BACKGROUND & AIMS: Epidemiologic studies have suggested beneficial effects of 
flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are 
rich in flavonoids and recent studies have demonstrated blood pressure lowering 
effects of dark chocolate. However, limited data are available on the 
association of chocolate consumption and the risk of coronary heart disease 
(CHD). We sought to examine the association between chocolate consumption and 
prevalent CHD.
METHODS: We studied in a cross-sectional design 4970 participants aged 25-93 
years who participated in the National Heart, Lung, and Blood Institute (NHLBI) 
Family Heart Study. Chocolate intake was assessed through a semi-quantitative 
food frequency questionnaire. We used generalized estimating equations to 
estimate adjusted odds ratios.
RESULTS: Compared to subjects who did not report any chocolate intake, odds 
ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 
(0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ 
times/week, respectively (p for trend <0.0001) adjusting for age, sex, family 
CHD risk group, energy intake, education, non-chocolate candy intake, linolenic 
acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. 
Consumption of non-chocolate candy was associated with a 49% higher prevalence 
of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)].
CONCLUSIONS: These data suggest that consumption of chocolate is inversely 
related with prevalent CHD in a general United States population.