Study finds higher levels of chocolate intake to be associated with a lower rate of clinically apparent atrial fibrillation among men and women

Eating a small amount of chocolate every week or so may decrease the risk of atrial fibrillation, according to a study from Denmark.

People who ate chocolate one to three times per month were about 10 per cent less likely to be diagnosed with atrial fibrillation than those who ate the sweet treatless than once a month, researchers found.

“As part of a healthy diet, moderate intake of chocolate is a healthy snack choice,” said lead author Elizabeth Mostofsky, of the Harvard T.H. Chan School of Public Health and the Beth Israel Deaconess Medical Centre in Boston.

The study cannot say for certain that it was the chocolate that prevented atrial fibrillation, however.

Mostofsky and colleagues wrote in the journal Heart this week that cocoa and cocoa-containing foods have a high volume of flavanols, which are believed to have anti-inflammatory, blood vessel-relaxing and antioxidant properties.

Past studies have found that eating chocolate – especially dark chocolate, which has more flavanols – is tied to better measures of heart health and decreased risk for certain conditions like heart attacks and heart failure, they add.

There is not as much research on whether chocolate is also linked to a lower risk of atrial fibrillation.

For the new analysis, the researchers used data collected for a long-term study of 55,502 men and women in Denmark. Participants were between 50 and 64 years old when it began and they provided information about their diets when they entered the study between 1993 and 1997.

I think our message here is that moderate chocolate intake as part of a healthy diet is an option

The researchers then linked that diet data to Denmark’s national health registries. Overall, about 3,346 cases of atrial fibrillation occurred during a mean follow-up of 13.5 years.

Based on their diets at the beginning of the study period, people who ate one serving, about 30 grams, of chocolate per week were 17 per cent less likely to be diagnosed with atrial fibrillation by the end of the study than people who reported eating chocolate less than once a month.

Similarly, those who ate 60g to 180g per week were 20 per cent less likely to be diagnosed with atrial fibrillation while those who ate more than 30g of chocolate a day were 16 per cent less likely to have the condition.

Among women, the biggest risk reduction was tied to eating one serving of chocolate per week. For men, the biggest reduction came with eating two to six servings per week.

“I think our message here is that moderate chocolate intake as part of a healthy diet is an option,” Mostofsky said.

The researchers cautioned that they cannot account for unmeasured factors, such as kidney disease and sleep apnoea, that may influence the risk of atrial fibrillation. They also did not have data on the type of chocolate or the amount of flavanols participants consumed. Their diets may have also changed over the nearly 14 years of data collection.

The data also suggests the participants who ate the most chocolate consumed more calories but had a lower body mass index than people who ate the least chocolate, noted Alice Lichtenstein, director and senior scientist at the Cardiovascular Nutrition Laboratory at Tufts University in Boston.

“It’s very likely – if I had to bet – that these people were more physically active,” said Lichtenstein, who was not involved in the study.

She said people likely cannot get around the fact that they need to have a healthy diet, be physically active and not smoke to optimise their health.

Medical doctors Sean Pokorney and Jonathan Piccini wrote in an accompanying editorial that the study’s findings were interesting and warranted further consideration despite their limitations.

“A double-blind randomised controlled trial is needed to evaluate the true efficacy of chocolate for the prevention of [atrial fibrillation] and such a trial would need to incorporate quantified doses of cocoa,” write Pokorney and Piccini, of Duke University Medical Centre in Durham, North Carolina.

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