Tags

Type your tag names separated by a space and hit enter

Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus.
Circ Res 2019; 124(6):920-929CircR

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.

Authors+Show Affiliations

From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine (M.G.-F., F.B.H., E.B.R., J.E.M., Q.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Department of Epidemiology (F.B.H., E.B.R., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine (M.G.-F., F.B.H., E.B.R., J.E.M., Q.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Department of Epidemiology (F.B.H., E.B.R., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine (M.G.-F., F.B.H., E.B.R., J.E.M., Q.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.Department of Epidemiology (F.B.H., E.B.R., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine (M.G.-F., F.B.H., E.B.R., J.E.M., Q.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Division of Preventive Medicine (J.E.M., K.M.R.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.Division of Preventive Medicine (J.E.M., K.M.R.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Division of Women's Health, Department of Medicine (K.M.R.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.From the Department of Nutrition (G.L., M.G.-F., Y.H., Y.L., F.B.H., E.B.R., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine (M.G.-F., F.B.H., E.B.R., J.E.M., Q.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30776978

Citation

Liu, Gang, et al. "Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus." Circulation Research, vol. 124, no. 6, 2019, pp. 920-929.
Liu G, Guasch-Ferré M, Hu Y, et al. Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus. Circ Res. 2019;124(6):920-929.
Liu, G., Guasch-Ferré, M., Hu, Y., Li, Y., Hu, F. B., Rimm, E. B., ... Sun, Q. (2019). Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus. Circulation Research, 124(6), pp. 920-929. doi:10.1161/CIRCRESAHA.118.314316.
Liu G, et al. Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus. Circ Res. 2019 Mar 15;124(6):920-929. PubMed PMID: 30776978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus. AU - Liu,Gang, AU - Guasch-Ferré,Marta, AU - Hu,Yang, AU - Li,Yanping, AU - Hu,Frank B, AU - Rimm,Eric B, AU - Manson,JoAnn E, AU - Rexrode,Kathryn M, AU - Sun,Qi, PY - 2020/03/15/pmc-release PY - 2019/2/20/pubmed PY - 2019/2/20/medline PY - 2019/2/20/entrez KW - cardiovascular disease KW - diabetes mellitus KW - diet KW - epidemiology KW - mortality KW - nuts SP - 920 EP - 929 JF - Circulation research JO - Circ. Res. VL - 124 IS - 6 N2 - 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. SN - 1524-4571 UR - https://www.unboundmedicine.com/medline/citation/30776978/Nut_Consumption_in_Relation_to_Cardiovascular_Disease_Incidence_and_Mortality_Among_Patients_With_Diabetes_Mellitus_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.314316?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -