Chocolate consumption and risk of heart failure in the Physicians' Health Study

Aims To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure ( HF ). Methods and Results We prospectively studied 20 278 men from the Physicians' Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self‐administered food frequency questionnaire and HF was ascertained through annual follow‐up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF . During a mean follow‐up of 9.3 years there were 876 new cases of HF . The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios [95% confidence intervals ( CI )] for HF were 1.0 (ref), 0.86 (0.72–1.03), 0.80 (0.66–0.98), 0.92 (0.74–1.13), and 0.82 (0.63–1.07), for chocolate consumption of less than 1/month, 1–3/week, 2–4/week, and 5+/week, respectively, after adjusting for age, body mass index ( BMI ), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation ( P for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was <25 kg/m 2 [ HR (95% CI ) = 0.59 (0.37–0.94) for consumption of 5+ servings/week, P for linear trend = 0.03) but not in those with BMI of 25+ kg/m 2 [ HR (95% CI ) = 1.01 (0.73–1.39), P for linear trend = 0.42, P for interaction = 0.17). Conclusions Our data suggest that moderate consumption of chocolate might be associated with a lower risk of HF in male physicians.