Evidence map›Paper›PMID 29931040›Full record

ArticleThe American journal of clinical nutrition2018

Chocolate intake and heart disease and stroke in the Women's Health Initiative: a prospective analysis.

James A Greenberg, JoAnn E Manson, Marian L Neuhouser, Lesley Tinker, Charles Eaton, Karen C Johnson, James M Shikany

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of clinical nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03453073 (Chocolate Intake and Heart Disease and Stroke in the Women's Health Initiative), which is not on this map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03453073 completednot on this map

Chocolate Intake and Heart Disease and Stroke in the Women's Health Initiative: a Prospective Analysis

TypeobservationalSponsorBrooklyn College of the City University of New YorkRan2014 to 2018Enrolled83,310ConditionsCardiovascular Disease, Heart Disease, StrokeArmschocolate consumption level, physician diagnosis of first occurrence of serious chronic disease
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Chocolate, "Food of the Gods": History, Science, and Human Health.International journal of environmental research and public health · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

James A GreenbergDepartment of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY.
JoAnn E MansonDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Marian L NeuhouserDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Lesley TinkerDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Charles EatonDepartment of Family Medicine and Epidemiology, Alpert Medical School, Brown University, Providence, RI.
Karen C JohnsonDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
James M ShikanyDepartment of Medicine, Division of Preventive Medicine, University of Alabama, Birmingham, AL.
Fred Hutch Cancer Center · USBrigham and Women's Hospital · USBrown University · USCity University of New York · USUniversity of Alabama at Birmingham · USUniversity of Tennessee Health Science Center · US

Funding

NHLBI NIH HHS HHSN268201100001INHLBI NIH HHS HHSN268201100046CNHLBI NIH HHS HHSN268201600001CNHLBI NIH HHS HHSN268201600002CNHLBI NIH HHS HHSN268201600003CNHLBI NIH HHS HHSN268201600004CNHLBI NIH HHS HHSN268201600018CWHI NIH HHS HHSN268201100001C
6 · The paper itself

Abstract

Background: Three recent meta-analyses found significant prospective inverse associations between chocolate intake and cardiovascular disease risk. Evidence from these meta-analyses suggests that such inverse associations may only apply to elderly individuals or those with pre-existing major chronic disease. Objective: We assessed the association between habitual chocolate intake and subsequent incident coronary heart disease (CHD) and stroke, and the potential effect of modification by age. Design: We conducted multivariable Cox regression analyses using data from 83,310 postmenopausal women free of baseline pre-existing major chronic disease in the prospective Women's Health Initiative cohort. Chocolate intake was assessed using a food-frequency questionnaire. Physician-adjudicated events or deaths were ascertained up to 30 September 2013. Results: After exclusions, there were 3246 CHD and 2624 stroke events or deaths, representing incidence rates of 3.9% and 3.2% during 1,098,091 and 1,101,022 person-years (13.4 y), respectively. We found no association between consumption of chocolate and risk of CHD (P for linear trend = 0.94) or stroke (P = 0.24). The results for CHD and stroke combined were similar (P = 0.30), but were significantly modified by age (P for interaction = 0.02). For women age <65 y at baseline, those who ate 1 oz (28.35 g) of chocolate <1/mo, 1 to <1.5/mo, 1.5 to <3.5/mo, 3.5/mo to <3/wk, and ≥3/wk had HRs (95% CIs) of 1.00 (referent), 1.17 (1.00, 1.36), 1.05 (0.90, 1.22), 1.09 (0.94, 1.25), and 1.27 (1.09, 1.49), respectively (P for linear trend = 0.005). No association was apparent for older women. Conclusion: We observed no association between chocolate intake and risk of CHD, stroke, or both combined in participants free of pre-existing major chronic disease. The relation for both combined was modified by age, with a significant positive linear trend and an increased risk in the highest quintile of chocolate consumption among women age <65 y. This trial was registered at clinicaltrials.gov as NCT03453073.

Indexed as

ChocolateFeeding BehaviorAgedAge FactorsEnergy IntakeExerciseFemaleHeart DiseasesHumansMiddle AgedModels, BiologicalProportional Hazards ModelsProspective StudiesRisk FactorsStroke

Identifiers

PMID29931040
PMCPMC6862600
OpenAlexW2808888160

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.