LAUSR

Aims The objective of this study was to evaluate the association of chocolate consumption and heart failure (HF) in a large population of Swedish men. Methods We conducted a prospective cohort study of 31,917 men 45‐79 years old with no history of myocardial infarction, diabetes, or HF at baseline who were participants in the population‐based Cohort of Swedish Men study. Chocolate consumption was assessed through a self‐administrated food frequency questionnaire. Participants were followed for HF hospitalization or mortality from January 1, 1998, to December 31, 2011, using record linkage to the Swedish inpatient and cause‐of‐death registries. Results During 14 years of follow‐up, 2,157 men were hospitalized (n = 1,901) or died from incident HF (n = 256). Compared with subjects who reported no chocolate intake, the multivariable‐adjusted rate ratio of HF was 0.88 (95% CI 0.78‐0.99) for those consuming 1‐3 servings per month, 0.83 (95% CI 0.72‐0.94) for those consuming 1‐2 servings per week, 0.82 (95% CI 0.68‐0.99) for those consuming 3‐6 servings per week, and 1.10 (95% CI 0.84‐1.45) for those consuming ≥1 serving per day (P for quadratic trend = .001). Conclusions In this large prospective cohort study, there was a J‐shaped relationship between chocolate consumption and HF incidence. Moderate chocolate consumption was associated with a lower rate of HF hospitalization or death, but the protective association was not observed among individuals consuming ≥1 serving per day. Journal Subject Codes: Etiology: Epidemiology, Heart failure: Congestive