Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies
Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T
BMC medicine · 275 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- University or hospital
- Norges Teknisk-Naturvitenskapelige Universitet
- Government
- National Institute for Health and Care Research
- University or hospital
- Imperial College London
- Government
- Helse Midt-Norge
- Nonprofit
- Olav og Gerd Meidel Raagholt’s Stiftelse for Medisinsk forskning
- Government
- the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU)
- University or hospital
- Imperial College National Institute of Health Research (NIHR) Biomedical Research Centre (BRC)
Based on 7 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2016-12-01 · BMC Med · vol. 14 · issue 1 · p. 207
- Publisher
- BioMed Central
- Cited
- 411 citations · more than 100% of similar papers · 9.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 92 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Nuts composition and effects · Peanut Plant Research Studies · Botany, Ecology, and Taxonomy Studies
- Keywords
- Medicine, Meta-analysis, Relative risk, Internal medicine, Cause of death, Diabetes mellitus, Confidence interval, Prospective cohort study, Disease, Cancer, Stroke (engine), Endocrinology
- MeSH
- humans, nuts, neoplasms, cardiovascular diseases, diet, mortality, risk, prospective studies, adult
10 authors
From NO, GB, US
- Dagfinn Aune · correspondingNorwegian University of Science and Technology; Imperial College London
- NaNa KeumHarvard University
- Edward L. GiovannucciBrigham and Women's Hospital; Harvard University
- Lars Thore FadnesUniversity of Bergen
- Paolo BoffettaTisch Hospital; Icahn School of Medicine at Mount Sinai
- Darren Charles GreenwoodUniversity of Leeds
Abstract
Background
Although nut consumption has been associated with a reduced risk of cardiovascular disease and all-cause mortality, data on less common causes of death has not been systematically assessed. Previous reviews missed several studies and additional studies have since been published. We therefore conducted a systematic review and meta-analysis of nut consumption and risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality.
Methods
PubMed and Embase were searched for prospective studies of nut consumption and risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality in adult populations published up to July 19, 2016. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. The burden of mortality attributable to low nut consumption was calculated for selected regions.
Results
Twenty studies (29 publications) were included in the meta-analysis. The summary RRs per 28 grams/day increase in nut intake was for coronary heart disease, 0.71 (95% CI: 0.63-0.80, I2 = 47%, n = 11), stroke, 0.93 (95% CI: 0.83-1.05, I2 = 14%, n = 11), cardiovascular disease, 0.79 (95% CI: 0.70-0.88, I2 = 60%, n = 12), total cancer, 0.85 (95% CI: 0.76-0.94, I2 = 42%, n = 8), all-cause mortality, 0.78 (95% CI: 0.72-0.84, I2 = 66%, n = 15), and for mortality from respiratory disease, 0.48 (95% CI: 0.26-0.89, I2 = 61%, n = 3), diabetes, 0.61 (95% CI: 0.43-0.88, I2 = 0%, n = 4), neurodegenerative disease, 0.65 (95% CI: 0.40-1.08, I2 = 5.9%, n = 3), infectious disease, 0.25 (95% CI: 0.07-0.85, I2 = 54%, n = 2), and kidney disease, 0.27 (95% CI: 0.04-1.91, I2 = 61%, n = 2). The results were similar for tree nuts and peanuts. If the associations are causal, an estimated 4.4 million premature deaths in the America, Europe, Southeast Asia, and Western Pacific would be attributable to a nut intake below 20 grams per day in 2013.
Conclusions
Higher nut intake is associated with reduced risk of cardiovascular disease, total cancer and all-cause mortality, and mortality from respiratory disease, diabetes, and infections.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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