TY - JOUR

T1 - Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial

AU - Guasch-Ferré, Marta

AU - Bulló, Mònica

AU - Martínez-González, Miguel Ángel

AU - Ros, Emilio

AU - Corella, Dolores

AU - Estruch, Ramon

AU - Fitó, Montserrat

AU - Arós, Fernando

AU - Wärnberg, Julia

AU - Fiol, Miquel

AU - Lapetra, José

AU - Vinyoles, Ernest

AU - Lamuela-Raventós, Rosa Maria

AU - Serra-Majem, Lluís

AU - Pintó, Xavier

AU - Ruiz-Gutiérrez, Valentina

AU - Basora, Josep

AU - Salas-Salvadó, Jordi

N1 - Funding Information: JS-S has received grants from Nut and Dried Fruit Foundation and is a non-paid member of the Scientific Advisory Board of the International Nut and Dried Fruit Foundation. ER has received grants from the California Walnut Commission and is a non-paid member of its Scientific Advisory Committee. No potential conflicts of interest relevant to this article were reported for any of the other authors. None of the funding sources played a role in the design, collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication.

PY - 2013

Y1 - 2013

N2 - Background: Prospective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person.Methods: We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED ('PREvención con DIeta MEDiterránea') study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality.Results: During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend <0.05, all). Compared to non-consumers, subjects consuming nuts >3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts >3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66). Conclusions: Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk.Trial registration: Clinicaltrials.gov. International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005.

AB - Background: Prospective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person.Methods: We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED ('PREvención con DIeta MEDiterránea') study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality.Results: During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend <0.05, all). Compared to non-consumers, subjects consuming nuts >3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts >3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66). Conclusions: Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk.Trial registration: Clinicaltrials.gov. International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005.

KW - Cancer

KW - Cardiovascular

KW - Mortality

KW - Nuts

KW - PREDIMED study

U2 - 10.1186/1741-7015-11-164

DO - 10.1186/1741-7015-11-164

M3 - Journal article

C2 - 23866098

AN - SCOPUS:84880422112

VL - 11

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 1

M1 - 164

ER -