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Chocolate linked to modest reduction in all-cause and cause-specific mortality in women

Consuming one to three serving of chocolate per week is enough to lower women’s risk of death, findings from a recent study suggest.

Focusing on post-menopausal women, free of cardiovascular disease (CVD) and cancer at baseline when enrolled in the study during 1993 through to 1998, the cohort were followed until March 2018. The outcomes of interest were all-cause mortality and cause-specific mortality from CVD, cancer and dementia.

Women’s intake of chocolate was categorised based on the intake frequency of a 1oz serving of chocolate as: none, less than one serving per week (<1 serving/wk), one to three serving per week (1-3 servings/wk), four to six servings per week (4-6 servings/wk) and more than one serving per day (≥1 serving/d).

Over 1,608,856 person-years of follow-up, there were a total of 25,388 deaths, which included 7,069 deaths from CVD, 7,030 from cancer and 3,279 from dementia. In multivariable adjusted analysis, compared to those who did not eat chocolate, the hazard ratio (HR) for all-cause mortality ranged from 0.95 (95% CI 0.92 – 0.98) for <1 serving/wk to 0.93 (95% CI 0.89 – 0.96) for 1-3 serving/wk (p for trend = 0.02).

For CVD mortality, the association was only significant for 1-3 servings/wk (HR = 0.88, 05% CI 0.82 – 0.95). In contrast, dementia mortality was significantly lower for both <1 serving/wk and 1-3 servings/wk.

Overall, there was no significant effect of chocolate intake on cancer mortality, but, in subgroup analysis, lung cancer mortality was significantly lower but only for 1-3 servings/wk (HR = 0.82, 95% CI 0.70 – 0.96).

The authors recognised how their analysis did not consider the different types of chocolate in their analysis, for example dark chocolate has purported health benefits, and this could have impacted on their findings. They also accepted that residual confounding could not be excluded, in other words, the findings could be due to other factors not considered.

Chocolate intake in context

A modest and inverse association between eating chocolate and mortality from all causes and cause-specific mortality from cardiovascular disease, cancer and dementia has previously been found in an analysis of data from Women’s Health Initiative (WHI) by US researchers.

Chocolate is known to contain a high content of the saturated fat, stearic acid and antioxidant flavonoids with the latter component likely responsible for a cardioprotective effect. Moreover, evidence from a meta-analysis of prospective studies, suggests that moderate consumption of chocolate is associated with a decreased risk of coronary heart disease (CHD), stroke and diabetes. But not all studies have concurred with this analysis. One, for instance, undertaken in women, was unable to find an association between chocolate intake and the risk of CHD and stroke. As well as potential cardiovascular benefits, it seems there is also an inverse relationship between regular intake of chocolate and a lower risk of cognitive decline.

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