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Cross-Sectional Assessment of Nut Consumption and Obesity, Metabolic Syndrome and Other Cardiometabolic Risk Factors: The PREDIMED Study

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PLOS ONE
Authors:
Nuria Ibarrola at Universitat Rovira i Virgili
Nuria Ibarrola
Mónica Bulló at Universitat Rovira i Virgili
Mónica Bulló
Marta Guasch-Ferré at Harvard University
Marta Guasch-Ferré
Emilio Ros at Hospital Clínic de Barcelona
Emilio Ros
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Abstract and Figures

Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors. To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk. Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as <1, 1-3, and >3 servings/wk. Control of confounding was done with multivariate logistic regression. Compared to participants consuming <1 serving/wk of nuts, those consuming >3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001), MetS (0.74, 0.65 to 0.85; P-trend<0.001), and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend<0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose. Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.
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Cross-Sectional Assessment of Nut Consumption and Obesity, Metabolic Syndrome and Other Cardiometabolic Risk Factors: The PREDIMED Stu
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Supplementary resources (2)

Table S2
Data
February 2013
Nuria Ibarrola · Mónica Bulló · Marta Guasch-Ferré · Emilio Ros · Jordi Salas-Salvadó
Table S1
Data
December 2012
Dolores Corella · Carolina Ortega-Azorín · Jose V. Sorlí · M.I. Covas · Ramon Estruch
... The trial was registered in 2014 at: [www.isrctn.com/ISRCTN89898870]. Eligible participants were community-dwelling adults aged 55 to 75 y, with overweight or obesity (BMI 27 to 40 kg/m 2 ), who at baseline met at least 3 criteria for the metabolic syndrome [22]. For the present study, participants who had not completed the baseline dietary questionnaire had reported energy intakes outside predefined limits (!800 to 4000 kcal/d for men, !500 to 3500 kcal/d for women) [23] or had reported nut consumption of !100g/d [24] were excluded. ...
... Intraclass correlation coefficients for relative reproducibility and validity for nut intake were 0.80 and 0.55, respectively [25]. Information collected from the FFQ was converted to grams per day by multiplying the numerical value of each frequency category by the nut serving size (30 g/serving) and was further recoded into 4 categories based on the distribution of the original nut consumption measure (right-skewed) of the study population, globally recommended quantities of nut intake [26], and prior studies [24,27]: <1 serving/wk, !1 to <3 servings/wk, !3 to <7 servings/wk, and !7 servings/wk. Each cognitive test at baseline and at 2-y follow-up was standardized for each participant to a z-score using the mean and SD of baseline data, and the difference between the standardized scores at 2 timepoints was calculated to examine changes in cognitive performance over time [28,29]. ...
Higher versus lower nut consumption and changes in cognitive performance over two years in a population at risk of cognitive decline: a cohort study
Article
Full-text available
  • Jun 2023
  • AM J CLIN NUTR
Background: Tree nuts and peanuts (henceforth, nuts) are nutrient-dense foods rich in neuroprotective components, thus their consumption could benefit cognitive health. However, evidence to date is limited and inconsistent regarding the potential benefits of nuts for cognitive function. Objective: To prospectively evaluate the association between nut consumption and 2-year changes in cognitive performance in older adults at cognitive decline risk. Methods: 6,630 participants aged 55-75 years (mean age 65.0±4.9 years, 48.4% women) with overweight/obesity and metabolic syndrome, completed a validated semi-quantitative food frequency questionnaire and a comprehensive battery of neuropsychological tests at baseline and after a 2-year follow-up. Composite cognitive scores were used to assess global, general, attention, and executive function domains. Nut consumption was categorized as <1, ≥1 to <3, ≥3 to <7, and ≥7 servings/week (1 serving=30 g). Multivariable-adjusted linear regression models were fitted to assess associations between baseline nut consumption and 2-year cognitive changes. Results: Nut consumption was positively associated with 2-year changes in general cognitive function (p-trend <0.001). Compared to participants consuming <1 serving/week of nuts, those categorized as consuming ≥3 to <7 and ≥7 servings/week showed more favorable changes in general cognitive performance (β z-score [95% CI]= 0.06 [0.00,0.12] and 0.13 [0.06,0.20], respectively). No significant changes were observed in the multivariable-adjusted models for other cognitive domains assessed. Conclusion: Frequent nut consumption was associated with smaller decline in general cognitive performance over a 2-year period in older adults at risk of cognitive decline. Randomized clinical trials to verify our findings are warranted.
