Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

Buitrago-Lopez, A.; Sanderson, J.; Johnson, L.; Warnakula, S.; Wood, A.; Di Angelantonio, E.; Franco, O. H.

doi:10.1136/bmj.d4488

Cited by 252Nutritional Studies and DietFood Chemistry and Fat AnalysisCoffee research and impacts

Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

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Buitrago-Lopez, A., Sanderson, J., Johnson, L., Warnakula, S., Wood, A., Di Angelantonio, E., Franco, O. H.·2011·BMJ

DOI 10.1136/bmj.d4488PMC PMC3163382

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Abstract

OBJECTIVE: To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders. DESIGN: Systematic review and meta-analysis of randomised controlled trials and observational studies. DATA SOURCES: Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors. STUDY SELECTION: Randomised trials and cohort, case-control, and cross sectional studies carried out in human adults, in which the association between chocolate consumption and the risk of outcomes related to cardiometabolic disorders were reported. DATA EXTRACTION: Data were extracted by two independent investigators, and a consensus was reached with the involvement of a third. The primary outcome was cardiometabolic disorders, including cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome. A meta-analysis assessed the risk of developing cardiometabolic disorders by comparing the highest and lowest level of chocolate consumption. RESULTS: From 4576 references seven studies met the inclusion criteria (including 114,009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study. Large variation was observed between these seven studies for measurement of chocolate consumption, methods, and outcomes evaluated. Five of the seven studies reported a beneficial association between higher levels of chocolate consumption and the risk of cardiometabolic disorders. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels. CONCLUSIONS: Based on observational evidence, levels of chocolate consumption seem to be associated with a substantial reduction in the risk of cardiometabolic disorders. Further experimental studies are required to confirm a potentially beneficial effect of chocolate consumption.

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Some observational studies evaluating total or selected dietary flavonoids observe lower risk of cardiometabolic events; no long-term clinical trials have been performed.
“Some observational studies evaluating total or selected dietary flavonoids observe lower risk of cardiometabolic events;299, 300 no long-term clinical trials have been performed.”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [300]

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Hermann F, Spieker LE, Ruschitzka F, Sudano I, Hermann M, Binggeli C, et al. Dark chocolate improves endothelial and platelet function. Heart 2006;92:119-20.

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Authors: Buitrago-Lopez, A., Sanderson, J., Johnson, L., Warnakula, S., Wood, A., Di Angelantonio, E., & Franco, O. H.
Affiliations: University of Cambridge (GB)
Corresponding author: Franco, O. H.
ORCID: Sanderson, J.
Johnson, L.
Wood, A.
Franco, O. H.
Venue: BMJ
Publisher: BMJ
Published: 2011-08-26
Volume: 343
Issue: aug26 1
Pages: d4488-d4488
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.d4488
PMC: PMC3163382
OpenAlex: W1974851838
Cited by: 252
References: 43
Citations by year: 2026: 3 · 2025: 4 · 2024: 9 · 2023: 9 · 2022: 15 · 2021: 12 · 2020: 10 · 2019: 13 · 2018: 19 · 2017: 24 · 2016: 21 · 2015: 23 · 2014: 23 · 2013: 33 · 2012: 20
FWCI: 4.38
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: British Heart Foundation (RG/08/014/24067)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Life Sciences › Agricultural and Biological Sciences › Food Science › Food Chemistry and Fat Analysis
Health Sciences › Medicine › Pharmacology › Coffee research and impacts
Keywords: chocolate consumption, cardiometabolic disease, cardiovascular disease, coronary artery disease, stroke, diabetes mellitus, metabolic syndrome, dietary intake, health benefits of chocolate
MeSH terms: Cacao, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Eating, Humans, Risk Factors, Metabolic Syndrome

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Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

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