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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.
SUBMITTER: Morze J
PROVIDER: S-EPMC7000512 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Morze Jakub J Schwedhelm Carolina C Bencic Aleksander A Hoffmann Georg G Boeing Heiner H Przybylowicz Katarzyna K Schwingshackl Lukas L
European journal of nutrition 20190225 1
<h4>Purpose</h4>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.<h4>Methods</h4>Prospective studies were searched until July 2018 in PubMed, Embase, and ...[more]