Tuesday, August 30, 2011

Eat More Chocolate!

Hot on the heels of my post last Thursday about eating (dark) chocolate to lower your cholesterol, the results of a meta-analysis were presented to the European Society of Cardiology yesterday and simultaneously published in the British Medical Journal, concluding that consumption of chocolate was associated with lower risk of cardiovascular disease and stroke.

Of course, some of the news agencies misrepresented the findings in their headlines as "Chocolate lowers heart, stroke risk".  Sure it's semantics, but in the case of medical research, there's a world of difference between associative conclusions derived from observational studies and cause & effect relationships derived from randomized controlled studies.

In this particular situation, the authors had to sift through 4,576 references to obtain 7 studies that met all their inclusion criteria, leading to a population of 114,009 participants followed for 8-16 years in 6 cohort & 1 cross sectional study.  More telling is the fact that none of these studies were randomized controlled trials, so all the data is observational in nature and thus any conclusions derived can only be used to generate hypotheses.

Of course, to make matters more difficult, each study used its own measure of chocolate consumption.  Worse, there was no differentiation between dark, milk and white chocolate, much less cacao (cocoa) content.  Therefore, the authors could only analyze greatest consumption vs least with respect to cardiovascular disease and stroke risk, noting 37% and 29% relative risk reduction respectively, regardless of the usual confounders, such as sex, age, body mass index, smoking, and other dietary factors, but without any benefit for heart failure.

So what's the bottom line for you and me?  Well, this study is consistent with all the other observational studies extant about which I've posted.  But due to the calorie & fat content, I would suggest moderation in consumption with focus on high quality, high cocoa/cacao content, dark chocolate.  Enjoy!

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