Chocolate, wine and heart health: a narrative review
What it found
In people, eating chocolate and drinking wine in moderate amounts has been linked to better heart outcomes in some studies, but the authors say the evidence is mixed and some of it is weak.
The review also looked at how these foods can interact with heart medicines.
What they found
Studies in people
Chocolate and heart disease
Seven studies that followed people for 12.9 to 30 years found that frequent chocolate eaters had a lower risk of heart disease and stroke. One analysis found a 45% lower risk compared with people who ate no chocolate.
Chocolate and blood vessels
A meta-analysis of 18 studies with 367 people found that eating chocolate or drinking cocoa improved how well blood vessels widen. The improvement was small but measurable.
Wine and heart health
Observational studies found that moderate wine drinkers had lower rates of heart disease and death than non-drinkers. The relationship followed a J-shape, meaning both abstainers and heavy drinkers had higher risks.
Wine and cholesterol
Alcohol was linked to better HDL cholesterol levels but did not affect other blood fats, clotting factors or markers of inflammation. One study found that people drinking more than 48 g of alcohol per day had the highest HDL levels.
Strength of evidence
When researchers used a grading system to check the quality of evidence, they did not confirm the heart benefits seen in some studies. Many of the studies were weak or inconsistent.
Studies in people and animals
Drug interactions
Chocolate and wine can interact with heart medicines. For example, taking aspirin with wine may increase bleeding risk, and statins taken with alcohol may reach higher levels in the blood.
What the authors conclude
“Our narrative review leads to the conclusion that there is abundant evidence to prove the beneficial impact of consuming both products on cardiovascular health, however some evidence still remains controversial.”
Also in their conclusions
- They conclude that there is abundant evidence for beneficial effects of chocolate and wine on heart health, but some evidence remains controversial.
- They say that well-designed, long-term studies are needed to determine the effects of these products on atherosclerosis and other heart diseases.
- They advise that patients taking heart medicines should be alert to the risk of interactions with chocolate and wine.
How it was done
The authors wanted to check recent reports on how chocolate and wine affect heart health, especially atherosclerosis, because these are pleasure foods that have been linked to both harms and benefits.
They searched three databases for studies published between 2010 and 2021 on chocolate, wine, alcohol, atherosclerosis and related topics. They included meta-analyses, experimental and clinical studies in people and animals, and looked at both benefits and drug interactions.
What it can’t tell you
- Most of the evidence comes from studies that follow people over time, which can show a link but cannot prove that chocolate or wine caused the heart benefits.
- The review could not settle whether the effects of wine come from the alcohol or from other compounds, because the studies were too inconsistent.
- The authors note that many of the studies were short or had weak evidence, so the long-term effects remain unclear.
Who paid
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- Nicolaus Copernicus University in Torun, Poland
The paper
- Title
- Cardiovascular Effects of Chocolate and Wine-Narrative Review
- Type
- Meta-analysis
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Sperkowska B, Murawska J, Przybylska A, et al (2021). Cardiovascular Effects of Chocolate and Wine-Narrative Review. Nutrients. doi:10.3390/nu13124269Free full textPubMed 34959821DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error