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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.
BMC Med. 2016 Dec 05; 14(1):207.BM

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.

Authors+Show Affiliations

Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. d.aune@imperial.ac.uk. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. d.aune@imperial.ac.uk.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.Centre for International Health, Department of Global Public Health and Primary Care & Department of Clinical Dentistry, University of Bergen, Bergen, Norway.The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27916000

Citation

Aune, Dagfinn, et al. "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." BMC Medicine, vol. 14, no. 1, 2016, p. 207.
Aune D, Keum N, Giovannucci E, et al. 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. BMC Med. 2016;14(1):207.
Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). 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. BMC Medicine, 14(1), 207.
Aune D, et al. 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. BMC Med. 2016 Dec 5;14(1):207. PubMed PMID: 27916000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Aune,Dagfinn, AU - Keum,NaNa, AU - Giovannucci,Edward, AU - Fadnes,Lars T, AU - Boffetta,Paolo, AU - Greenwood,Darren C, AU - Tonstad,Serena, AU - Vatten,Lars J, AU - Riboli,Elio, AU - Norat,Teresa, Y1 - 2016/12/05/ PY - 2016/01/28/received PY - 2016/10/26/accepted PY - 2016/12/6/entrez PY - 2016/12/6/pubmed PY - 2017/6/1/medline KW - All-cause mortality KW - Cancer KW - Cardiovascular disease KW - Cause-specific mortality KW - Meta-analysis KW - Nuts KW - Peanuts SP - 207 EP - 207 JF - BMC medicine JO - BMC Med VL - 14 IS - 1 N2 - 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. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/27916000/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_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0730-3 DB - PRIME DP - Unbound Medicine ER -