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Dr. Vetrici and Dr. Selfridge report no financial relationships relevant to this field of study.
Summary Points
* Chocolate consumption on a weekly basis was associated with a significantly reduced risk of atrial fibrillation (AF) in a cohort study of Danish men and women 50-64 years of age who were followed for 13.5 years.* The highest inverse association was seen at two to six servings per week for men and one serving per week for women.* The cocoa content of chocolate appears to be important. The authors recommended chocolate that has a high proportion of cocoa solids (at least 30%), correlating with higher levels of cocoa flavonoids.
SOURCE: Mostofsky E, Berg Johansen M, Tjønneland A, et al. Chocolate intake and risk of clinically apparent atrial fibrillation: The Danish diet, cancer, and health study. Heart 2017;103:1163-1167.
The most common sustained arrhythmia, atrial fibrillation (AF) is associated with significant morbidity and mortality because of an increased risk of thromboembolism, stroke, heart failure, and cognitive impairment. The U.S. prevalence is 2% in people younger than 65 years of age and 9% in those older than 65 years of age, with people of European descent having higher incidence rates than African Americans.1,2 In people of European descent older than 40 years of age, the lifetime risk of developing AF is 26% in men and 23% in women, and the incidence doubles with every decade of life.1,2 The pathophysiology of AF involves a complex inflammatory cascade that generates cytokines and reactive oxygen species, leading to electrical and structural remodeling ultimately resulting in AF.3,4
Cocoa-containing foods show antioxidant, anti-inflammatory, and vasodilatory properties.5 Ingestion of cocoa flavonoids lowers blood pressure, increases high-density lipoprotein cholesterol, and improves endothelial function.5,6 Moderate chocolate consumption is associated with improved markers of cardiovascular health and lower rates of myocardial infarction and heart failure.5,6 The neuroprotective and neuromodulatory effects of cocoa flavonoids have been shown to protect human cognition and prevent cognitive decline.7
Mostofsky et al set out to determine whether there was an association between chocolate intake and incidental, clinically apparent AF by analyzing data from the Danish Diet, Cancer and Health Study. The authors of this prospective, population-based, cohort study recruited participants from December 1993 to May 1997, and...