Consuming moderate amounts of chocolate on a regular basis may be associated with a lower risk for heart failure, according to a study published in Circulation: Heart Failure, a journal of the American Heart Association.

Clinical and observational studies have demonstrated chocolate consumption and lower blood pressure (both systolic and diastolic) and an inverse relationship between chocolate intake and cardiovascular disease.

Given that elevated blood pressure is a particularly strong risk factor for heart failure, Harvard Medical School researchers wanted to investigate the relationship between chocolate intake and heart failure (HF).

This population-based study, published in 2010, remains one of the largest studies examining the links between chocolate and heart failure to date.

• Participants included over 31,000 Swedish women
• Aged 48 to 83 years
• The women were followed for almost 9 years, starting in 1998 until end of 2006

To determine chocolate intake, a food frequency questionnaire was administered. Participants were then placed into 8 groups according to their chocolate intake, ranging from none to several servings per day.

In the younger Swedish women, the average portion of chocolate was 30 grams. In participants over 61 years, the average portion was 19 grams.

Chocolate Protects Against Heart Failure

During the study, 419 women (15.1 cases per 10,000 person years) were either hospitalized or died from heart failure. This compares to 17.1 in the general Swedish population in 2000.

After adjusting for demographic, anthropomorphic, and lifestyle factors:

• Women who consumed 1-3 servings per month of chocolate were 26% less likely to have HF.
• Women who consumed 1-2 servings per week were 32% less likely to have HF.

However, as the servings of chocolate increased, the incidence of HF increased. At 3-6 servings per week, women were 9% more likely to have HF; at more than 1 serving a day, they were 23% more likely to have HF.

Milk vs. Dark Chocolate

Chocolate, especially the dark version, is one of the most concentrated sources of flavonoids. In addition to lowering blood pressure, these compounds may protect against the oxidation of LDL or "bad" cholesterol through its antioxidant function. Cocoa and chocolate is associated with inhibition of platelet aggregation, increased HDL or “good” cholesterol, and reduced inflammation.

In Sweden, milk chocolate contains about 30% cocoa solids whereas in the U.S. only 15% cocoa solids are required to be considered dark chocolate. As a result, the same health benefits may not be found by consuming dark chocolate found in this country.

The Bottom Line

Even if chocolate contains health-promoting compounds, it still is high in fat, sugar and calories. So, moderation is key. If you enjoy an occasional indulgence, opt for dark instead of milk chocolate. Or, visit a specialty or gourmet store to find a European brand. The higher cost may inspire you to eat less, but the higher cocoa content may offer greater health benefits.

I think my English grandmother, who lived to 105 years, summed it up best:

“A little bit of what you fancy does you good.”

Dr. David Rahm, MD, VitaMedica Founder

Last Updated: February 2025