Author + information
- Received June 13, 2017
- Revision received September 1, 2017
- Accepted September 12, 2017
- Published online November 13, 2017.
- Marta Guasch-Ferré, PhDa,∗ (, )
- Xiaoran Liu, PhDa,
- Vasanti S. Malik, PhDa,b,
- Qi Sun, MD, ScDa,b,
- Walter C. Willett, MD, DrPHa,b,c,
- JoAnn E. Manson, MD, DrPHc,d,
- Kathryn M. Rexrode, MD, MPHc,d,
- Yanping Li, MD, PhDa,
- Frank B. Hu, MD, PhDa,b,c and
- Shilpa N. Bhupathiraju, PhDa,b,∗ ()
- aDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
- bChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- cDepartment of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
- dDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. Marta Guasch-Ferré OR Dr. Shilpa N. Bhupathiraju, Department of Nutrition, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, Massachusetts 02115.
Background The associations between specific types of nuts, specifically peanuts and walnuts, and cardiovascular disease remain unclear.
Objectives The authors sought to analyze the associations between the intake of total and specific types of nuts and cardiovascular disease, coronary heart disease, and stroke risk.
Methods The authors included 76,364 women from the Nurses’ Health Study (1980 to 2012), 92,946 women from the Nurses’ Health Study II (1991 to 2013), and 41,526 men from the Health Professionals Follow-Up Study (1986 to 2012) who were free of cancer, heart disease, and stroke at baseline. Nut consumption was assessed using food frequency questionnaires at baseline and was updated every 4 years.
Results During 5,063,439 person-years of follow-up, the authors documented 14,136 incident cardiovascular disease cases, including 8,390 coronary heart disease cases and 5,910 stroke cases. Total nut consumption was inversely associated with total cardiovascular disease and coronary heart disease after adjustment for cardiovascular risk factors. The pooled multivariable hazard ratios for cardiovascular disease and coronary heart disease among participants who consumed 1 serving of nuts (28 g) 5 or more times per week, compared with the reference category (never or almost never), were 0.86 (95% confidence interval: 0.79 to 0.93; p for trend = 0.0002) and 0.80 (95% confidence interval: 0.72 to 0.89; p for trend <0.001), respectively. Consumption of peanuts and tree nuts (2 or more times/week) and walnuts (1 or more times/week) was associated with a 13% to 19% lower risk of total cardiovascular disease and 15% to 23% lower risk of coronary heart disease.
Conclusions In 3 large prospective cohort studies, higher consumption of total and specific types of nuts was inversely associated with total cardiovascular disease and coronary heart disease.
This study was supported by research grants UM1 CA186107, R01 HL034594, R01 HL088521, UM1 CA176726, UM1 CA167552, R01 HL35464, and R01 HL60712 from the National Institutes of Health (NIH). Dr. Bhupathiraju is supported by a Career Development Grant from the NIH (K01 DK107804). Dr. Malik has received research support from the Peanut Institute. Drs. Li and Hu have received research support from the California Walnut Commission. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 13, 2017.
- Revision received September 1, 2017.
- Accepted September 12, 2017.
- 2017 American College of Cardiology Foundation
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