Chocolate consumption and risk of stroke


Chocolate consumption and risk of stroke

A prospective cohort of men and meta-analysis

Susanna C. Larsson, PhD,

Jarmo Virtamo, MD and

Alicja Wolk, DMSc

+ Author Affiliations

From the Division of Nutritional Epidemiology (S.C.L., A.W.), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and Department of Chronic Disease Prevention (J.V.), National Institute for Health and Welfare, Helsinki, Finland.

Correspondence & reprint requests to Dr. Larsson:

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Objective: To investigate the association between chocolate consumption and risk of stroke in men and conduct a meta-analysis to summarize available evidence from prospective studies of chocolate consumption and stroke.

Methods: We prospectively followed 37,103 men in the Cohort of Swedish Men. Chocolate consumption was assessed at baseline using a food-frequency questionnaire. Cases of first stroke were ascertained from the Swedish Hospital Discharge Registry. For the meta-analysis, pertinent studies were identified by searching the PubMed and EMBASE databases through January 13, 2012. Study-specific results were combined using a random-effects model.

Results: During 10.2 years of follow-up, we ascertained 1,995 incident stroke cases, including 1,511 cerebral infarctions, 321 hemorrhagic strokes, and 163 unspecified strokes. High chocolate consumption was associated with a lower risk of stroke. The multivariable relative risk of stroke comparing the highest quartile of chocolate consumption (median 62.9 g/week) with the lowest quartile (median 0 g/week) was 0.83 (95 % CI 0.70?0.99). The association did not differ by stroke subtypes. In a meta-analysis of 5 studies, with a total of 4,260 stroke cases, the overall relative risk of stroke for the highest vs lowest category of chocolate consumption was 0.81 (95% CI 0.73?0.90), without heterogeneity among studies (p = 0.47).

Conclusion: These findings suggest that moderate chocolate consumption may lower the risk of stroke.


Study funding: Supported by research grants from the Swedish Council for Working Life and Social Research (FAS) and the Swedish Research Council/Committee for Infrastructure and by a Research Fellow grant from Karolinska Institutet (to Dr. Larsson). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the article.

Received February 2, 2012.

Accepted May 1, 2012.

Copyright ? 2012 by AAN Enterprises, Inc.

Responses to this article

Matthew R Walters

Acute effect of chocolate ingestion on the cerebral vasculature Neurology published online September 5, 2012

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