Intended for healthcare professionals


The temptations of chocolate

BMJ 2011; 343 doi: (Published 20 September 2011) Cite this as: BMJ 2011;343:d5883
  1. Johan P Mackenbach, professor
  1. 1Department of Public Health, Erasmus MC, 3000 CA Rotterdam, Netherlands
  1. j.mackenbach{at}

Observational evidence suggests a health benefit, but only randomised trials can give a definitive answer

Epidemiologists only rarely bring good news—most messages about the health risks of our preferred consumption and behaviour patterns are unwelcome. It is therefore good to see a positive report on the health effects of chocolate, which people all over the world enjoy, in the linked study by Buitrago-Lopez and colleagues (doi:10.1136/bmj.d4488).1

The authors performed a systematic review and meta-analysis to assess the association of chocolate consumption with the risk of developing cardiometabolic disorders. The authors found no randomised trials, six cohort studies, and one cross sectional study. There was heterogeneity in terms of the measurement of chocolate consumption, methods, and outcomes evaluated. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (five studies: relative risk 0.63, 95% confidence interval 0.44 to 0.90) and a 29% reduction in stroke compared with lowest levels.

Chocolate consumption has a long and intriguing …

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