Abstract
Although epidemiological studies have examined the role of chocolate in preventing cardiometabolic disease, the results remain inconsistent. Herein, we conducted a meta-analysis of prospective studies to determine the association between chocolate intake and risk of coronary heart disease (CHD), stroke, and diabetes. A systematical search in PubMed and Embase through March 2017, together with reference scrutiny of relevant literatures, was performed to identify eligible studies. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled using random effect models. Fourteen prospective studies of primary prevention with 508,705 participants were finally included, with follow-up durations ranging from 5 to 16 years. The summary RRs for the highest versus lowest chocolate consumption were 0.90 (95% CI: 0.82–0.97; n = 6) for CHD, 0.84 (95% CI: 0.78–0.90; n = 7) for stroke, and 0.82 (95% CI: 0.70–0.96; n = 5) for diabetes. Dose–response meta-analysis suggested a nonlinear association of chocolate consumption with all outcomes. For both CHD and stroke, there was little additional risk reduction when consuming chocolate ≥3 servings/week (one serving was defined as 30 g of chocolate). For diabetes, the peak protective effect of chocolate emerged at 2 servings/week (RR: 0.75, 95% CI: 0.63–0.89), with no benefit observed when increasing consumption above 6 servings/week. In conclusion, chocolate intake is associated with decreased risks of CHD, stroke, and diabetes. Consuming chocolate in moderation (≤6 servings/week) may be optimal for preventing these disorders.
Highlights
Cardiovascular disease, including coronary heart disease (CHD) and stroke, remains the leading cause of morbidity and mortality worldwide [1]
The summary Relative risks (RRs) for the highest versus lowest chocolate consumption were 0.90 for CHD, 0.84 for stroke, and 0.82 for diabetes
We combined these terms with free-text word searches that included “coronary heart disease”, “coronary artery disease”, “ischemic heart disease”, “stroke”, “cardiovascular disease”, and “diabetes”
Summary
Cardiovascular disease, including coronary heart disease (CHD) and stroke, remains the leading cause of morbidity and mortality worldwide [1]. It was estimated that nearly 16.7 million deaths in 2010 were attributable to these diseases, with projections suggesting a staggering 23.3 million by 2030 [2]. The global prevalence of diabetes is rising progressively and is estimated to increase from 366 million cases in the year 2011 to 552 million cases in 2030 [3]. A number of experimental and clinical studies have indicated a protective role of chocolate against oxidative stress, inflammation, endothelial dysfunction, and atherogenesis [4]. These salutary effects have been confirmed in recent meta-analyses of feeding trials, supporting the favorable impact of chocolate on cardiometabolic risk factors such as Nutrients 2017, 9, 688; doi:10.3390/nu9070688 www.mdpi.com/journal/nutrients
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
