Chocolate intake and heart failure incidence
A chocolate bar a week keeps the heart doctor away:
Jacob Schor, ND, FABNO
December 16, 2010
You are going to love this study. Last September, Elisabeth Mostofsky and colleagues at Harvard published a study that connects eating chocolate with decreased risk of heart failure.
The study was a prospective cohort study that followed 31,823 women aged 48 to 83 years who were participants in the Swedish Mammography Cohort.
The researchers gathered information on how often these women ate chocolate. The frequency of chocolate consumption was contrasted with incidence of heart failure. The women were followed from January 1, 1998, through December 31, 2006, for heart failure (HF) hospitalization or death. During this period, 419 women were hospitalized for incident HF (n=379) or died of HF (n=40).
Women who ate 1 to 3 servings of chocolate per month compared with women who didn’t eat chocolate, had a 26% lower risk of heart failure. Those women consuming 1 to 2 servings per week, had a 32% decrease in risk. Eating more than that did not provide greater protection. 
These data suggest that moderate consumption of chocolate, in the range of 1 to 2 servings a week might lower risk of heart failure in women, a finding that few will complain about.
As mentioned in earlier articles a number of recent clinical trials utilizing high polyphenol chocolate have suggested that chocolate exerts a blood pressure lowering effect in hypertensive individuals. A meta-analysis published in June 2010 combined data from 13 studies and concluded that, “…that dark chocolate is superior to placebo in reducing systolic hypertension or diastolic prehypertension.” 
What is striking about this new Mostofsky study is that no ‘special’ chocolate was required. ‘Plain old’ chocolate, or at least the chocolate commonly consumed in Sweden, was adequate to produce significant benefit. This does not say that the ‘special high polyphenol’ chocolates may not produce even greater benefit.
While on this topic, mention must be made of the 2009 study by Janszky et al. In this earlier paper, 1,169 Swedish patients were followed after they had been hospitalized with a first heart attack. Chocolate consumption along with hospitalizations and mortality were tracked. Chocolate consumption had a strong inverse association with cardiac mortality. When compared with those never eating chocolate, the hazard ratios were 0.73 for those consuming chocolate less than once per month, 0.56 up to once per week and 0.34 for twice or more per week. In contrast, intake of other sweets was not associated with cardiac or total mortality. 
Thus the data now clearly support the idea that weekly consumption of chocolate is not only acceptable but actually recommended for those at elevated risk for heart failure or myocardial infarction. Now it’s not just an apple a day, it’s now a chocolate bar twice a week….
All of this of course gives me an excuse to drool over the chocolate mousse recipe in this month’s issue of Sunset magazine. The magazine gives credit to Isabel Allende for this recipe.
Here it is:
18 ounces bittersweet chocolate
one-half cup strong coffee
one-third cup sugar
6 eggs separated
1 and a half cups cream
one quarter cup Grand Marnier
1. Melt chocolate with coffee in a double boiler
2. Beat whites to stiff peaks
3. Whip cream to soft ribbons
4. Stir yolks and liqueur into chocolate/coffee mixture
5. Fold in whites and then cream into chocolate mixture.
6. Cover and chill. Serve with more whipped cream if you can stand the thought.
1. Mostofsky E, Levitan EB, Wolk A, Mittleman MA. Chocolate intake and incidence of heart failure: a population-based prospective study of middle-aged and elderly women. Circ Heart Fail. 2010 Sep 1;3(5):612-6.
2. Ried K, Sullivan T, Fakler P, Frank OR, Stocks NP. Does chocolate reduce blood pressure? A meta-analysis. BMC Med. 2010 Jun 28;8:39.
3. Janszky I, Mukamal KJ, Ljung R, Ahnve S, Ahlbom A, Hallqvist J. Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program. J Intern Med. 2009 Sep;266(3):248-57.