ArticleBMJ (Clinical research ed.)2024
Chocolate intake and risk of type 2 diabetes: prospective cohort studies.
Article in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of glucagon-like peptide-1 receptor agonists on renal parameters: a meta-analysis of randomized controlled trials.BMC endocrine disorders · 2025Pooled it
- Beyond Taste: The Impact of Chocolate on Cardiovascular and Steatotic Liver Disease Risk Factors.Nutrients · 2026Review
- Self-reported dark chocolate consumption and depressive symptoms among community-dwelling older adults in Nagoya, Japan: a cross-sectional study.Frontiers in nutrition · 2026Article
- Early-onset colorectal cancer as an emerging disease of metabolic dysregulation.Nature reviews. Endocrinology · 2025Review
- Pre-pregnancy inflammatory and insulinemic dietary patterns and risk of gestational diabetes mellitus: a prospective cohort study of 14,674 women.BMC medicine · 2025Article
- The Modulatory Role of Bioactive Compounds in Functional Foods on Inflammation and Metabolic Pathways in Chronic Diseases.Foods (Basel, Switzerland) · 2025Review
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo prospectively investigate the associations between dark, milk, and total chocolate consumption and risk of type 2 diabetes (T2D) in three US cohorts.
designProspective cohort studies.
settingNurses' Health Study (NHS; 1986-2018), Nurses' Health Study II (NHSII; 1991-2021), and Health Professionals Follow-Up Study (HPFS; 1986-2020).
participantsAt study baseline for total chocolate analyses (1986 for NHS and HPFS; 1991 for NHSII), 192 208 participants without T2D, cardiovascular disease, or cancer were included. 111 654 participants were included in the analysis for risk of T2D by intake of chocolate subtypes, assessed from 2006 in NHS and HPFS and from 2007 in NHSII.
main outcome measureSelf-reported incident T2D, with patients identified by follow-up questionnaires and confirmed through a validated supplementary questionnaire. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals (CIs) for T2D according to chocolate consumption.
resultsIn the primary analyses for total chocolate, 18 862 people with incident T2D were identified during 4 829 175 person years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors, participants consuming ≥5 servings/week of any chocolate showed a significant 10% (95% CI 2% to 17%; P trend=0.07) lower rate of T2D compared with those who never or rarely consumed chocolate. In analyses by chocolate subtypes, 4771 people with incident T2D were identified. Participants who consumed ≥5 servings/week of dark chocolate showed a significant 21% (5% to 34%; P trend=0.006) lower risk of T2D. No significant associations were found for milk chocolate intake. Spline regression showed a linear dose-response association between dark chocolate intake and risk of T2D (P for linearity=0.003), with a significant risk reduction of 3% (1% to 5%) observed for each serving/week of dark chocolate consumption. Intake of milk, but not dark, chocolate was positively associated with weight gain.
conclusionsIncreased consumption of dark, but not milk, chocolate was associated with lower risk of T2D. Increased consumption of milk, but not dark, chocolate was associated with long term weight gain. Further randomized controlled trials are needed to replicate these findings and further explore the mechanisms.
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