Chocolate Candy and Incident Invasive Cancer Risk in the Women's Health Initiative: An Observational Prospective Analysis.

BACKGROUND: Laboratory and animal studies suggest an inverse association between chocolate consumption and the risk of cancer. Epidemiological studies have yielded inconsistent evidence. OBJECTIVE: To assess the association of chocolate candy consumption with incident, invasive total, breast, colorectal, and lung cancers in a large cohort of postmenopausal American women. DESIGN: Prospective cohort study with a mean 14.8-year follow-up. Chocolate candy intake was assessed by food frequency questionnaire. Invasive cancer events were assessed by physician adjudication. PARTICIPANTS/SETTING: The Women's Health Initiative Study enrolled 161,808 postmenopausal women at 40 clinical centers nationwide between 1993 and 1998. Of these women, 114,281 with plausible food frequency or biometric data and no missing data on chocolate candy exposure were selected for analysis. MAIN OUTCOME MEASURES: Cancer risk in quartiles of chocolate candy consumption with the first quartile as referent. STATISTICAL ANALYSES: Multivariable Cox regression was used to calculate hazard ratios and 95% confidence intervals. RESULTS: There were 16,164 documented incident invasive cancers, representing an incidence rate of 17.0 per 100 participants and 12.3 per 1000 person years during follow-up among participants without any preexisting cancers or missing outcome data. There were no statistically significant associations for total invasive cancer (P-linear = .47, P-curvature = .14), or invasive breast cancer (P-linear = .77, P-curvature = .26). For colorectal cancer P-linear was .02, P-curvature was .03, and compared with women eating a 1 oz (28.4 g) chocolate candy serving <1 time per month, the hazard ratio for ≥1.5 times/wk was 1.18 (95% confidence interval: 1.04-1.35). This result may be attributable to the excess adiposity associated with frequent chocolate candy consumption. CONCLUSIONS: In the Women's Health Initiative, there was no significant association between chocolate candy consumption and invasive total or breast cancer. There was a modest 18% higher risk of invasive colorectal cancer for women who ate chocolate candy at least 1.5 times/wk. These results require confirmation.

[Chocolate consumption and Hungarian Nobel laureates]. / Csokoládéfogyasztás és a magyar Nobel-díjasok.

INTRODUCTION: Certain dietary items contain significant amounts of flavonoids which was shown to improve cognitive function. An earlier investigation demonstrated a strong linear correlation between chocolate consumption and the number of Nobel laureates in a given country. However, Hungary and the Hungarian Nobel laureates were not included in this analysis. AIM: In this publication, we aim to complement these data by analyzing data available for Hungary. METHOD: The number of Nobel laureates per country and the international data on chocolate consumption were based on the previously published results. The amount of chocolate consumption in Hungary was based on data from the Hungarian Central Statistical Office. GDP per capita and Research and Development Expenditure data for the investigated countries were derived from the World Bank. RESULTS: There are 11 Nobel laureates from Hungary. Based on this, Hungary ranks the 9th amongst the 24 studied countries. However, it only ranks the 19th when it comes to chocolate consumption. Correlations were found between the number of Nobel laureates and GDP per capita (r = 0.734; p = 0.001) as well as Research and Development Expenditure (r = 0.532; p = 0.01) amongst the studied countries. CONCLUSION: The achievements of Hungarian scholars do not support the earlier notion that there is a link between the number of Nobel laureates (cognitive function) and the chocolate consumption in a given country. Their biographies highlight the importance and more possibilities of research funding in wealthier countries. Orv Hetil. 2019; 160(1): 26-29.

Effects of a non-eating confederate on food intake do not persist for everyone over time when people are left alone: An exploratory study.

An extensive body of research has established that eating with others can have inhibitory effects on food intake. Recent findings suggest that these effects may (partly) persist over time when the eating norm is no longer enforced. To gain more insights into the persistence of effects of a live non-eating stranger, the main aim of the present study is to explore how food intake of young women changes as a result of previous exposure to a non-eating confederate (i.e., adult stranger). To address this aim, an experiment was conducted in which 64 young women, aged 17 to 26 (M = 19.81, SD = 1.95), were given access to chocolates at two different time points. First, participants were all paired with a non-eating stranger (i.e., confederate). Afterwards, half of the participants remained with the non-eating stranger (i.e., together-together condition), while the other half was left alone with the food (i.e., together-alone condition). Results indicated that participants who were left alone increased their intake on average, although raw data revealed interesting individual differences. In contrast, most of the participants who remained with the non-eating stranger did not increase intake. Participants in an ad hoc added control condition (i.e., no exposure to a non-eating confederate; alone-alone condition; n = 26) showed food intake similar to participants in the together-alone condition after they were left alone. Our findings suggest that if intake behaviors are too extreme and divergent from the desire to eat as much as possible, women may, on average, only adhere to these behaviors in the presence of others.

Television food advertising to children in Slovenia: analyses using a large 12-month advertising dataset.

OBJECTIVES: The marketing of energy-dense foods is recognised as a probable causal factor in children's overweight and obesity. To stimulate policymakers to start using nutrient profiling to restrict food marketing, a harmonised model was recently proposed by the WHO. Our objective is to evaluate the television advertising of foods in Slovenia using the above-mentioned model. METHODS: An analysis is performed using a representative dataset of 93,902 food-related advertisements broadcast in Slovenia in year 2013. The advertisements are linked to specific foods, which are then subject to categorisation according to the WHO and UK nutrient profile model. RESULTS: Advertising of chocolate and confectionery represented 37 % of food-related advertising in all viewing times, and 77 % in children's (4-9 years) viewing hours. During these hours, 96 % of the food advertisements did not pass the criteria for permitted advertising according to the WHO profile model. CONCLUSIONS: Evidence from Slovenia shows that, in the absence of efficient regulatory marketing restrictions, television advertising of food to children is almost exclusively linked to energy-dense foods. Minor modifications of the proposed WHO nutrient profile model are suggested.

A new food frequency questionnaire to assess chocolate and cocoa consumption.

OBJECTIVE: Cocoa has been highlighted as a food with potential benefits to human health because of its polyphenol content. However, few studies show the contribution of cocoa and chocolate products in polyphenol intake. The aim of this work was to develop a food frequency questionnaire (FFQ) for evaluating the intake of food products containing cocoa (C-FFQ). METHODS: A sample of 50 university students was recruited to complete the 90-item questionnaire, a validated questionnaire (called here European Food Safety Authority [EFSA]-Q) as well as a 24-hour dietary recall (24 HDR). Spearman correlation test, Bland-Altman plots, and quintile classification analysis were conducted together with the Wilcoxon test and descriptive statistics. RESULTS: Significant correlations between the C-FFQ and the EFSA-Q for the most common cocoa/chocolate products were observed (P < 0.05), as well as between data from the C-FFQ and 24 HDR (P < 0.05). However, a number of cocoa/chocolate products frequently consumed by the participants were detected by the C-FFQ and 24 HDR which were not included in the EFSA-Q. According to the C-FFQ, chocolate bars were the main source of cocoa in university students, but dairy products also provided an important amount of cocoa. CONCLUSION: The developed C-FFQ questionnaire can be considered as a valid option for assessing the consumption frequency of cocoa/chocolate-derived products, thereby allowing the evaluation of cocoa polyphenol intake in further studies.

Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis.

OBJECTIVE: To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data. METHODS AND RESULTS: The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease. RESULTS: The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%). CONCLUSIONS: Chocolate consumption is associated with lower risk of MI and ischaemic heart disease.