Table 3. Subgroup analyses on the association of chocolate consumption with mortality from all causes, cardiovascular disease, and cancera.
| Subgroup variable | Energy-adjusted chocolate consumption (servings/week) | Pinteraction | ||||
| 0 | >0–0.5 | >0.5–1 | >1–2 | >2 | ||
| All-cause mortality | ||||||
| Age (years) | ||||||
| ≥60 | 1.00 (reference) | 0.88 (0.83–0.93) | 0.83 (0.77–0.88) | 0.85 (0.80–0.92) | 0.87 (0.81–0.93) | 0.369 |
| <60 | 1.00 (reference) | 1.03 (0.83–1.28) | 1.03 (0.81–1.31) | 1.01 (0.79–1.30) | 0.96 (0.75–1.21) | |
| Sex | ||||||
| Male | 1.00 (reference) | 0.90 (0.83–0.98) | 0.86 (0.79–0.95) | 0.87 (0.79–0.96) | 0.90 (0.82–0.98) | 0.879 |
| Female | 1.00 (reference) | 0.87 (0.80–0.94) | 0.82 (0.75–0.89) | 0.85 (0.77–0.94) | 0.84 (0.77–0.92) | |
| Trial group | ||||||
| Screening | 1.00 (reference) | 1.00 (0.94–1.07) | 0.89 (0.83–0.95) | 0.95 (0.90–1.02) | 0.93 (0.87–1.00) | 0.683 |
| Control | 1.00 (reference) | 0.97 (0.91–1.04) | 0.88 (0.82–0.94) | 0.92 (0.87–0.98) | 0.94 (0.88–1.00) | |
| Body mass index (kg/m2) | ||||||
| ≥25 | 1.00 (reference) | 0.88 (0.82–0.95) | 0.86 (0.79–0.93) | 0.86 (0.79–0.94) | 0.88 (0.81–0.95) | 0.755 |
| <25 | 1.00 (reference) | 0.90 (0.82–0.99) | 0.82 (0.74–0.92) | 0.89 (0.79–1.00) | 0.88 (0.79–0.98) | |
| Alcohol consumption (g/day)b | ||||||
| No, light or moderate | 1.00 (reference) | 0.91 (0.85–0.96) | 0.85 (0.79–0.91) | 0.87 (0.81–0.94) | 0.88 (0.82–0.94) | 0.306 |
| Heavy | 1.00 (reference) | 0.79 (0.68–0.93) | 0.80 (0.67–0.95) | 0.86 (0.71–1.03) | 0.83 (0.69–0.98) | |
| Smoking status | ||||||
| Current or former | 1.00 (reference) | 0.91 (0.85–0.98) | 0.92 (0.84–0.99) | 0.93 (0.85–1.01) | 0.94 (0.87–1.02) | 0.006 |
| Never | 1.00 (reference) | 0.87 (0.79–0.95) | 0.76 (0.69–0.85) | 0.80 (0.72–0.89) | 0.81 (0.74–0.90) | |
| Milk consumption (servings/day) | ||||||
| ≥ median | 1.00 (reference) | 0.91 (0.83–0.99) | 0.84 (0.77–0.93) | 0.88 (0.79–0.97) | 0.85 (0.78–0.93) | 0.118 |
| < median | 1.00 (reference) | 0.87 (0.80–0.94) | 0.84 (0.77–0.92) | 0.86 (0.78–0.94) | 0.91 (0.83–1.00) | |
| History of hypertension | ||||||
| Yes | 1.00 (reference) | 0.92 (0.85–1.01) | 0.86 (0.77–0.95) | 0.94 (0.84–1.05) | 0.93 (0.84–1.03) | 0.207 |
| No | 1.00 (reference) | 0.86 (0.79–0.92) | 0.83 (0.76–0.90) | 0.82 (0.75–0.89) | 0.83 (0.77–0.90) | |
| Cardiovascular mortality | ||||||
| Age (years) | ||||||
| ≥60 | 1.00 (reference) | 0.80 (0.72–0.89) | 0.78 (0.69–0.88) | 0.77 (0.68–0.88) | 0.79 (0.70–0.89) | 0.639 |
| <60 | 1.00 (reference) | 0.73 (0.50–1.05) | 0.59 (0.38–0.92) | 0.68 (0.43–1.09) | 0.76 (0.50–1.15) | |