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... First, daily consumption of tree nuts as between-meal snacks significantly reduced total metabolic syndrome risk score in young adults, most of whom met BMI criteria for overweight or obesity and had at least one METSx risk factor at baseline. Although this is the first trial comparing consumption of tree nuts as snacks versus typical carbohydrate snacks in young adults, the reduction in MetSx score is consistent with NHANES data showing lower prevalence of MetSx in tree nut consumers [32], findings from the PREDIMED trial showing decreased risk for MetSx in individuals with high cardiovascular disease risk [33], and the Tehran Lipid and Glucose study which showed reduced incidence of MetSx with tree nut consumption of five or more servings per week [34]. ...
Consumption of Tree Nuts as Snacks Reduces Metabolic Syndrome Risk in Young Adults: A Randomized Trial
Article
Full-text available
  • Dec 2023
Metabolic syndrome (MetSx) and its chronic disease consequences are major public health concerns worldwide. Between-meal snacking may be a modifiable risk factor. We hypothesized that consuming tree nuts as snacks, versus typical carbohydrate snacks, would reduce risk for MetSx in young adults. A prospective, randomized, 16-week parallel-group diet intervention trial was conducted in 84 adults aged 22–26 with BMI 24.5 to 34.9 kg/m2 and ≥1 MetSx clinical risk factor. Tree nuts snacks (TNsnack) were matched to carbohydrate snacks (CHOsnack) for energy (kcal), protein, fiber, and sodium content as part of a 7-day eucaloric menu. Difference in change between groups was tested by analysis of covariance using general linear models. Multivariable linear regression modeling assessed main effects of TNsnack treatment and interactions between TNsnack and sex on MetSx score. Age, BMI, and year of study enrollment were included variables. There was a main effect of TNsnack on reducing waist circumference in females (mean difference: −2.20 ± 0.73 cm, p = 0.004) and a trend toward reduced visceral fat (−5.27 ± 13.05 cm2, p = 0.06). TNsnack decreased blood insulin levels in males (−1.14 ± 1.41 mIU/L, p = 0.05) and multivariable modeling showed a main effect of TNsnack on insulin. Main effects of TNsnack on triglycerides and TG/HDL ratio were observed (p = 0.04 for both) with TG/HDL ratio reduced ~11%. A main effect of TNsnack (p = 0.04) and an interaction effect between TNsnack and sex (p < 0.001) on total MetSx score yielded 67% reduced MetSx score in TNsnack females and 42% reduced MetSx score in TNsnack males. To our knowledge, this is the first randomized parallel-arm study to investigate cardiometabolic responses to TNsnacks versus typical CHOsnacks among young adults at risk of MetSx. Our study suggests daily tree nut consumption reduces MetSx risk by improving waist circumference, lipid biomarkers, and/or insulin sensitivity—without requiring caloric restriction.
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... However, the results of these studies are contradictory. Some epidemiological evidences suggest that dietary intake of legumes and nuts is associated with a reduced risk of MetS or its components [23][24][25][26][27] , while other studies have shown conflicting results [28][29][30][31][32] . A recently published investigation has evaluated the link of nuts and legumes intake with metabolic health status in Iranian adolescents 33 , but no previous study has investigated this relationship among adults, especially in Middle Eastern populations. ...
Legumes and nuts intake in relation to metabolic health status, serum brain derived neurotrophic factor and adropin levels in adults
Article
Full-text available
  • Sep 2023
Abstract There is controversial evidence about the relationship between consumption of legumes and nuts with metabolic disturbances. The present study was undertaken to explore the association of legumes and nuts intake with metabolic health status among Iranian adults. This cross-sectional study was conducted on 527 adults (45.7% female, aged 20–65 years) chosen through a multistage cluster random-sampling approach. Dietary intakes of individuals were assessed using a validated food frequency questionnaire. Fasting blood samples were gathered to evaluate biochemical parameters. Metabolic health status of subjects was determined according to the criteria defined by Wildman. Data of covariates were collected using pre-tested procedures. The overall prevalence of metabolic unhealthy (MU) phenotype was 42.5%. After controlling all confounders, participants with highest intake of legumes and nuts had lower odds of MU status, compared with the lowest intake (OR 0.35; 95% CI 0.18–0.71). This association was stronger in normal-weight rather than overweight/obese adults and also in women rather than men. Higher consumption of legumes and nuts was additionally related to decreased odds of hyperglycemia, hypertriglyceridemia, and hypertension. A marginally inverse association was observed between legumes and nuts intake with low brain-derived neurotrophic factor (BDNF) levels, in fully-adjusted model (ORT3 vs. T1 0.50; 95% CI 0.25–1.01). Each tertile increase in legumes and nuts intake was marginally related to higher adropin levels ( $$\beta$$ β = 4.06; P = 0.07). In conclusion, this study demonstrated that higher intake of legumes and nuts is associated with lower chance of MU both in normal weight and overweight/obese adults. The association may be facilitated through serum BDNF and adropin.
