The meta-analysis included 14 prospective studies with a total of 508,705 participants, spanning follow-up durations of 5 to 16 years. The systematic search covered PubMed and Embase through March 2017. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled using random effect models. The study explored the association between chocolate intake and the risk of CHD, stroke, and diabetes, analyzing data on the highest versus lowest chocolate consumption.

The findings indicate that higher chocolate consumption is associated with a reduced risk of CHD, stroke, and diabetes. The relationship follows a nonlinear pattern, with little additional risk reduction observed when consuming chocolate beyond 3 servings per week for CHD and stroke. For diabetes, the peak protective effect emerged at 2 servings per week, with no additional benefit noted beyond 6 servings per week. The study suggests that consuming chocolate in moderation (up to 6 servings per week) may be optimal for preventing these cardiometabolic disorders.