Wednesday, May 07, 2008

Chocolate and health--it just keeps on coming!

This one makes sense, given recent reports on chocolate consumption and hypertension, but interesting nonetheless! Here's a summary of this month's report from the journal Epidemiology:

Eating Chocolate May Decrease Risk for Preeclampsia

May 2, 2008 — Chocolate may decrease the risk for preeclampsia, according to the results of a prospective cohort study reported in the May issue of Epidemiology.

"Preeclampsia is a major pregnancy complication with cardiovascular manifestations," writes Elizabeth W. Triche, PhD, from the Yale Center for Perinatal, Pediatric and Environmental Epidemiology in New Haven, Connecticut, and colleagues. "Recent studies suggest that chocolate consumption may benefit cardiovascular health."

The study sample used to evaluate the association of chocolate consumption with the risk for preeclampsia consisted of 2291 pregnant women who delivered a singleton live birth between September 1996 and January 2000.

The investigators measured chocolate consumption by self-report in the first and third trimesters and by umbilical cord serum concentrations of theobromine, which is the main methylxanthine component of chocolate. Detailed medical record review for 1943 of the women allowed determination of preeclampsia. Logistic regression models controlling for potential confounders were used to determine adjusted odds ratios (aOR) and 95% confidence intervals (CIs).

Of 1681 women, preeclampsia developed in 63 (3.7%). Umbilical cord serum theobromine concentrations were inversely associated with preeclampsia (for the highest vs the lowest quartile [aOR, 0.31; CI, 0.11 - 0.87]).

Self-reported estimates of chocolate consumption were also negatively associated with preeclampsia. The risk for preeclampsia was decreased for women consuming 5 or more servings per week vs women consuming less than 1 serving of chocolate weekly (aOR, 0.81; CI, 0.37 - 1.79 for consumption in the first 3 months of pregnancy and aOR, 0.60; CI, 0.30 - 1.24 in the last 3 months).

"Our results suggest that chocolate consumption during pregnancy may lower risk of preeclampsia," the study authors write. "However, reverse causality may also contribute to these findings."

Limitations of this study include difficulty standardizing self-reported chocolate consumption, possible reverse causality if women diagnosed with preeclampsia reduced their calorie intake after diagnosis, possible residual confounding by smoking or body mass index (BMI), small number of women with preeclampsia, and potential misclassification of exposure.

"Because of the importance of preeclampsia as a major complication of pregnancy, replication of these results in other large prospective studies with a detailed assessment of chocolate consumption is warranted," the study authors write. "Measurements of chocolate exposure should be designed to permit careful examination of the temporal relationship between chocolate consumption in pregnancy and subsequent risk of preeclampsia."

The National Institute on Drug Abuse supported this study.

Epidemiology. 2008;19:459-464.

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