Chocolate Linked to Lower Risk of Heart Failure

The nine-year study found that women who ate an average of one to two servings of high-quality chocolate per week had a 32 percent lower risk of developing heart failure.

DALLAS (PRNewswire) -- 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


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'


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


"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.

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