| Sex | ||||||
| Male | 1.00 (reference) | 0.81 (0.70–0.94) | 0.84 (0.71–0.99) | 0.80 (0.67–0.96) | 0.83 (0.70–0.98) | 0.345 |
| Female | 1.00 (reference) | 0.77 (0.67–0.89) | 0.68 (0.58–0.80) | 0.73 (0.61–0.87) | 0.74 (0.63–0.86) | |
| Trial group | ||||||
| Screening | 1.00 (reference) | 0.98 (0.87–1.11) | 0.88 (0.77–1.00) | 0.87 (0.77–0.98) | 0.90 (0.80–1.02) | 0.627 |
| Control | 1.00 (reference) | 0.91 (0.81–1.02) | 0.83 (0.73–0.94) | 0.91 (0.80–1.02) | 0.89 (0.78–1.01) | |
| Body mass index (kg/m2) | ||||||
| ≥25 | 1.00 (reference) | 0.81 (0.72–0.91) | 0.77 (0.67–0.88) | 0.77 (0.66–0.89) | 0.81 (0.70–0.93) | 0.891 |
| <25 | 1.00 (reference) | 0.78 (0.65–0.93) | 0.79 (0.64–0.97) | 0.79 (0.63–0.99) | 0.76 (0.62–0.93) | |
| Alcohol consumption (g/day)b | ||||||
| No, light or moderate | 1.00 (reference) | 0.91 (0.85–0.96) | 0.85 (0.79–0.91) | 0.87 (0.81–0.93) | 0.88 (0.82–0.94) | 0.279 |
| Heavy | 1.00 (reference) | 0.80 (0.68–0.93) | 0.80 (0.67–0.95) | 0.86 (0.71–1.04) | 0.83 (0.70–0.99) | |
| Smoking status | ||||||
| Current or former | 1.00 (reference) | 0.79 (0.69–0.90) | 0.82 (0.70–0.95) | 0.83 (0.70–0.97) | 0.86 (0.74–1.00) | 0.045 |
| Never | 1.00 (reference) | 0.81 (0.70–0.95) | 0.71 (0.60–0.85) | 0.71 (0.58–0.86) | 0.72 (0.60–0.86) | |
| Milk consumption (servings/day) | ||||||
| ≥ median | 1.00 (reference) | 0.88 (0.76–1.03) | 0.80 (0.68–0.95) | 0.80 (0.67–0.96) | 0.84 (0.71–0.99) | 0.227 |
| < median | 1.00 (reference) | 0.72 (0.63–0.83) | 0.74 (0.63–0.87) | 0.75 (0.63–0.89) | 0.75 (0.64–0.88) | |
| History of hypertension | ||||||
| Yes | 1.00 (reference) | 0.85 (0.73–0.98) | 0.81 (0.68–0.96) | 0.85 (0.70–1.02) | 0.84 (0.71–1.00) | 0.636 |
| No | 1.00 (reference) | 0.75 (0.65–0.86) | 0.73 (0.62–0.85) | 0.70 (0.60–0.83) | 0.73 (0.63–0.85) | |
| Cancer mortality | ||||||
| Age (years) | ||||||
| ≥60 | 1.00 (reference) | 0.94 (0.84–1.06) | 0.92 (0.81–1.04) | 0.97 (0.85– 1.11) | 0.98 (0.87–1.11) | 0.348 |
| <60 | 1.00 (reference) | 1.05 (0.73–1.50) | 1.24 (0.84–1.82) | 1.19 (0.80– 1.77) | 1.05 (0.71–1.54) | |
| Sex | ||||||
| Male | 1.00 (reference) | 1.07 (0.91–1.26) | 1.05 (0.88–1.25) | 1.14 (0.95–1.37) | 1.10 (0.92–1.31) | 0.339 |
| Female | 1.00 (reference) | 0.86 (0.74–1.00) | 0.86 (0.73–1.01) | 0.87 (0.73–1.04) | 0.90 (0.76–1.05) | |
| Trial group | ||||||
| Screening | 1.00 (reference) | 0.92 (0.81–1.03) | 0.93 (0.83–1.06) | 0.99 (0.89–1.11) | 1.06 (0.94–1.20) | 0.265 |
| Control | 1.00 (reference) | 0.95 (0.84–1.06) | 0.99 (0.88–1.11) | 0.92 (0.82–1.03) | 0.95 (0.84–1.08) | |
| Body mass index (kg/m2) | ||||||
