In the Journals

Higher nut intake may decrease risk for AF, HF

Consuming nuts regularly may reduce risk for atrial fibrillation and, potentially, HF, according to a study published in Heart.

Susanna C. Larsson, PhD, associate professor in the unit of nutritional epidemiology and senior researcher at Karolinska Institutet in Stockholm, and colleagues reviewed data from 61,364 participants who completed a questionnaire in 1997 that collected information on smoking status and history, diet, height, weight, alcohol consumption, physical activity, aspirin use, family history of MI, and history of hypertension, diabetes and hypercholesterolemia. Participants were excluded if they had prevalent CVD, cancer or an extreme energy intake.

Nut consumption was assessed with a Food Frequency Questionnaire, and participants were categorized based on their intake: none (n = 32,334; mean age, 60 years), one to three times per month (n = 24,707; mean age, 58 years), one to two times per week (n = 3,315; mean age, 57 years) and at least three times per week (n = 1,008; mean age, 57 years).

The endpoints of interest were HF, MI, aortic valve stenosis, AF, ischemic stroke, abdominal aortic aneurysm and intracerebral hemorrhage. Follow-up was conducted from 1998 to the date of diagnosis of an endpoint, death or 2014, whichever occurred first.

During 17 years of follow-up, HF was diagnosed in 3,160 participants, 4,983 participants had an MI, 7,550 participants were diagnosed with AF and 983 had an AAA. After adjusting for multiple risk factors, the associations were attenuated. There was a linear, dose-response association with AF (P for trend = .004) and a nonlinear association with HF (P for nonlinearity = .003).

Compared with participants who reported no nut consumption, the HR for AF was 0.97 for participants who reported consumption one to three times per month (95% CI, 0.93-1.02), 0.88 for those who reported consumption one to two times per week (95% CI, 0.79-0.99) and 0.82 for participants who reported consumption at least three times per week (95% CI, 0.68-0.99). Compared with nonconsumers, the HRs for HF were 0.87 for consumption one to three times per month (95% CI, 0.8-0.94), 0.8 for one to two times per week (95% CI, 0.67-0.97) and 0.98 for at least three times per week (95% CI, 0.76-1.27).

There was no association between nut consumption and the risk for ischemic stroke, aortic valve stenosis or intracerebral hemorrhage.

Results were similar in sensitivity analyses for all CVD outcomes when excluding participants with a history of diabetes.

“Nuts may also beneficially influence cardiovascular health through anti-inflammatory and antioxidant effects, improvement of endothelial function and reduction of total and low-density lipoprotein cholesterol levels,” Larsson and colleagues wrote. “However, the effect of nut intake on cholesterol appears to be nonlinear with an effect primarily seen at intakes of at least 60 g per day. Nut consumption in this study population may have been too low to have a meaningful impact on cholesterol levels.” – by Darlene Dobkowski

Disclosure s : Larsson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Consuming nuts regularly may reduce risk for atrial fibrillation and, potentially, HF, according to a study published in Heart.

Susanna C. Larsson, PhD, associate professor in the unit of nutritional epidemiology and senior researcher at Karolinska Institutet in Stockholm, and colleagues reviewed data from 61,364 participants who completed a questionnaire in 1997 that collected information on smoking status and history, diet, height, weight, alcohol consumption, physical activity, aspirin use, family history of MI, and history of hypertension, diabetes and hypercholesterolemia. Participants were excluded if they had prevalent CVD, cancer or an extreme energy intake.

Nut consumption was assessed with a Food Frequency Questionnaire, and participants were categorized based on their intake: none (n = 32,334; mean age, 60 years), one to three times per month (n = 24,707; mean age, 58 years), one to two times per week (n = 3,315; mean age, 57 years) and at least three times per week (n = 1,008; mean age, 57 years).

The endpoints of interest were HF, MI, aortic valve stenosis, AF, ischemic stroke, abdominal aortic aneurysm and intracerebral hemorrhage. Follow-up was conducted from 1998 to the date of diagnosis of an endpoint, death or 2014, whichever occurred first.

During 17 years of follow-up, HF was diagnosed in 3,160 participants, 4,983 participants had an MI, 7,550 participants were diagnosed with AF and 983 had an AAA. After adjusting for multiple risk factors, the associations were attenuated. There was a linear, dose-response association with AF (P for trend = .004) and a nonlinear association with HF (P for nonlinearity = .003).

Compared with participants who reported no nut consumption, the HR for AF was 0.97 for participants who reported consumption one to three times per month (95% CI, 0.93-1.02), 0.88 for those who reported consumption one to two times per week (95% CI, 0.79-0.99) and 0.82 for participants who reported consumption at least three times per week (95% CI, 0.68-0.99). Compared with nonconsumers, the HRs for HF were 0.87 for consumption one to three times per month (95% CI, 0.8-0.94), 0.8 for one to two times per week (95% CI, 0.67-0.97) and 0.98 for at least three times per week (95% CI, 0.76-1.27).

There was no association between nut consumption and the risk for ischemic stroke, aortic valve stenosis or intracerebral hemorrhage.

Results were similar in sensitivity analyses for all CVD outcomes when excluding participants with a history of diabetes.

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“Nuts may also beneficially influence cardiovascular health through anti-inflammatory and antioxidant effects, improvement of endothelial function and reduction of total and low-density lipoprotein cholesterol levels,” Larsson and colleagues wrote. “However, the effect of nut intake on cholesterol appears to be nonlinear with an effect primarily seen at intakes of at least 60 g per day. Nut consumption in this study population may have been too low to have a meaningful impact on cholesterol levels.” – by Darlene Dobkowski

Disclosure s : Larsson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.