HR (95% CI) of incident CVD according to nut consumption in Swedish adults, 1998–2014
Outcome | Frequency of nut consumption | Ptrend | ||||
None | 1–3/month | 1–2/week | ≥3/week | Linear | Non-linear | |
Myocardial infarction | ||||||
Cases (n=4983) | 2962 | 1734 | 213 | 74 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.88 (0.83 to 0.93) | 0.79 (0.69 to 0.91) | 0.77 (0.61 to 0.96) | <0.001 | <0.001 |
Multivariable model 1† | 1.00 (reference) | 0.96 (0.90 to 1.02) | 0.88 (0.77 to 1.02) | 0.86 (0.68 to 1.09) | 0.04 | 0.10 |
Multivariable model 2†‡ | 1.00 (reference) | 0.98 (0.92 to 1.04) | 0.91 (0.79 to 1.05) | 0.88 (0.70 to 1.11) | 0.12 | 0.26 |
Non-fatal myocardial infarction | ||||||
Cases (n=4066) | 2368 | 1466 | 182 | 51 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.92 (0.86 to 0.98) | 0.83 (0.71 to 0.96) | 0.66 (0.50 to 0.88) | <0.001 | 0.01 |
Multivariable model 1† | 1.00 (reference) | 0.99 (0.92 to 1.06) | 0.92 (0.79 to 1.08) | 0.75 (0.57 to 0.99) | 0.03 | 0.31 |
Multivariable model 2†‡ | 1.00 (reference) | 1.01 (0.95 to 1.08) | 0.95 (0.82 to 1.11) | 0.76 (0.58 to 1.01) | 0.09 | 0.26 |
Fatal myocardial infarction | ||||||
Cases (n=917) | 595 | 268 | 31 | 23 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.73 (0.63 to 0.84) | 0.63 (0.44 to 0.91) | 1.19 (0.78 to 0.80) | 0.14 | <0.001 |
Multivariable model 1† | 1.00 (reference) | 0.82 (0.71 to 0.95) | 0.72 (0.50 to 1.05) | 1.32 (0.86 to 2.01) | 0.78 | 0.009 |
Multivariable model 2†‡ | 1.00 (reference) | 0.85 (0.73 to 0.99) | 0.75 (0.52 to 1.09) | 1.34 (0.88 to 2.05) | 0.99 | 0.03 |
Heart failure | ||||||
Cases (n=3160) | 2034 | 950 | 114 | 62 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.78 (0.72 to 0.84) | 0.72 (0.60 to 0.87) | 0.94 (0.73 to 1.21) | 0.001 | <0.001 |
Multivariable model 1† | 1.00 (reference) | 0.83 (0.77 to 0.90) | 0.76 (0.63 to 0.92) | 0.94 (0.73 to 1.22) | 0.01 | <0.001 |
Multivariable model 2†‡ | 1.00 (reference) | 0.87 (0.80 to 0.94) | 0.80 (0.67 to 0.97) | 0.98 (0.76 to 1.27) | 0.07 | 0.003 |
Atrial fibrillation | ||||||
Cases (n=7550) | 4372 | 2737 | 328 | 113 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.97 (0.92 to 1.01) | 0.88 (0.79 to 0.99) | 0.87 (0.67 to 0.89) | 0.002 | 0.18 |
Multivariable model 1† | 1.00 (reference) | 0.95 (0.91 to 1.00) | 0.85 (0.76 to 0.95) | 0.79 (0.65 to 0.95) | <0.001 | 0.06 |
Multivariable model 2†‡ | 1.00 (reference) | 0.97 (0.93 to 1.02) | 0.88 (0.79 to 0.99) | 0.82 (0.68 to 0.99) | 0.004 | 0.24 |
Aortic valve stenosis | ||||||
Cases (n=972) | 561 | 356 | 41 | 14 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 1.01 (0.89 to 1.16) | 0.90 (0.66 to 1.24) | 0.78 (0.46 to 1.33) | 0.29 | 0.26 |
Multivariable model 1† | 1.00 (reference) | 1.06 (0.92 to 1.21) | 0.95 (0.69 to 1.31) | 0.83 (0.48 to 1.41) | 0.61 | 0.25 |
Multivariable model 2†‡ | 1.00 (reference) | 1.09 (0.95 to 1.26) | 1.00 (0.72 to 1.37) | 0.87 (0.51 to 1.41) | 0.89 | 0.20 |
Abdominal aortic aneurysm | ||||||
Cases (n=983) | 608 | 324 | 42 | 9 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.84 (0.74 to 0.97) | 0.82 (0.60 to 1.12) | 0.49 (0.25 to 0.94) | 0.03 | 0.12 |
Multivariable model 1† | 1.00 (reference) | 0.93 (0.81 to 1.07) | 0.90 (0.65 to 1.24) | 0.56 (0.29 to 1.09) | 0.06 | 0.47 |
Multivariable model 2†‡ | 1.00 (reference) | 0.94 (0.82 to 1.08) | 0.92 (0.67 to 1.26) | 0.58 (0.30 to 1.13) | 0.89 | 0.53 |
Ischaemic stroke | ||||||
Cases (n=3782) | 2202 | 1335 | 180 | 65 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 0.95 (0.89 to 1.02) | 1.00 (0.86 to 1.16) | 0.93 (0.73 to 1.19) | 0.42 | 0.24 |
Multivariable model 1† | 1.00 (reference) | 1.01 (0.94 to 1.08) | 1.09 (0.93 to 1.27) | 1.01 (0.79 to 1.30) | 0.54 | 0.80 |
Multivariable model 2†‡ | 1.00 (reference) | 1.04 (0.97 to 1.11) | 1.12 (0.96 to 1.31) | 1.03 (0.80 to 1.32) | 0.29 | 0.49 |
Intracerebral haemorrhage | ||||||
Cases (n=543) | 306 | 205 | 22 | 10 | ||
Age-adjusted and sex-adjusted model* | 1.00 (reference) | 1.01 (0.84 to 1.21) | 0.83 (0.54 to 1.28) | 1.04 (0.55 to 1.95) | 0.78 | 0.28 |
Multivariable model 1† | 1.00 (reference) | 1.04 (0.86 to 1.25) | 0.84 (0.54 to 1.30) | 1.00 (0.53 to 1.90) | 0.79 | 0.27 |
Multivariable model 2†‡ | 1.00 (reference) | 1.04 (0.86 to 1.25) | 0.84 (0.54 to 1.30) | 1.00 (0.53 to 1.89) | 0.77 | 0.29 |
*HRs were estimated by Cox proportional hazards models with age as the time scale and stratified by sex.
†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 <20 pack-years, past ≥20 pack-years, current <20 pack-years or current ≥20 pack-years), walking/bicycling (almost never,<20 min/day, 20–40 min/day or >40 min/day), exercise (<1 hour/week, 1–2 hours/week, 3–4 hours/week or ≥5 hours/week), aspirin use (never, 1–6 tablets/week or ≥7 tablets/week) and consumption of alcohol (never drinkers, past drinkers or current drinkers of <1 drink/week, 1–6 drinks/week, 7–14 drinks/week, 14–21 drinks/week or >21 drinks/week), fruits (quintiles), vegetables (quintiles) and total energy (kcal/day; continuous).
‡HRs were adjusted for the same variables as in model 1 and further for potential intermediates of the nut–CVD relationship, including body mass index (<22.5, 22.5–24.9, 25.0–29.9 or ≥30.0 kg/m2), history of diabetes (yes/no), history of hypertension (yes/no) and history of hypercholesterolaemia (yes/no).
CVD, cardiovascular disease.