In this edition of Heart, Kwok and
colleagues (see page 1279) examined the
association between chocolate consumption
and risk of cardiovascular disease (CVD)
based on dietary histories in over 20 thousand
men and women in the European
Prospective Investigation into Cancer-
Norfolk (EPIC-Norfolk) study. At a median
followup of 11.9 years, coronary heart
disease was present in 9.7% of patients in
the highest, compared to 13.8% of patients
in the lowest, quintile of chocolate consumption
Similarly, the rate for stroke was
3.1% in the highest, compared to 5.4% in
the lowest quintile.With multivariate adjustment,
the hazard ratio was 0.88 (95% CI
0.77 to 1.01) for those in the top quintile of
chocolate consumption (16–99 g/day)
versus those who ate no chocolate. This
trend was confirmed in a propensity score
matched analysis and in a meta-analysis of
nine previous publications (figure 1).