Nut consumption and risk of stroke.Eur J Epidemiol 2015; 30(3):189-96EJ
Nut consumption has been inconsistently associated with risk of stroke. Our aim was to carry out a meta-analysis of prospective studies to assess the relation between nut consumption and stroke risk and mortality. Pertinent studies were identified by a search of PubMed and Embase through June 2014 and by reviewing the references of retrieved articles. Prospective cohort studies that reported relative risks (RRs) with 95% confidence intervals (CIs) for the association between nut consumption and risk of stroke were included. Six articles including nine independent prospective cohorts with 476,181 participants were included in the meta-analysis. The pooled RR of stroke was 0.90 (95% CI 0.83-0.98) comparing the highest with the lowest nut consumption. Stratifying by gender, significant inverse association was observed for females (RR 0.88; 95% CI 0.78-0.98). Sensitivity analysis restricted to studies with adjustment for common confounding factors showed similar results, strengthening the association between nut consumption and stroke risk. Moreover, we observed a trend toward an inverse association between higher nut consumption and stroke mortality (RR 0.86; 95% CI 0.69-1.06), although it is not significant. Current evidence indicated that nut consumption is inversely associated with risk of stroke.