Nut consumption and incidence of seven cardiovascular diseases

Abstract

Background: Nut consumption has been found to be inversely associated with cardiovascular disease mortality, but the association between nut consumption and incidence of specific cardiovascular diseases is unclear. We examined the association between nut consumption and incidence of seven cardiovascular diseases.

Methods: This prospective study included 61 364 Swedish adults who had completed a Food Frequency Questionnaire and were followed up for 17 years through linkage with the Swedish National Patient and Death Registers.

Results: Nut consumption was inversely associated with risk of myocardial infarction, heart failure, atrial fibrillation and abdominal aortic aneurysm in the age-adjusted and sex-adjusted analysis. However, adjustment for multiple risk factors attenuated these associations and only a linear, dose-response, association with atrial fibrillation (ptrend=0.004) and a non-linear association (pnon-linearity=0.003) with heart failure remained. Compared with no consumption of nuts, the multivariable HRs (95% CI) of atrial fibrillation across categories of nut consumption were 0.97 (0.93 to 1.02) for 1-3 times/month, 0.88 (0.79 to 0.99) for 1-2 times/week and 0.82 (0.68 to 0.99) for ≥3 times/week. For heart failure, the corresponding HRs (95% CI) were 0.87 (0.80 to 0.94), 0.80 (0.67 to 0.97) and 0.98 (0.76 to 1.27). Nut consumption was not associated with risk of aortic valve stenosis, ischaemic stroke or intracerebral haemorrhage.

Conclusions: These findings suggest that nut consumption or factors associated with this nutritional behaviour may play a role in reducing the risk of atrial fibrillation and possibly heart failure.

Trial registration number: NCT01127711 and NCT01127698;Results.

Keywords: acute myocardial infarction; aortic aneurysm; aortic stenosis; atrial fibrillation; heart failure.

Conflict of interest statement

Competing interests: ND has received consultancy fees from Biosense Webster.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1

Multivariable HRs (95% CI) of incident cardiovascular disease (CVD) per additional portion of nuts per week. HRs were estimated by Cox proportional hazards models with age as the time scale and stratified by sex, and adjusted for education (less than high school, high school or university), family history of myocardial infarction before 60 years of age (yes/no), smoking (never, past 40 min/day), exercise (21 drinks/week), fruits (quintiles), vegetables (quintiles), total energy (kcal/day; continuous), body mass index (2), history of diabetes (yes/no), history of hypertension (yes/no) and history of hypercholesterolaemia (yes/no).