Effects of Some Common Food Constituents on Cardiovascular Disease

Table 2

Observational studies of the association of flavanol-rich food with the risk of cardiovascular disease.

Authors	Type of study	Subjects	Methods	Findings
Cocoa
Buijsse et al. [29]	Prospective	19,357 Germans aged 35–65 years free of MI, stroke and not on antihypertensive medication with mean followup of 8 years	Interview using questionnaire on consumption frequency of 50 g milk/dark/white/unspecified chocolate bars	Highest quartile of chocolate consumption (mainly milk and dark chocolate) had lower relative risk of the combined outcome of MI and stroke
Janszky et al. [30]	Population-based case-control	1,169 nondiabetic and newly diagnosed first AMI patients with followup of 8 years	Questionnaire on consumption frequency of 50 g chocolate (ranging from never to twice or more per week)	Chocolate consumption reduced cardiac mortality in a dose-dependent manner
Mostofsky et al. [31]	Prospective	31,823 women aged 48–83 in Sweden without DM, HF or MI with followup of 9 years	Questionnaire on chocolate consumption frequency (ranging from never to ≥3 times/d)	Moderate (1–3 times/month) habitual chocolate intake was associated with a lower rate of HF hospitalization or death but there was no protection with intake ≥1 time/d
Tea
Kuriyama et al. [32]	Population-based prospective	40,530 Japanese aged 40–79 without history of stroke, CHD, or cancer with followup of 11 years	Questionnaire on green tea consumption frequency (ranging from never to >5 cups/d)	Compared with those consumed <1 cup/d green tea, consumption of ≥5 cups/d had lower risk of all-cause and CVD mortality, and this effect was stronger in women
Nakachi et al. [33]	Prospective	8,497 residents in Japan aged over 40 with followup of 11 years	Questionnaire on green tea consumption frequency (ranging from <3 to over 10 cups/d)	Consumption of >10 cups/d green tea decreased the relative risk of death from CVD
Tanabe et al. [34]	Prospective	6,358 Japanese aged 40–89 without a history of stroke or heart disease with followup of 5 years	Questionnaire on tea consumption frequency (ranging from ≤ several cups a week to >5 cups/d)	Green tea consumption of > several cups every 2-3 days was associated with reduced risk of total stroke incidence
Yang et al. [35]	Prospective	1,507 Taiwanese aged ≥20 without hypertensive history	Interview using questionnaire on green tea consumption frequency (ranging from nonhabitual <120 mL/d to ≥600 mL/d) and standard measurement of anthropometry and blood pressure	An inverse association between the newly diagnosed hypertension risk and habitual tea consumption
Red wine and grapes
Gronbaek et al. [36]	Community-based prospective	13,285 subjects in Denmark aged 30–70 with followup of 10–12 years	Questionnaire on alcohol (beer, wine, or spirit) consumption	Low to moderate intake (3–5 glasses) of wine reduced the risk of death from CVD and cerebrovascular disease

AMI: acute myocardial infarction; CHD: coronary heart disease; CVD: cardiovascular disease; DM: diabetes mellitus; HF: heart failure; MI: myocardial infraction.