Association of Nut Consumption With Total and Cause-Specific Mortality

Study Questions:

What is the association between nut consumption and mortality?

Methods:

This was an analysis of 76,464 women in the Nurses’ Health Study (1980-2010) and 42,498 men in the Health Professionals Follow-Up Study (1986-2010). Participants with a history of cancer, heart disease, or stroke at baseline were excluded. Self-reported dietary intake was assessed with validated food-frequency questionnaires administered every 2-4 years. Updating of all dietary variables was suspended following self-reporting of stroke, heart disease, angina, or cancer. The authors examined the association between nut consumption and total and cause-specific mortality.

Results:

During 30 years of follow-up, the authors demonstrated a significant, dose-dependent inverse association between nut consumption and total mortality in adjusted analyses. Specifically, the pooled multivariate hazard ratios for death among those who ate nuts, compared to those who did not, were 0.93 (95% confidence interval [CI], 0.90-0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86-0.93) for once per week, 0.87 (95% CI, 0.83-0.90) for 2-4 times per week, 0.85 (95% CI, 0.79-0.91) for 5 or 6 times per week, and 0.80 (95% CI, 0.73-0.86) for 7 or more times per week. The inverse associations between nut consumption and mortality were observed for most major causes of death and for both peanuts and tree nuts.

Conclusions:

The authors concluded that the frequency of nut consumption (both peanuts and tree nuts) is independently and inversely associated with total and cause-specific mortality.

Perspective:

The results from this large observational analysis suggest a significant, dose-dependent, and inverse association between nut consumption and total and cause-specific mortality. Although the study design certainly does not allow for an assignment of causality, these findings corroborate findings from previous smaller studies, and from a secondary analysis of the PREDIMED (Prevencion con Dieta Mediterranea) trial (in which the hazard ratio for death from consumption of three servings of nuts weekly was 0.61 [95% CI, 0.45-0.93], compared to no nut consumption). The association of nut consumption and less mortality lend support to the Food and Drug Administration’s conclusion that consumption of 43 g (1.5 oz.) of nuts per day (as part of a low-fat diet) may have beneficial cardiovascular effects.

Keywords: Follow-Up Studies, Eating, United States Food and Drug Administration, Cardiovascular Diseases, Nuts, Arachis hypogaea, Questionnaires


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