Please use this identifier to cite or link to this item:
Title: Association of nut intake with risk factors, cardiovascular disease, and mortality in 16 countries from 5 continents: Analysis from the Prospective Urban and Rural Epidemiology (PURE) study
Authors: de Souza, Russell J. 
Dehghan, Mahshid 
Mente, Andrew 
Bangdiwala, Shrikant I. 
Ahmed, Suad Hashim 
Alhabib, Khalid F. 
Altuntas, Yuksel 
Basiak-Rasała, Alicja 
Dagenais, Gilles-R. 
Diaz, Rafael 
Amma, Leela Itty 
Kelishadi, Roya 
Khatib, Rasha 
Lear, Scott A. 
Lopez-Jaramillo, Patricio 
Mohan, Viswanathan 
Poirier, Paul 
Rangarajan, Sumathy 
Rosengren, Annika 
Ismail, Rosnah 
Swaminathan, Sumathi 
Wentzel-Viljoen, Edelweiss 
Yeates, Karen 
Yusuf, Rita 
Teo, Koon K. 
Anand, Sonia S. 
Yusuf, Salim 
Keywords: Global health;Nuts - Health aspects;Cardiovascular system - Diseases - Mortality - Prevention;Prospective cohort
Issue Date: 2020
Publisher: American Journal of Clinical Nutrition
Abstract: Background: The association of nuts with cardiovascular disease and deaths has been investigated mostly in Europe, the USA, and East Asia, with few data available from other regions of the world or from low- and middle-income countries. Objective: To assess the association of nuts with mortality and cardiovascular disease (CVD). Methods: The Prospective Urban Rural Epidemiology study is a large multinational prospective cohort study of adults aged 35–70 y from 16 low-, middle-, and high-income countries on 5 continents. Nut intake (tree nuts and ground nuts) was measured at the baseline visit, using country-specific validated FFQs. The primary outcome was a composite of mortality or major cardiovascular event [nonfatal myocardial infarction (MI), stroke, or heart failure]. Results: We followed 124,329 participants (age = 50.7 y, SD = 10.2; 41.5% male) for a median of 9.5 y. We recorded 10,928 composite events [deaths (n = 8,662) or major cardiovascular events (n = 5,979)]. Higher nut intake (>120 g per wk compared with <30 g per mo) was associated with a lower risk of the primary composite outcome of mortality or major cardiovascular event [multivariate HR (mvHR): 0.88; 95% CI: 0.80, 0.96; P-trend = 0.0048]. Significant reductions in total (mvHR: 0.77; 95% CI: 0.69, 0.87; Ptrend <0.0001), cardiovascular (mvHR: 0.72; 95% CI: 0.56, 0.92; Ptrend = 0.048), and noncardiovascular mortality (mvHR: 0.82; 95% CI: 0.70, 0.96; P-trend = 0.0046) with a trend to reduced cancer mortality (mvHR: 0.81; 95% CI: 0.65, 1.00; P-trend = 0.081) were observed. No significant associations of nuts were seen with major CVD (mvHR: 0.91; 95% CI: 0.81, 1.02; P-trend = 0.14), stroke (mvHR: 0.98; 95% CI: 0.84, 1.14; P-trend = 0.76), or MI (mvHR: 0.86; 95% CI: 0.72, 1.04; P-trend = 0.29). Conclusions: Higher nut intake was associated with lower mortality risk from both cardiovascular and noncardiovascular causes in low-, middle-, and high-income countries. Am J Clin Nutr 2020;112:208–219.
DOI: 10.1093/ajcn/nqaa108
Appears in Collections:Fulltext Publications

Show full item record

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.