OBJECTIVE: To examine whether chocolate consumption is associated with a reduced 
risk of ischaemic heart disease, we used data from a prospective study of 
Swedish adults and we performed a meta-analysis of available prospective data.
METHODS AND RESULTS: The Swedish prospective study included 67 640 women and men 
from the Cohort of Swedish Men and the Swedish Mammography Cohort who had 
completed a food-frequency questionnaire and were free of cardiovascular disease 
at baseline. Myocardial infarction (MI) cases were ascertained through linkage 
with the Swedish National Patient and Cause of Death Registers. PubMed and 
EMBASE databases were searched from inception until 4 February 2016 to identify 
prospective studies on chocolate consumption and risk of ischaemic heart 
disease.
RESULTS: The results from eligible studies were combined using a random-effects 
model. During follow-up (1998-2010), 4417 MI cases were ascertained in the 
Swedish study. Chocolate consumption was inversely associated with MI risk. 
Compared with non-consumers, the multivariable relative risk for those who 
consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for 
trend =0.04). Five prospective studies on chocolate consumption and ischaemic 
heart disease were identified. Together with the Swedish study, the 
meta-analysis included six studies with a total of 6851 ischaemic heart disease 
cases. The overall relative risk for the highest versus lowest category of 
chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity 
among studies (I(2)=24.3%).
CONCLUSIONS: Chocolate consumption is associated with lower risk of MI and 
ischaemic heart disease.