Table 1.
Nut consumption and cardiometabolic morbidity and mortality.
| Author, Year, Country [Ref] | Design | Subjects (F:M) Mean Age (Range) |
Length of Study | Comparison Group | Intake of Nuts | Findings |
|---|---|---|---|---|---|---|
| Salas-Salvadó et al., 2011,2018 Spain [13] | RCT | 418 (293:125) 67 (55–80) y |
4 y | Control (low-fat diet *) | MD + 30 g/d nuts (15 g W, 7.5 g H, 7.5 g A) | ↓ diabetes incidence, HR 0.47 (95% CI: 0.23–0.98) (vs. control) |
| Estruch et al., 2018, Spain [20] | RCT, Parallel, multicenter |
2454 (1326:1128) 66.7 ± 6.1 |
4.8 y | Control (nut free diet) | MD + 30 g/d mixed nuts (15 g W, 7.5 g A, 7.5 g H) | ↓ incidence of CV events (myocardial infarction, stroke, death from CV causes) (vs. control) HR 0.64 (95% CI: 0.47–0.88) |
| Pan et al., 2013, USA [14] | Prospective (NHS) | 58,063 F 52–77 y |
22 y | Tree nuts and peanuts (1) Never/rarely (2) <1 serving/wk (3) 1 serving/wk (4) 2–4 servings/wk (5) ≥5 servings/wk |
↓ T2DM risk (p-trend < 0.001) for tree nuts and peanuts HR 0.80 (95% CI: 0.71–0.90) for (2) to (4) vs. (1) HR 0.74 (95% CI: 0.65–0.84) for (5) vs. (1) ↓ T2DM risk (p-trend = 0.002) for walnuts HR 0.76 (95% CI: 0.62–0.94) for (4),(5) vs. (1) |
|
| Ibarrola-Jurado et al., 2013, Spain [15] | Cross-sectional (PREDIMED) | 7210 (4143:3067) 67 (55–80) y |
Tree nuts and peanuts (1) <1 serving/wk (2) 1–3 servings/wk (3) >3 servings/wk |
↓ prevalence of diabetes (3) vs. (1): OR 0.87 (95% CI: 0.78–0.99), p-trend = 0.043 ↓ prevalence of MS (3) vs. (1): OR 0.74 (95% CI: 0.65–0.85), p-trend < 0.001 ↓ prevalence of obesity (3) vs. (1): OR 0.61 (95% CI: 0.54–0.68), p-trend < 0.001 |
||
| Guasch-Ferré et al., 2013, Spain [16] | Prospective (PREDIMED) |
7216 (4145:3071) 67 y |
4.8 y | Tree nuts and peanuts (1) none (2) 1–3 servings/wk (3) >3 servings/wk |
↓ CV mortality (3) vs. (1) for walnuts HR 0.53 (95% CI: 0.29–0.98), p-trend = 0.047 ↓ CV mortality (3) vs. (1) for tree nuts (no walnuts) and peanuts HR 0.42 (95% CI: 0.20–0.89), p-trend = 0.031 ↓ total mortality risk (3) vs. (1) for tree nuts (walnuts included) and peanuts HR 0.61 (95% CI: 0.45–0.83), p-trend = 0.01 |
|
| Hshieh et al., 2015, USA [17] | Prospective | 20,742 M 67 y |
9.6 y | Tree nuts and peanuts (1) <1 serving/mo (2) 1–3 servings/mo (3) 1 serving/wk (4) 2–4 servings/wk (5) ≥5 servings/wk |
↓ CVD deaths (5) vs. (1) HR 0.74 (95% CI: 0.55–1.02), p-trend = 0.015 |
|
| Guasch-Ferré et al., 2017, USA [18] | Prospective (a) NHS (b) NHS II (c) HPFS |
(a) 76,364 F (b) 92,946 F (c) 41,526 M 56 y |
28.7 y 21.5 y 22.5 y |
Tree nuts and peanuts (1) Never/almost never (2) <1 time/wk (3) 1 time/wk (4) 2–4 times/wk (5) ≥5 times/wk |
(5) vs. (1) for tree nuts and peanuts ↓ CVD-HR 0.86 (95% CI: 0.79–0.93, p-trend < 0.001) ↓ CHD-HR 0.80 (95% CI: 0.72–0.89, p-trend < 0.001) ≥2 times/wk tree nuts and peanuts ↓ 13–19% CVD risk ↓ 15–23% CHD risk |
|
| Larsson et al., 2018, Sweden [19] | Prospective | 61,364 (28,453:32,911) 58 (45–83) y |
17 y | Tree nuts and peanuts (1) none (2) 1–3 times/mo (3) 1–2 times/wk (4) ≥3 times/wk |
↓ risk of atrial fibrillation for (4) vs. (1) (linear association) HR 0.82 (95% CI: 0.68–0.99), p-trend = 0.004 ↓ risk of heart failure for (3) vs. (1) (non-linear association) HR 0.80 (95% CI: 0.67–0.97), p-trend = 0.003 (fully adjusted models) |
|
| Liu et al., 2019, USA [21] | Prospective (NHS, HPFS) | 16,217 (12,006:4211) 64.7–69.4 y |
34 y 28 y |
Tree nuts and peanuts (1) <1 serving/mo (2) <1 serving/wk (3) 1 serving/wk (4) 2–4 servings/wk (5) ≥5 servings/wk |
(5) vs. (1) HRs ↓ CVD incidence, 0.83 (0.71–0.98), p-trend = 0.01 ↓ CHD incidence, 0.80 (0.67–0.96), p-trend = 0.005 ↓ CVD mortality, 0.66 (0.52–0.84), p-trend < 0.001 ↓ all-cause mortality 0.69 (0.61–0.77), p-trend < 0.001 |
* low-fat diet—all types of fat, from both animal and vegetable sources, reduced, but no fat-free foods. A—almonds; CHD—coronary heart disease; CI—confidence interval; CV—cardiovascular; CVD—cardiovascular diseases; F—women; H—hazelnuts; HR—hazard ratio; HPFS—Health Professionals Follow-Up Study; M—men; MD—Mediterranean diet; MS—metabolic syndrome; NHS—Nurses’ Health Study; OR—odds ratio; RCT—randomized controlled trial; RR—risk ratio; T2DM—type 2 diabetes mellitus; W—walnuts.