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Nut consumption and total and cause-specific mortality: results from the Golestan Cohort Study.
Int J Epidemiol 2017; 46(1):75-85IJ

Abstract

Background

A number of prospective studies have observed inverse associations between nut consumption and chronic diseases. However, these studies have predominantly been conducted in Western countries, where nut consumption tends to be more common among individuals with healthier lifestyles. It is important to examine the association in other parts of the world, and particularly among populations with different patterns of disease, socioeconomic status, lifestyles and disease risk factors. Our objective was to examine the association between nut consumption and mortality in a population whose nut consumption does not track with a healthy lifestyle.

Methods

We examined the association between nut consumption and all-cause and cause-specific mortality in the 50 045 participants of the Golestan Cohort Study. Participants were aged 40 and older at baseline in 2004, and have been actively followed since that time. Dietary data were collected using a validated semi-quantitative food frequency questionnaire that was administered at baseline.

Results

During 349 677 person-years of follow-up, 3981 cohort participants died, including 1732 women and 2249 men. Nut consumption was associated inversely with all-cause mortality. The pooled multivariate adjusted hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.89 [95% confidence interval (CI), 0.82-0.95] for the consumption of less than one serving of nuts per week, 0.75 (95% CI, 0.67-0.85) for one to less than three servings per week and 0.71 (95% CI, 0.58-0.86) for three or more servings per week (P < 0.001 for trend). Among specific causes, significant inverse associations were observed between nut consumption and deaths due to cardiovascular disease, all cancers and gastrointestinal cancers.

Conclusions

This study provides evidence for an inverse association between nut consumption and mortality in a developing country, where nut consumption does not track with a healthy lifestyle. Further work is needed to establish the underlying mechanisms responsible for this association.

Authors+Show Affiliations

Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Icahn School of Medicine at Mount Sinai, New York, NY, USA.Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Surveillance and Health Services Research, American Cancer Society Atlanta, GA, USA.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, Maryland.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.Genetic Epidemiology Group, International Agency for Research on Cancer (IARC / WHO), Lyon, France.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Division of Gastroenterology, Hepatology and Nutrition, UBC, BC, Canada.Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26946539

Citation

Eslamparast, Tannaz, et al. "Nut Consumption and Total and Cause-specific Mortality: Results From the Golestan Cohort Study." International Journal of Epidemiology, vol. 46, no. 1, 2017, pp. 75-85.
Eslamparast T, Sharafkhah M, Poustchi H, et al. Nut consumption and total and cause-specific mortality: results from the Golestan Cohort Study. Int J Epidemiol. 2017;46(1):75-85.
Eslamparast, T., Sharafkhah, M., Poustchi, H., Hashemian, M., Dawsey, S. M., Freedman, N. D., ... Malekzadeh, R. (2017). Nut consumption and total and cause-specific mortality: results from the Golestan Cohort Study. International Journal of Epidemiology, 46(1), pp. 75-85. doi:10.1093/ije/dyv365.
Eslamparast T, et al. Nut Consumption and Total and Cause-specific Mortality: Results From the Golestan Cohort Study. Int J Epidemiol. 2017 02 1;46(1):75-85. PubMed PMID: 26946539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nut consumption and total and cause-specific mortality: results from the Golestan Cohort Study. AU - Eslamparast,Tannaz, AU - Sharafkhah,Maryam, AU - Poustchi,Hossein, AU - Hashemian,Maryam, AU - Dawsey,Sanford M, AU - Freedman,Neal D, AU - Boffetta,Paolo, AU - Abnet,Christian C, AU - Etemadi,Arash, AU - Pourshams,Akram, AU - Malekshah,Akbar Fazeltabar, AU - Islami,Farhad, AU - Kamangar,Farin, AU - Merat,Shahin, AU - Brennan,Paul, AU - Hekmatdoost,Azita, AU - Malekzadeh,Reza, PY - 2015/12/18/accepted PY - 2016/3/8/pubmed PY - 2018/4/10/medline PY - 2016/3/7/entrez KW - Golestan Cohort Study KW - Nuts KW - cancer KW - cardiovascular KW - mortality SP - 75 EP - 85 JF - International journal of epidemiology JO - Int J Epidemiol VL - 46 IS - 1 N2 - Background: A number of prospective studies have observed inverse associations between nut consumption and chronic diseases. However, these studies have predominantly been conducted in Western countries, where nut consumption tends to be more common among individuals with healthier lifestyles. It is important to examine the association in other parts of the world, and particularly among populations with different patterns of disease, socioeconomic status, lifestyles and disease risk factors. Our objective was to examine the association between nut consumption and mortality in a population whose nut consumption does not track with a healthy lifestyle. Methods: We examined the association between nut consumption and all-cause and cause-specific mortality in the 50 045 participants of the Golestan Cohort Study. Participants were aged 40 and older at baseline in 2004, and have been actively followed since that time. Dietary data were collected using a validated semi-quantitative food frequency questionnaire that was administered at baseline. Results: During 349 677 person-years of follow-up, 3981 cohort participants died, including 1732 women and 2249 men. Nut consumption was associated inversely with all-cause mortality. The pooled multivariate adjusted hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.89 [95% confidence interval (CI), 0.82-0.95] for the consumption of less than one serving of nuts per week, 0.75 (95% CI, 0.67-0.85) for one to less than three servings per week and 0.71 (95% CI, 0.58-0.86) for three or more servings per week (P < 0.001 for trend). Among specific causes, significant inverse associations were observed between nut consumption and deaths due to cardiovascular disease, all cancers and gastrointestinal cancers. Conclusions: This study provides evidence for an inverse association between nut consumption and mortality in a developing country, where nut consumption does not track with a healthy lifestyle. Further work is needed to establish the underlying mechanisms responsible for this association. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/26946539/Nut_consumption_and_total_and_cause_specific_mortality:_results_from_the_Golestan_Cohort_Study_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyv365 DB - PRIME DP - Unbound Medicine ER -