Chocolate and Coronary Heart Disease

No study has found chocolate clearly harmful in relation to clinical cardiovascular events. However, no study has examined or was designed to examine excessive consumption explicitly. In long-term observational studies, there is suggestive but not definitive evidence that chocolate consumption – at least in moderation – might inversely be associated with coronary heart disease and other cardiovascular events. Laboratory and short-term randomized studies indicate that cardiovascular protection from chocolate consumption is biologically plausible, and there are several potential mechanisms to explain the observed inverse association as causal effects of chocolate. However, owing to several potential methodological weaknesses in the long-term observational studies, we cannot yet make a firm conclusion on the long-term cardiovascular effects of chocolate. We need more long-term studies with a rigorous design; a long-term randomized trial focusing on clinical events is especially missing.