Swedish researchers found that of more than 37,000 men followed for a decade, those who ate the most chocolate had a 17 percent lower risk of stroke than men who avoided chocolate.

The chocolate-loving group typically had the equivalent of a third of a cup of chocolate chips each week.

The study, published in the journal Neurology, is hardly the first to link chocolate to cardiovascular benefits. Several have suggested that chocolate fans have lower rates of certain risks for heart disease and stroke, like high blood pressure.

But those studies do not prove that chocolate is the reason. And the new one, funded by the Swedish Council for working Life and Social Research and the Swedish Research Council, doesn't either, according to a neurologist not involved in the study.

"It's very important for people to take the news on chocolate with a grain of salt," said Dr. Richard B. Libman, vice chair of neurology at the Cushing Neuroscience Institute in Manhasset, New York.

The study was well done, Libman told Reuters Health, but it's what researchers call an observational study. That means investigators look for patterns, like whether chocolate lovers have fewer strokes. The results cannot prove cause-and-effect.

That, Libman said, would take a controlled clinical trial, where people would be randomly assigned to eat chocolate or not, without knowing what they were eating, then followed to see what their stroke rates were over time.

"I don't think a trial like that will ever be done," he said.

For one, Libman noted, that would mean feeding people a good dose of sugar, fat and calories for a long time.

The current findings are based on 37,100 Swedish men ages 49 to 75 who reported on their usual intake of chocolate and other foods. Over the next 10 years, 1,995 men suffered a first-time stroke.

Among men in the top 25 percent for chocolate intake, the stroke rate was 73 per 100,000 men per year.

That compared with a rate of 85 per 100,000 among men who ate the least chocolate, report the researchers, led by Susanna Larsson of the Karolinska Institute in Stockholm.

Larsson's team had information on some other factors - like the men's weight and other diet habits, whether they smoked and whether they had high blood pressure. Even with those things considered, men who ate the most chocolate had a 17 percent lower stroke risk.

Still, Libman said, there could be unmeasured factors that would account for the chocolate-stroke connection.

It's always possible, he noted, that men who ate chocolate were already in generally better health, and saw themselves that way. So they might have felt freer to "indulge" in chocolate than other men did.

‘JUST A THEORY'

There are reasons to believe chocolate could have real effects. "The beneficial effect of chocolate consumption on stroke may be related to the flavonoids in chocolate," Larsson said in a written release from the journal. (She could not be reached for comment.)

Flavonoids are compounds that act as antioxidants and may, based on studies, have positive effects on blood pressure, cholesterol and blood vessel function.

But Libman pointed out that the flavonoid theory is just that, a theory.

On top of that, chocolate does not corner the market on flavonoids. A range of plant foods contain various flavonoids - including many fruits (like berries, citrus and apples) and vegetables (like kale, spinach and broccoli), nuts, soy, tea and wine.

For now, Libman said the message is "everything in moderation." If you already eat chocolate now and then, and your waistline does not seem to be suffering, there's no reason to stop.

But adding the calories to your diet may not be wise. "You can't start advising people to eat chocolate based on this," Libman said. "Think of the negative effects that could result, like obesity and type 2 diabetes."

For women who are wondering if the current findings might apply to them, Larsson's team found similar results in a study of 33,000 Swedish women last year. But the same caveats also apply.

SOURCE: bit.ly/lUcacJ Neurology, online August 29, 2012.

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