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Moderate
chocolate consumption linked to lower risks
of heart failure
DALLAS, Aug. 17, 2010 – Middle-aged and
elderly Swedish women who regularly ate a
small amount of chocolate had lower risks of
heart failure risks, in a study reported in Circulation:
Heart Failure, a journal of the American
Heart Association.
The nine-year study, conducted among 31,823
middle-aged and elderly Swedish women,
looked at the relationship of the amount of
high-quality chocolate the women ate,
compared to their risk for heart failure.
The quality of chocolate consumed by the
women had a higher density cocoa content
somewhat like dark chocolate by American
standards. In this study, researchers found:
Women who ate an average of one to two
servings of the high-quality chocolate per
week had a 32 percent lower risk of
developing heart failure.
Those who had one to three servings per
month had a 26 percent lower risk.
Those who consumed at least one serving
daily or more didn’t appear to benefit from
a protective effect against heart failure.
The lack of a protective effect among women
eating chocolate every day is probably due
to the additional calories gained from
eating chocolate instead of more nutritious
foods, said Murrray Mittleman, M.D., Dr.P.H.,
lead researcher of the study.
“You can’t ignore that chocolate is a
relatively calorie-dense food and large
amounts of habitual consumption is going to
raise your risks for weight gain,” said
Mittleman, director of the Cardiovascular
Epidemiology Research Unit at Harvard
Medical School’s Beth Israel Deaconess
Medical Center in Boston. “But if you’re
going to have a treat, dark chocolate is
probably a good choice, as long as it’s in
moderation.”
High concentration of compounds called
“flavonoids” in chocolate may lower blood
pressure, among other
benefits, according to mostly short-term
studies. However, this is the first study to
show long-term outcomes related specifically
to heart failure, which can result from
ongoing untreated high blood pressure.
In the observational study, researchers
analyzed self-reported food-frequency
questionnaire responses from participants
48-to-83-years-old in the Swedish
Mammography Cohort. Combining the results
with data from national Swedish
hospitalization and death registries between
1998 through 2006, the researchers used
multiple forms of statistical modeling to
reach their conclusions on heart failure and
chocolate consumption.
Mittleman said differences in chocolate
quality affect the study’s implications for
Americans. Higher cocoa content is
associated with greater heart benefits. In
Sweden, even milk chocolate has a higher
cocoa concentration than dark chocolate sold
in the United States.
Although 90 percent of all chocolate eaten
across Sweden during the study period was
milk chocolate, it contained about 30
percent cocoa solids. U.S. standards only
require 15 percent cocoa solids to qualify
as dark chocolate. So, by comparison,
American chocolate may have fewer heart
benefits and more calories and fat per
equivalent amounts of cocoa content compared
to the chocolate eaten by the Swedish women
in the study.
Also, the average serving size for Swedish
women in the study ranged from 19 grams
among those 62 and older, to 30 grams among
those 61 and younger. In contrast, the
standard American portion size is 20 grams.
“Those tempted to use these data as their
rationale for eating large amounts of
chocolate or engaging in more frequent
chocolate consumption are not interpreting
this study appropriately,” said Linda
Van Horn, Ph.D., R.D., immediate past chair
of the American Heart Association Nutrition
Committee and professor in the Department of
Preventive Medicine at Northwestern
University’s Feinberg School of Medicine in
Chicago. “This is not an ‘eat all you want’
take-home message, rather it’s that eating a
little dark chocolate can be healthful, as
long as other adverse behaviors do not
occur, such as weight gain or excessive
intake of non-nutrient dense ‘empty’
calories.”
Heart failure occurs among about 1 percent
of Americans over age 65. A condition in
which the heart can’t pump enough blood to
the rest of the body, heart failure rates
are increasing as our aging population
grows.
“Anything that helps to decrease heart
failure is an important issue worth
examining,” Mittleman said.
Co-authors are Elizabeth Mostofsky, M.P.H.;
Emily Levitan, Sc.D.; and Alicja Wolk,
Dr.Med.Sci. Author disclosures and funding
support are on the manuscript.
###
Statements and conclusions of study authors
published in American Heart Association
scientific journals are solely those of the
study authors and do not necessarily reflect
the association’s policy or position. The
association makes no representation or
guarantee as to their accuracy or
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funding primarily from individuals;
foundations and corporations (including
pharmaceutical, device manufacturers and
other companies) also make donations and
fund specific association programs and
events. The association has strict policies
to prevent these relationships from
influencing the science content. Revenues
from pharmaceutical and device corporations
are available at www.americanheart.org/corporatefunding.
