Funded in part by Diabetes Centre Sun Life Financial New Investigator
Nut consumption and incidence of cardiovascular diseases and cardiovascular disease mortality: a meta-analysis of prospective cohort studies
Becerra-Tomás N, Paz-Graniel I, W C Kendall C, Kahleova H, Rahelić D, Sievenpiper JL, Salas-Salvadó J
Nutrition reviews · 116 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
- 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
- Industry funded
- Government
- Ministerio de Educación, Cultura y Deporte
- Nonprofit
- European Association for the Study of Diabetes
- Government
- Canadian Institutes of Health Research
- University or hospital
- Institute of Nutrition, Metabolism and Diabetes
- Nonprofit
- Canadian Diabetes Association Clinician Scientist
- Unclassified
- PSI Graham Farquharson Knowledge Translation Fellowship
- Company
- Diabetes Centre Sun Life Financial New Investigator
- Government
- Spanish Ministry of Education, Culture and Sports
- Nonprofit
- The Diabetes and Nutrition Study Group
- Authors
- At least one author declares a financial tie to industry
- Grants
- Ministerio de Educación, Cultura y Deporte (FPU 17/01925)
Based on 9 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2019-05-09 · Nutr Rev · vol. 77 · issue 10 · pp. 691–709
- Publisher
- Oxford University Press
- Cited
- 174 citations · more than 97% of similar papers · 4.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 66 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Nuts composition and effects · Botany, Ecology, and Taxonomy Studies · Peanut Plant Research Studies
- Keywords
- Meta-analysis, Medicine, Prospective cohort study, Incidence (geometry), Cohort study, Disease, Epidemiology, Cohort, Nut, Environmental health, Internal medicine, Gerontology
- MeSH
- humans, nuts, cardiovascular diseases, incidence, prospective studies, observational studies as topic
7 authors
From ES, CA, US, CZ, HR
- Nerea Becerra‐Tomás · correspondingInstituto de Salud Carlos III; Institut de Recerca Biomèdica Catalunya Sud; Centro de Investigación Biomédica en Red; Universitat Rovira i Virgili
- Indira Paz‐GranielInstitut de Recerca Biomèdica Catalunya Sud; Hospital Universitari Sant Joan de Reus; Universitat Rovira i Virgili
- Cyril W.C. KendallSt. Michael's Hospital; University of Toronto; University of Saskatchewan
- Hana KahleováPhysicians Committee for Responsible Medicine; Institute of Clinical and Experimental Medicine
- Dario RahelićUniversity of Zagreb; Klinička bolnica Merkur
- John L. SievenpiperSt. Michael's Hospital; University of Toronto
Abstract
Context
Previous meta-analyses evaluating the association between nut consumption and the risk of cardiovascular disease (CVD) had substantial methodological limitations and lacked recently published large prospective studies; hence, making an updated meta-analysis highly desirable.
Objective
To update the clinical guidelines for nutrition therapy in relation to the European Association for the Study of Diabetes (EASD), a systematic review and meta-analysis of prospective studies was conducted using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to summarize the evidence of the association between total nuts, specific types of nuts, and the incidence of, and mortality from, CVD outcomes.
Data sources
Relevant articles were identified by searching the PubMed and Cochrane databases.
Data extraction
Two independent researchers screened the articles to identify those that met the inclusion criteria.
Data analysis
The inverse variance method with fixed-effect or random-effects models was used to pool data across studies (expressed as risk ratio [RR] and 95% confidence interval [CI]). Heterogeneity was tested and quantified using the Cochrane Q test and I2-statistic, respectively. The GRADE system was used to assess the quality of the evidence.
Results
Nineteen studies were included in the analyses. The results revealed an inverse association between total nut consumption (comparing highest vs lowest categories) and CVD incidence (RR, 0.85; 95%CI, 0.800.91; I2, 0%), CVD mortality (RR, 0.77; 95%CI, 0.72-0.82; I2, 3%), coronary heart disease (CHD) incidence (RR, 0.82; 95%CI, 0.69-0.96; I2, 74%), CHD mortality (RR, 0.76; 95%CI, 0.67-0.86; I2, 46%), stroke mortality (RR, 0.83; 95%CI, 0.75-0.93; I2, 0%), and atrial fibrillation (RR, 0.85; 95%CI, 0.73-0.99; I2, 0%). No association was observed with stroke incidence and heart failure. The certainty of the evidence ranged from moderate to very low.
Conclusions
This systematic review and meta-analysis revealed a beneficial role of nut consumption in reducing the incidence of, and mortality from, different CVD outcomes.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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