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- Title
Chocolate and risk of chronic disease: a systematic review and dose-response meta-analysis.
- Authors
Morze, Jakub; Schwedhelm, Carolina; Bencic, Aleksander; Hoffmann, Georg; Boeing, Heiner; Przybylowicz, Katarzyna; Schwingshackl, Lukas
- Abstract
Purpose: Evidence for the association between chocolate intake and risk of chronic diseases is inconclusive. Therefore, we aimed to synthesize and evaluate the credibility of evidence on the dose-response association between chocolate consumption with risk of all-cause mortality, coronary heart disease (CHD), stroke, heart failure (HF), type 2 diabetes (T2D), colorectal cancer (CRC), and hypertension. Methods: Prospective studies were searched until July 2018 in PubMed, Embase, and Web of Science. Random-effects meta-analyses comparing highest versus lowest intake categories, linear, and non-linear dose-response analyses were conducted. The credibility of evidence was evaluated with the NutriGrade scoring-system. Results: Overall, 27 investigations were identified (n = 2 for all-cause mortality, n = 9 for CHD, n = 8 for stroke, n = 6 for HF, n = 6 for T2D, n = 2 for hypertension and CRC, respectively). No associations with HF (RR 0.99, 95% CI 0.94, 1.04) and T2D (RR 0.94, 95% CI 0.88, 1.01) per each 10 g/day increase in chocolate intake were observed in the linear dose-response meta-analyses. However, a small inverse association for each 10 g/daily increase could be shown for the risk of CHD (RR 0.96, 95% CI 0.93, 0.99), and stroke (RR 0.90, 95% CI 0.82, 0.98). The credibility of evidence was rated either very low (all-cause mortality, HF, T2D, CRC or hypertension) or low (CHD, stroke). Conclusion: Chocolate consumption is not related to risk for several chronic diseases, but could have a small inverse association with CHD and stroke. Our findings are limited by very low or low credibility of evidence, highlighting important uncertainty for chocolate–disease associations.
- Subjects
CHRONIC disease risk factors; CORONARY heart disease risk factors; HYPERTENSION risk factors; TYPE 2 diabetes risk factors; HEART failure risk factors; STROKE risk factors; CACAO; CHRONIC diseases; COLON tumors; CONFIDENCE intervals; DOSE-response relationship in biochemistry; MEDICAL information storage &; retrieval systems; MEDLINE; META-analysis; ONLINE information services; RECTUM tumors; SYSTEMATIC reviews; RELATIVE medical risk; DISEASE risk factors
- Publication
European Journal of Nutrition, 2020, Vol 59, Issue 1, p389
- ISSN
1436-6207
- Publication type
Article
- DOI
10.1007/s00394-019-01914-9