| ≥25 | 1.00 (reference) | 1.01 (0.88–1.16) | 1.01 (0.87–1.17) | 1.06 (0.91–1.24) | 1.01 (0.87–1.17) | 0.305 |
| <25 | 1.00 (reference) | 0.86 (0.72–1.02) | 0.84 (0.69–1.04) | 0.87 (0.70–1.08) | 0.95 (0.78–1.16) | |
| Alcohol consumption (g/day)a | ||||||
| No, light or moderate | 1.00 (reference) | 1.02 (0.90–1.15) | 1.00 (0.88–1.14) | 1.05 (0.92–1.21) | 1.05 (0.92–1.20) | 0.108 |
| Heavy | 1.00 (reference) | 0.69 (0.54–0.88) | 0.72 (0.54–0.96) | 0.73 (0.54–1.00) | 0.71 (0.53–0.95) | |
| Smoking status | ||||||
| Current or former | 1.00 (reference) | 0.99 (0.87–1.13) | 0.98 (0.84–1.13) | 1.08 (0.92–1.26) | 1.04 (0.90–1.20) | 0.504 |
| Never | 1.00 (reference) | 0.91 (0.76–1.09) | 0.94 (0.76–1.15) | 0.88 (0.71–1.10) | 0.96 (0.78–1.17) | |
| Milk consumption (servings/day) | ||||||
| ≥ median | 1.00 (reference) | 1.02 (0.87–1.20) | 1.01 (0.84–1.20) | 1.06 (0.88–1.27) | 0.98 (0.82–1.17) | 0.117 |
| < median | 1.00 (reference) | 0.90 (0.78–1.04) | 0.90 (0.76–1.06) | 0.94 (0.79–1.12) | 1.03 (0.88–1.22) | |
| History of hypertension | ||||||
| Yes | 1.00 (reference) | 1.09 (0.90–1.31) | 1.02 (0.82–1.26) | 1.21 (0.97–1.51) | 1.13 (0.92–1.39) | 0.204 |
| No | 1.00 (reference) | 0.89 (0.78–1.02) | 0.91 (0.78–1.05 | 0.90 (0.77–1.05) | 0.92 (0.80–1.06) | |
aValues are hazard ratios (95% confidence intervals). Hazard ratios were adjusted for age (years), sex (male, female), ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, others), educational level (college below, college graduate, postgraduate), marital status (married or living as married, widowed, divorced, separated, never married), study center (10 categories), history of hypertension (yes, no), history of diabetes (yes, no), aspirin use (yes, no), hormone use status (current, former, never) for women, smoking status (current, former, never), alcohol consumption (g/day), body mass index (kg/m2), physical activity (min/week), energy intake from diet (kcal/day), and consumption of red meat (g/day), processed meat (g/day), fruit (g/day), vegetable (g/day), whole grain (servings/day), dairy (cups/day), coffee (g/day), and tea (g/day). For all-cause and cancer mortality, the model was further adjusted for family history of cancer (yes, no). In subgroup analyses stratified by sex, smoking status, and history of hypertension, hazard ratios were not adjusted for the stratification factor.
bFor men, light, moderate, and heavy alcohol consumption referred to ≤ 6 g/day, > 6–28 g/day, and > 28 g/day, respectively; for women, light, moderate, and heavy alcohol consumption referred to ≤ 6 g/day, > 6–14 g/day, and > 14 g/day, respectively.