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Chocolate helps prevent heart failure?

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By Jimmy Downs

Thursday Oct 11, 2012 (foodconsumer.org) -- A study in Circulation, Heart Failure suggests that eating 1 to 3 servings of chocolate per month may help reduce the risk of heart failure.  It is a suggestion and those who are at the risk should not give up statins yet because the study was not a clinical trial and a causal relationship between chocolate intake and heart failure risk has not been established.

However, it should not be a surprise if eating chocolate was found to be associated with reduced risk of heart failure because according to researchers randomized clinical trials have already shown that chocolate intake reduced systolic and diastolic blood pressure and high blood pressure is linked to heart disease.

Additionally previous observational studies have also found an inverse association between chocolate consumption and risk of cardiovascular disease, which includes heart disease and stroke among other conditions, according to study authors E. Mostofsky of Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass and colleagues. 

The current prospective study of 31,823 women aged 48 to 83 years without diabetes or a history of heart failure or myocardial infarction at baseline who participated in the Swedish Mammography Cohort, was intended to examine the association between chocolate consumption and incidence of heart failure.

For the study, participants answered health and lifestyle questions by completing a food-frequency questionnaire.  During the follow-up from Jan. 1998 through Dec. 2006, 419 women were hospitalized for incident heart failure or died from the condition. 

The researchers found that compared with those who did not have regular chocolate intake, those who consumed 1 to 3 servings of chocolate per month, 1 to 2 servings per week and 3 to 6 servings per week and one serving per day or more were 26 percent less likely, 32 percent less likely, 9 percent more likely, and 23 percent more likely to develop heart failure, respectively. 

The researchers concluded "In this population, moderate habitual chocolate intake was associated with a lower rate of HF hospitalization or death, but the protective association was not observed with intake of ≥1 servings per day."

In response to the study, Aline Marcadenti, MSc at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil and Erlon Oliveira de Abreu Silva, MD gtp at Universidade Federal de São Paulo in São Paulo, Brazil published a comment in the same journal to point out the limitations of the study suggesting the uncertainty of the study conclusion the Harvard researchers did not explain.

They first pointed out that the study excluded women with diabetes or previous myocardial infarction at baseline and in the meantime, more people in the control group had hypertension and cholesterol than other groups.  This would result in a conclusion that inflated the potential benefit of chocolate consumption.

A second limitation of the study was that the dietary information was obtained at baseline only, which could not reveal whether or not participants changed their dietary habits during the 8-year follow-up.

A third problem with the study as the Brazilian researchers pointed out is that the study did not include in their analyses those proven protective factors that had been associated with lower risk of heart failure. Not included in the analysis either were other diseases and other well established risk factors for heart failure.

In total, the Brazilian researchers pointed out six reasons to demonstrate that the study led by Dr. Mostofsky and colleagues at Harvard Medical School was not as reliable or meaningful to say the least as it was supposed to be.  Thus the real benefits of chocolate consumption, or protection against heart failure in this case remained uncertain.

It should be recognized that the active ingredient in chocolate should likely be beneficial when it is consumed as part of cocoa.  When this ingredient becomes part of chocolate, the benefit may be non-existent or at least not as beneficial as it is when present in chocolate products because high content of sugar and fat is present in chocolate.
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