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... Nuts and seeds are considered an important component of a healthy diet in dietary guidelines in several countries [10][11][12] and this is attributed to their plant-based origin while being a source of high quality protein, as well as containing high amounts of mono-and poly-unsaturated fats, dietary fiber, micronutrients, and phytochemicals with antioxidative properties [13]. Habitual nut consumption has been associated with improved weight management [14] and a lower risk of cardiovascular and all-cause mortality [15,16], but the association with the risk of metabolic syndrome has been inconsistent [17,18]. Furthermore, few studies have investigated the health benefits of seeds alone even though they have comparable nutrient profiles to nuts and belong to the same food group within dietary guidelines. ...
Nut and seed consumption is inversely associated with metabolic syndrome in females but not males: findings from the 2005–2018 NHANES data
Article
Full-text available
  • Apr 2023
  • EUR J NUTR
Purpose To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, central obesity, and blood pressure. Methods This cross-sectional analysis used data from 22,687 adults (aged ≥ 18 years) involved in seven cycles (2005–2018) of the National Health and Nutrition Examination Survey (NHANES). Habitual nut and seed intakes were estimated by the Multiple Source Method using data from two 24-h dietary recalls. Metabolic syndrome was ascertained using biochemical data and self-reported medication use. Sex-specific effect estimates were obtained using logistic and linear regressions adjusting for lifestyle and socioeconomic confounders. Results Compared to non-consumers, female, but not male, habitual consumers of either nuts or seeds had lower odds of having metabolic syndrome (OR: 0.83, 95% CI 0.71, 0.97). Both nut intake alone and seed intake alone were inversely associated with high fasting glucose and low HDL-cholesterol in females compared to non-consumers. When restricted to habitual consumers only, the combined intake of nuts and seeds at 6 g/day was associated with the lowest triglycerides and highest HDL-cholesterol in females. Combined consumption of nuts and seeds up to one ounce-equivalent (15 g) per day, but not in higher intake levels, was inversely associated with metabolic syndrome, high fasting glucose, central obesity, and low HDL-cholesterol in females. Conclusions Nut and seed consumption, both separately or combined, below 15 g/day was inversely associated with metabolic syndrome and its component conditions in females but not males.
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... A bunch of risk factors for CAD and diabetes mellitus type 2, which mostly occurs simultaneously known as the metabolic syndrome (MetS). Approximately every third adult has been identified with MetS all over the world population 3 . Cardio metabolic risk is a condition in which there is potential of emerging diabetes mellitus and atherosclerotic CVD due to the existence of insulin resistance and atherogenic dyslipidemias. ...
Effect of Ginger, Garlic, Lemon, Apple Cider Vinegar and Honey mixture on Cardio-metabolic risk factors: A Double Blinded Randomized Placebo Control Trial
Article
Full-text available
  • Mar 2023
To evaluate the efficacy of ginger, garlic, lemon, apple cider vinegar and honey mixture on cardio metabolic risk factors in patients with metabolic syndrome. A double blinded Randomized control was conducted in OPD of Military Hospital, Pakistan, from 30 June 2018 to 30 Sep 2018. Eighty eight participants with positive cardio metabolic risk factors between 30 to 65 years were randomly selected and allocated into experimental and placebo Group. Equal quantities of garlic, ginger, lemon juice and apple cider vinegar were boiled at 70°C for 15 minutes. At the start, after 45 th days and after 90 th day anthropometric measurements, blood pressure, lipid profile and blood sugar level. Blood pressure and fasting blood sugar, TC, LDL, HDL were significantly decreased in experimental group from 155 to 132mg/dl [P<0.03]. While no remarkable change has been detected on anthropometric measurements. The findings of the study concluded that ginger, garlic, lemon, apple cider vinegar and honey mixture exhibited anti-hyperlipidemia, antihypertensive and anti-diabetic properties, while no significant change was observed in BMI and waist to hip ratio.
