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Original research article
Nut consumption and incidence of seven cardiovascular diseases
  1. Susanna C Larsson1,
  2. Nikola Drca2,
  3. Martin Björck3,
  4. Magnus Bäck4,5,
  5. Alicja Wolk1,3
  1. 1 Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2 Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  3. 3 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
  4. 4 Divison of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
  5. 5 Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Susanna C Larsson, Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm SE-17177, Sweden; susanna.larsson{at}ki.se

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.

  • atrial fibrillation
  • heart failure
  • aortic aneurysm
  • aortic stenosis
  • acute myocardial infarction

This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors SCL is responsible for the overall content as a guarantor, contributed to the conception and design of the work, statistical analysis and interpretation of the data, and drafting of the manuscript. ND, MBj and MBä contributed to the interpretation of the data and critical revision of the manuscript for important intellectual content. AW contributed to the acquisition and interpretation of the data, and critical revision of the manuscript for important intellectual content.

  • Funding This study was supported by the Swedish Research Council (grant nos: 2016-01042 and 2015-02302) and the Swedish Stroke Association.

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

  • Patient consent Obtained.

  • Ethics approval The Regional Ethical Review Board in Stockholm, Sweden, approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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