BACKGROUND AND AIMS: Chocolate consumption may have a beneficial effect on 
cardiovascular health, but evidence from prospective cohort studies is still 
limited. We aimed to examine the prospective associations between chocolate 
consumption and risk of stroke among men and women in a large population-based 
cohort.
METHODS: A total of 38,182 men and 46,415 women aged 44-76 years, and free of 
cardiovascular disease, diabetes, and cancer at baseline in 1995 and 1998, were 
followed up until the end of 2009 and 2010, respectively. We obtained data on 
chocolate consumption for each participant using a self-administrated food 
frequency questionnaire that included 138 food and beverage items. Cox 
proportional hazards regression models were used to estimate hazard ratios (HRs) 
of stroke in relation to chocolate consumption.
RESULTS: During a median follow-up of 12.9 years, we identified 3558 incident 
strokes cases (2146 cerebral infarctions and 1396 hemorrhagic strokes). After 
adjustment for age, body mass index, life styles, dietary intakes, and other 
risk factors, chocolate consumption was associated with a significant lower risk 
of stroke in women (HR = 0.84; 95% CI, 0.71-0.99). However, the association in 
men was not significant (HR = 0.94; 95% CI, 0.80-1.10). In addition, the 
association did not vary by stroke subtypes in either men or women.
CONCLUSIONS: Findings from this large Japanese cohort supported a significant 
inverse association between chocolate consumption and risk of developing stroke 
in women. However, residual confounding could not be excluded as an alternative 
explanation for our findings.