Nuts have long been associated with health benefits, including a lower risk of coronary heart disease, in multiple small observational studies. This prompted an official recommendation from the FDA in 2003 that 43 g (1.5 oz) of nut consumption daily may “reduce the risk of heart disease.”
A recent large observational study published in The New England Journal ofMedicine examined the association between nut consumption and all-cause mortality in the Health Professional Follow-up Study (Physician’s and Nurse’s Health Study) over 24 years. Nut consumption was recorded at baseline and again every 2 to 4 years among healthy participants with a very long follow-up-more than 3 million person-years. Nut consumption was divided into peanuts or other nuts. After multivariate adjustment, nut consumption was inversely associated with total mortality in a dose-dependent fashion: HR = 0.93 for nuts less than once a week; HR = 0.89 for once a week; HR = 0.87 for 2 to 4 times a week; HR = 0.85 for 5 or 6 times a week; HR = 0.80 for 7 or more times a week. In addition, there were significant inverse associations with cardiovascular death, cancer deaths, diabetes, and deaths from respiratory disease.
This large study does provide preliminary evidence of the independent inverse relationship between nut consumption and all-cause death among physicians and nurses. It remains to be seen whether this association is directly causative or simply a marker of an overall healthier lifestyle. Furthermore, the frequency of nut consumption was assessed by self-reported surveys and may have been subject to participants’ recall bias. Finally, this was a relatively healthy cohort of physicians and nurses so whether this outcome would be expected in a population with established cardiovascular heart disease has not yet been established.
Bao Y, Han J, Hu FB, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med. 2013;369:2001-2011. doi:10.1056/NEJMoa1307352. (FULL TEXT HERE)