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

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.

The cardiometabolic benefits of flavonoids and dark chocolate intake in patients at risk

“…Usually, the human body lacks of antioxidants and become susceptible to damage by free radicals. Flavonoids from cocoa have antioxidant qualities on vascular health, lowering the blood pressure, improving the blood flow to the brain and heart, making the blood platelets less sticky and preventing the clotting [14,[15][16][17][18][19][20][21]23]. Beside the cocoa, the flavonoids are found in variety beverages like tea, peanuts, apples, onions, cranberries and red wine.…”

“…The beneficial effects of flavonoids have been extensively studied, results of reviews and meta-analyses supporting the positive role of cocoa on blood pressure by increasing the formation of endothelial nitric oxide involved in vasodilatation, on cholesterol levels, on atherosclerosis and insulin resistance [14,[15][16][17][18][19][20][21]. Still, it remains unclear whether chocolate consumption is related to reductions in hard cardiovascular outcomes (such as myocardial infarction and stroke) or has just an intermediate effect on cardiometabolic disorders.…”

The beneficial vascular effects of cacao flavanols: having your cake and eating it too

“…The associ-ation of chocolate consumption with a 37% reduction in cardiovascular disease as reported by Buitrago-Lopez et al (2) sets the stage for the reconsideration of cocoa products as potentially healthy like those recognized for red wine and olive and fish oils. However, the conveyance of this message needs to be clearly linked with the consumption of modest amounts of low-calorie (Ϫ)-epicatechin-rich cocoa products.…”

“…A SIGNIFICANT NUMBER OF EPIDEMIOLOGICAL studies report on the apparent beneficial effects of chocolate (i.e., cocoa) consumption on cardiovascular health, including reductions in morbidity and mortality (1,2,4). However, these reports are mostly of retrospective nature and do not demonstrate causality.…”

Current trend and future prospective of functional probiotic milk chocolates and related products - a review

“…Chocolates also contain minerals, especially potassium, magnesium, copper, and iron. The presence of biologically active phenolic compounds in cocoa has stimulated researches into its effects in ageing, oxidative stress, blood pressure regulation, atherosclerosis, and reduction of the heart disease risk and stroke (Buitrago-Lopez et al 2011). According to Maillard and Landuyt (2008), chocolate has been identified as an ideal carrier for probiotics and has also been found to absorb more probiotics than yoghurt (Deanna 2009).…”