMI, body mass index; CVD, cardiovascular disease; EPIC, European Prospective Investigation into Cancer; IHD, ischaemic heart disease; MI, myocardial infarction; NA, not available; RR relative risk.