Clinical Edge

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Does Chocolate Consumption Reduce MI Risk?

Heart; 2016 Jul; Larsson, Åkesson, et al

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There was a lower risk of myocardial infarction (MI) and ischemic heart disease among those who consumed chocolate than those who did not, according to a recent prospective study. The meta-analysis included 67,640 women and men who had completed a food frequency questionnaire and were free of cardiovascular disease (CVD) at baseline. Researchers found:

• During follow-up from 1998 to 2010, 4,417 MI cases were ascertained.

• Chocolate consumption was inversely associated with MI risk.

• Multivariable relative risk for those who consumed ≥3 to 4 servings/week of chocolate was 0.87 compared with nonconsumers.

• Meta-analysis included 6 studies with a total of 6,851 ischemic heart disease cases.

• Overall relative risk for the highest vs lowest category of chocolate consumption was 0.90, with little heterogeneity among studies.

Citation: Larsson SC, Åkesson A, Gigante B, Wolk A. Chocolate consumption and risk of myocardial infarction: A prospective study and meta-analysis. Heart. 2016;102:1017-1022. doi:10.1136/heartjnl-2015-309203.

Commentary: The data on chocolate is in and it is strong! While there may not be enough evidence to routinely recommend skin cancer screening (see article this week on the USPSTF’s new recommendation) the data is consistent and robust on the benefits of chocolate. Previous studies have shown that cocoa decreases blood pressure.1,2 This adds to some of my other favorite studies, which include the beneficial effects of pistachio consumption on glucose metabolism and insulin resistance.3 Studies really do seem to show that dark chocolate has a beneficial effect on both blood pressure and the development of coronary artery disease. In elderly men one study showed a 50% reduction in cardiovascular mortality in the tertile of men who ate the most dark chocolate compared to men who ate the least.4 —Neil Skolnik, MD

1. Taubert D, et al. Effect of cocoa and tea intake on blood pressure. Arch Int Med. 2007; 167(7):626-634. doi:10.1001/archinte.167.7.626.

2. Taubert D, Roesen R, Lehmann C, Jung N, Schömig E. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: A randomized controlled trial. JAMA. 2007;298(1):49-60. doi:10.1001/jama.298.1.49.

3. Hernández-Alonso P, Salas-Salvado J, Baldrich-Mora M, Juanola-Falfarona M, Bulló M. Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: A randomized clinical trial. Diabetes Care. 2014;37(11):3098-3105. doi:10.2337/dc14-1431.

4. Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: The Zutphen Elderly Study. Arch Int Med. 2006;166:(4):411-417.

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