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Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program
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2009 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 266, no 3, 248-257 p.Article in journal (Refereed) Published
Abstract [en]


To assess the long-term effects of chocolate consumption amongst patients with established coronary heart disease.


In a population-based inception cohort study, we followed 1169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction (AMI) between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm Heart Epidemiology Program. Participants self-reported usual chocolate consumption over the preceding 12 months with a standardized questionnaire distributed during hospitalization and underwent a health examination 3 months after discharge. Participants were followed for hospitalizations and mortality with national registries for 8 years.


Chocolate consumption had a strong inverse association with cardiac mortality. When compared with those never eating chocolate, the multivariable-adjusted hazard ratios were 0.73 (95% confidence interval, 0.41-1.31), 0.56 (0.32-0.99) and 0.34 (0.17-0.70) for those consuming chocolate less than once per month, up to once per week and twice or more per week respectively. Chocolate consumption generally had an inverse but weak association with total mortality and nonfatal outcomes. In contrast, intake of other sweets was not associated with cardiac or total mortality.


Chocolate consumption was associated with lower cardiac mortality in a dose dependent manner in patients free of diabetes surviving their first AMI. Although our findings support increasing evidence that chocolate is a rich source of beneficial bioactive compounds, confirmation of this strong inverse relationship from other observational studies or large-scale, long-term, controlled randomized trials is needed.

Place, publisher, year, edition, pages
2009. Vol. 266, no 3, 248-257 p.
Keyword [en]
acute myocardial infarction, chocolate, prognosis
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-123677DOI: 10.1111/j.1365-2796.2009.02088.xISI: 000268928400004PubMedID: 19711504OAI: oai:DiVA.org:uu-123677DiVA: diva2:315280
Available from: 2010-04-28 Created: 2010-04-28 Last updated: 2012-07-25Bibliographically approved

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