Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus
Liu G, Guasch-Ferré M, Hu Y, Li Y, Hu FB, Rimm EB, Manson JE, Rexrode KM, Sun Q
Circulation research · 63 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NCI NIH HHS
- Government
- NHLBI NIH HHS
- Government
- NIDDK NIH HHS
- Grants
- National Cancer Institute (U01 CA167552); National Heart, Lung, and Blood Institute (R01-HL034594); National Cancer Institute (UM1 CA186107); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK082486); National Heart, Lung, and Blood Institute (R01 HL035464); National Heart, Lung, and Blood Institute (R01-HL-088521); National Cancer Institute (U01 CA176726); National Cancer Institute (UM1-CA-167552); National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK058845); National Cancer Institute (UM1 CA176726)
Based on 6 listed funder(s).
Publication
- Published
- 2019-02-19 · Circ Res · vol. 124 · issue 6 · pp. 920–929
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 93 citations · more than 98% of similar papers · 8.0× the field average
- Impact
- Top 10% most cited in its field
- References
- 55 works
- Access
- Free to read
- Research areas
- Nuts composition and effects · Peanut Plant Research Studies · Botany, Ecology, and Taxonomy Studies
- Keywords
- Medicine, Diabetes mellitus, Incidence (geometry), Hazard ratio, Nut, Stroke (engine), Type 2 Diabetes Mellitus, Prospective cohort study, Disease, Internal medicine, Confidence interval, Endocrinology
- MeSH
- humans, nuts, neoplasms, cardiovascular diseases, coronary disease, diabetes complications, diet, incidence, prospective studies, adult, aged, middle aged, female, male
9 authors
From US, VN
- Gang Liu · correspondingBrigham and Women's Hospital; Harvard University; General Department of Preventive Medicine
- Marta Liu Guasch-FerréBrigham and Women's Hospital; Harvard University
- Yang HuHarvard University
- Yanping LiHarvard University
- Frank B. HuBrigham and Women's Hospital; Harvard University
- Eric B. RimmBrigham and Women's Hospital; Harvard University
Abstract
Rationale
The evidence regarding the potential health benefits of nut consumption among individuals with type 2 diabetes mellitus is limited.
Objective
To examine intake of total and specific types of nuts, including tree nuts and peanuts, in relation to subsequent risk of cardiovascular disease (CVD), including coronary heart disease and stroke, and all-cause and cause-specific mortality among individuals with diabetes mellitus.
Methods and results
This prospective analysis included 16 217 men and women with diabetes mellitus at baseline or diagnosed during follow-up (Nurses' Health Study: 1980-2014, Health Professionals Follow-Up Study: 1986-2014). Nut consumption was assessed using a validated food frequency questionnaire and updated every 2 to 4 years. During 223 682 and 254 923 person-years of follow-up, there were 3336 incident CVD cases and 5682 deaths, respectively. Higher total nut consumption was associated with a lower risk of CVD incidence and mortality. The multivariate-adjusted hazard ratios (95% CIs) for participants who consumed 5 or more servings of total nuts per week (1 serving=28 g), compared with those who consumed <1 serving per month, were 0.83 (0.71-0.98; P trend=0.01) for total CVD incidence, 0.80 (0.67-0.96; P trend=0.005) for coronary heart disease incidence, 0.66 (0.52-0.84; P trend <0.001) for CVD mortality, and 0.69 (0.61-0.77; P trend <0.001) for all-cause mortality. Total nut consumption was not significantly associated with risk of stroke incidence or cancer mortality. For specific types of nuts, higher tree nut consumption was associated with lower risk of total CVD, coronary heart disease incidence, and mortality because of CVD, cancer, and all causes, whereas peanut consumption was associated with lower all-cause mortality only (all P trend <0.001). In addition, compared with participants who did not change the consumption of total nuts from pre- to post-diabetes mellitus diagnosis, participants who increased consumption of total nuts after diabetes mellitus diagnosis had an 11% lower risk of CVD, a 15% lower coronary heart disease risk, a 25% lower CVD mortality, and a 27% lower all-cause mortality. The associations persisted in subgroup analyses stratified by sex/cohort, body mass index at diabetes mellitus diagnosis, smoking status, diabetes mellitus duration, nut consumption before diabetes mellitus diagnosis, or diet quality.
Conclusions
Higher consumption of nuts, especially tree nuts, is associated with lower CVD incidence and mortality among participants with diabetes mellitus. These data provide novel evidence that supports the recommendation of incorporating nuts into healthy dietary patterns for the prevention of CVD complications and premature deaths among individuals with diabetes mellitus.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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