Chocolate and risk of chronic disease: a systematic review and dose-response meta-analysis.


Journal

European journal of nutrition
ISSN: 1436-6215
Titre abrégé: Eur J Nutr
Pays: Germany
ID NLM: 100888704

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 12 11 2018
accepted: 23 01 2019
pubmed: 26 2 2019
medline: 20 11 2020
entrez: 27 2 2019
Statut: ppublish

Résumé

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. 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. 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). 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.

Identifiants

pubmed: 30805697
doi: 10.1007/s00394-019-01914-9
pii: 10.1007/s00394-019-01914-9
pmc: PMC7000512
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

389-397

Références

Hypertens Pregnancy. 2018 May;37(2):68-80
pubmed: 29658370
Am J Clin Nutr. 2007 Mar;85(3):895-909
pubmed: 17344514
Am J Clin Nutr. 2013 Jun;97(6):1201-9
pubmed: 23595874
Cochrane Database Syst Rev. 2017 Apr 25;4:CD008893
pubmed: 28439881
Heart. 2016 Jul 1;102(13):1017-22
pubmed: 26936339
Adv Nutr. 2017 Nov 15;8(6):793-803
pubmed: 29141965
Am J Epidemiol. 2012 Jan 1;175(1):66-73
pubmed: 22135359
Stat Med. 1989 May;8(5):551-61
pubmed: 2657958
Prev Med. 2007 Apr;44(4):305-10
pubmed: 17275898
Circ Heart Fail. 2010 Sep;3(5):612-6
pubmed: 20713904
PLoS One. 2013 Aug 07;8(8):e70271
pubmed: 23950919
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
J Nutr. 2016 Nov;146(11):2325-2333
pubmed: 27683874
Eur J Epidemiol. 2017 May;32(5):363-375
pubmed: 28397016
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
Nutrition. 2018 Feb;46:103-114
pubmed: 29290347
Curr Opin Lipidol. 2015 Feb;26(1):10-9
pubmed: 25551798
Eur J Clin Nutr. 2017 Sep;71(9):1088-1093
pubmed: 28402326
Eur J Heart Fail. 2014 Dec;16(12):1372-6
pubmed: 25311633
Am Heart J. 2017 Jan;183:18-23
pubmed: 27979037
Heart. 2019 Jan;105(1):49-55
pubmed: 30061161
Eur J Clin Nutr. 2016 Nov;70(11):1318-1324
pubmed: 27460264
Nutr Metab (Lond). 2006 Jan 03;3:2
pubmed: 16390538
Syst Rev. 2016 Jul 27;5(1):125
pubmed: 27460907
Eur J Clin Nutr. 2019 May;73(5):671-678
pubmed: 29795238
Antioxid Redox Signal. 2011 Nov 15;15(10):2779-811
pubmed: 21470061
Nutrients. 2017 Jul 02;9(7):
pubmed: 28671591
Adv Nutr. 2016 Nov 15;7(6):994-1004
pubmed: 28140319
Hypertension. 2005 Dec;46(6):e21-2; author reply e22
pubmed: 16286580
Int J Cardiol. 2013 Oct 15;168(6):5448-50
pubmed: 23295039
J Am Coll Cardiol. 2011 Oct 18;58(17):1828-9
pubmed: 21996399
Arch Intern Med. 2010 Nov 8;170(20):1857-8
pubmed: 21059981
Cancer Prev Res (Phila). 2018 Jun;11(6):347-358
pubmed: 29674390
Am J Clin Nutr. 2018 Jul 1;108(1):41-48
pubmed: 29931040
Appetite. 2017 Jan 1;108:263-269
pubmed: 27725277
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
Am J Clin Nutr. 2015 Feb;101(2):362-7
pubmed: 25646334
Int J Cancer. 2018 May 1;142(9):1748-1758
pubmed: 29210053
Am J Epidemiol. 1992 Jun 1;135(11):1301-9
pubmed: 1626547
Clin Nutr. 2015 Feb;34(1):129-33
pubmed: 24582922
Obesity (Silver Spring). 2015 Mar;23(3):677-83
pubmed: 25644711
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Neurology. 2012 Sep 18;79(12):1223-9
pubmed: 22933736
Proc Nutr Soc. 2018 Nov;77(4):432-444
pubmed: 29708078
Crit Rev Food Sci Nutr. 2019;59(7):1071-1090
pubmed: 29039970
Nutr Metab Cardiovasc Dis. 2016 Aug;26(8):722-34
pubmed: 27052923
Br J Nutr. 2015 Oct 28;114(8):1294-303
pubmed: 26299892
Clin Nutr. 2019 Jun;38(3):1101-1108
pubmed: 29903472
Adv Nutr. 2015 Jan 15;6(1):139S-46S
pubmed: 25593156
Am J Clin Nutr. 2000 Oct;72(4):1059-61
pubmed: 11010953
Heart. 2015 Aug;101(16):1279-87
pubmed: 26076934
Atherosclerosis. 2017 May;260:8-12
pubmed: 28324761
Br J Nutr. 2010 Feb;103(3):453-9
pubmed: 19818197
Am J Clin Nutr. 1997 Apr;65(4 Suppl):1220S-1228S; discussion 1229S-1231S
pubmed: 9094926
Eur J Nutr. 2019 Sep;58(6):2243-2251
pubmed: 29987352
Br J Nutr. 2016 Oct;116(8):1479-1489
pubmed: 27751190
Eur Heart J. 2010 Jul;31(13):1616-23
pubmed: 20354055
Am J Clin Nutr. 2017 Jun;105(6):1462-1473
pubmed: 28446499
Lancet. 2011 Apr 23;377(9775):1438-47
pubmed: 21474174
J Intern Med. 2009 Sep;266(3):248-57
pubmed: 19711504
BMJ. 2011 Aug 26;343:d4488
pubmed: 21875885
Nutrients. 2017 Apr 20;9(4):
pubmed: 28425931
Am J Clin Nutr. 2016 Apr;103(4):1091-8
pubmed: 26936332

Auteurs

Jakub Morze (J)

Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland.

Carolina Schwedhelm (C)

Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, 14458, Nuthetal, Germany.

Aleksander Bencic (A)

Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.

Georg Hoffmann (G)

Department of Nutritional Sciences, University of Vienna, Althanstraße 14, UZA II, 1090, Vienna, Austria.

Heiner Boeing (H)

Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.

Katarzyna Przybylowicz (K)

Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland.

Lukas Schwingshackl (L)

Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. schwingshackl@ifem.uni-freiburg.de.
NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, 14458, Nuthetal, Germany. schwingshackl@ifem.uni-freiburg.de.
Institute for Evidence in Medicine, Medical Center, University of Freiburg, Breisacher Straße 153, 79110, Freiburg, Germany. schwingshackl@ifem.uni-freiburg.de.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH