In a recent study published in the Journal of the Academy of Nutrition and Dietetics, researchers examine the relationship between chocolate consumption and both all-cause and cause-specific mortality in women.
Study: Chocolate Consumption in Relation to All-Cause and Cause-Specific Mortality in Women: The Women’s Health Initiative. Image Credit: Dean Drobot / Shutterstock.com
The health effects of chocolate
The short- and long-term health impacts of chocolate consumption have gained significant attention in recent years. However, studies investigating the link between chocolate intake and cardiovascular disease (CVD) have yielded conflicting results.
To this end, one recent study found no association between chocolate intake and coronary heart disease (CHD) or stroke, despite previous studies suggesting a potential inverse relationship. To date, researchers have not explored the link between chocolate consumption and the risk of mortality from specific causes.
About the study
The Women’s Health Initiative (WHI) is a national health study that aims to prevent heart disease, colorectal and breast cancer, and osteoporotic fractures among postmenopausal women through long-term strategies. Between 1993 to 1998, researchers recruited postmenopausal women between 50 and 79 years of age from 40 clinical centers in the United States for either a clinical trial (CT) or an observational study (OS).
The WHI evaluated diet at the beginning of the study using a validated food frequency questionnaire (FFQ) that was self-administered and derived from the Health Habits and Lifestyle Questionnaire. The WHI FFQ consisted of three parts, including 122 food items that asked about portion size and intake frequency, 19 questions about fat intake, and four summary questions about the usual consumption of vegetables, fruits, and added fats to be compared with specific food item data.
The WHI FFQ analyzed a nutrient database sourced from the Nutrition Data System for Research. This database includes over 140 nutrients and compounds, such as energy, sodium, and saturated fat.
The baseline data from the WHI FFQ was used to evaluate chocolate consumption. The FFQ inquired about the frequency of consuming one ounce of chocolate candies and candy bars over the past three months.
Five categories of chocolate intake frequency based on the responses of the participants were established. These included no intake, less than one serving per week, one to three servings every week, four to six servings each week, and one serving each day.
Study findings
Over a period of 1,608,856 person-years, 25,388 deaths were recorded, with 7,069 deaths due to CVD, 7,030 deaths due to cancer, and 3,279 deaths due to dementia. Women who consumed more chocolate tended to have unhealthy habits such as smoking, higher energy intake, less physical activity, lower diet quality, and consuming more coffee or tea.
A correlation was found between higher chocolate intake in women and a lower likelihood of having diabetes and high blood cholesterol at the start of the study. However, these women were more likely to have a higher body mass index (BMI).
Study participants who consumed chocolate had a lower risk of all-cause mortality as compared to those who did not consume chocolate. The risk was even lower for those who consumed chocolate more frequently, with the lowest risk observed in those who consumed one serving each day. These findings were adjusted for various factors such as age, socioeconomic status, race and ethnicity, dietary and lifestyle factors, history of diseases, BMI, and history of diseases.
Chocolate consumption had a slight impact on CVD mortality, with those consuming less than one serving each week having a slightly lower risk of CVD, while those who consumed one to three servings every week had the lowest risk. Women who consumed one serving each day had a risk similar to those who did not consume chocolate at all. Chocolate consumption showed similar associations with CHD and CVD mortality; however, no association with stroke mortality was found.
Individuals who consumed chocolate had a lower risk of lung cancer mortality compared to those who did not, with the lowest risk observed among those who consumed four to six servings each week. Consuming chocolate was also associated with a reduced risk of mortality from dementia, excluding Alzheimer's disease.
Conclusions
Consuming chocolate appears to be associated with a slightly lower risk of mortality. More specifically, a moderate chocolate intake of three servings every week was particularly beneficial, even after accounting for various confounding factors. Moderate chocolate intake also correlated with a slight reduction in the risk of all-cause, CVD, and dementia mortality.
Further research is needed to investigate the potential link between high chocolate intake and all-cause and cause-specific deaths.
Journal reference:
- Sun, Y., Liu, B., Snetselaar, L. G., et al. (2023). Chocolate Consumption in Relation to All-Cause and Cause-Specific Mortality in Women: The Women’s Health Initiative. Journal of the Academy of Nutrition and Dietetics 123(6); 902-911. doi:10.1016/j.jand.2022.12.007
Long-term air pollution exposure linked to increased risk of acute kidney injury and mortality