An analysis was performed to test the effects of excluding participants with preclinical serious chronic disease in addition to those with evidence of preexisting serious chronic disease. Preclinical serious chronic disease was defined as a self-reported diagnosis of heart attack, stroke or cancer, or a diagnosis of diabetes based on verified usage of anti-diabetic medications, within three years of the assessment of chocolate consumption. All exam 1 data were excluded for participants with evidence of preexisting or preclinical serious chronic disease at exam 1