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... As a result of experiments in animals and humans, daily consumption of pistachio can improve obesity, type 2 diabetes, and metabolic abnormalities. In addition, according to a study, a study found that eating pistachios at least three times a week at the recommended amount per serving lowered the risk of death by 39%, and showed that the mortality rate from cancer and cardiovascular disease was also reduced (Sabatè and Ang, 2009;Carughi et al., 2016;Parham et al., 2013;Ibarrola-Jurado et al., 2013;Guasch-Ferré et al., 2013;Terzo et al., 2018;De Souza et al., 2017;). Therefore, health-conscious consumers are increasing, and now with the spread of COVID-19, more consumers are taking into consideration nutrition and efficacy. ...
Potential anti-oxidative properties and quality characteristics of korean traditional rice cake added with pistachio (pistacia vera l.) as inner beauty material
Article
Full-text available
  • Aug 2022
In modern society, interest in health is increasing, and more consumers are taking care of their health due to COVID-19. As a result, immunity enhancement and antioxidant foods help to promote health, and the intake rate is increasing. Therefore, the purpose of this study was to investigate quality characteristics and antioxidant activity by adding 0%, 3%, 6%, 9% and 12% pistachios to rice cake, a traditional Korean food. The moisture content and pH decreased as the amount of pistachio added and the chromaticity L and a values tended to decrease, but the b values increased. It was confirmed that the polyphenol, ABTS a DPPH significantly increased as the amount of pistachio added increased. As a result of confirming the functionality and overall preference, it is suggested that the 9% content is the best, and this experiment is expected to improve the quality of rice cake and improve the nutritional balance, so that it can become an antioxidant functional food. As far as we know, it is the first study to prove that pistachios and rice cakes are combined, suggesting that rice cakes with added pistachios, a physiologically active substance, are healthful foods.
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... A total of 59.8% consumed less than three servings of nuts per week, moving away from the recommendation (≥3 servings/week). As such, consumption should be increased, as it has been shown to have an inverse relationship with MetS and its components [70,71]. ...
Adherence to the Mediterranean Diet Is Inversely Associated with the Prevalence of Metabolic Syndrome in Older People from the North of Spain
Article
Full-text available
  • Oct 2022
Background: The aim of this study was to relate adherence to the Mediterranean diet (MedDiet) to the prevalence of metabolic syndrome (MetS) in an elderly population from the north of Spain. Methods: We carried out an observational, descriptive, cross-sectional, and correlational study involving 556 non-institutionalised individuals aged 65 to 79 years. The MEDAS-14 questionnaire score was used to define the degree of adherence to the Mediterranean diet. The diagnosis of MetS was conducted using the International Diabetes Federation (IDF) criteria. Results: In 264 subjects with an average age of 71.9 (SD: ±4.2), 39% of whom were men, 36.4% had good adherence (score ≥ 9 in MEDAS-14), with no differences by gender or age. The prevalence of MetS was 40.2%, with 47.6% in men and 35.4% in women (p < 0.05). The prevalence of MetS was 2.4 times more frequent among individuals who consumed less than two servings (200 g) of vegetables daily compared with those who consumed two or more servings of vegetables daily (OR: 2.368, 95%CI: 1.141-4.916, p = 0.021). Low adherence to the MedDiet (MEDAS-14 score ≤ 8) was associated with an 82% higher prevalence of MetS (OR: 1.817, 95%CI: 1.072-3.081, p = 0.027). Conclusion: An inverse relationship was established between adherence to the MedDiet and the prevalence of MetS.
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Brazil nut (Bertholletia excelsa H.B.K.) and Brazil nut oil: effects on oxidative stress and potential therapeutic health benefits from human, animal, and cell culture models
Article
  • Mar 2024
  • NUTR REV
Brazil nut (Bertholletia excelsa H.B.K.) is characterized by its high nutritional and energetic value. It contains high levels of l-arginine, antioxidant vitamins, phenolic compounds, and phytosterols. In addition to their biological functions, bioactive compounds and essential fatty acids present therapeutic effects on chronic disease prevention through their antioxidant effects. Thus, this review aims to present the most recent scientific evidence on the effect of Brazil nut on human health. A search for scientific articles was carried out through the MEDLINE/PubMed, Science Direct, and LILACS databases, considering articles published between the years 2010 and 2023. The results showed that Brazil nuts and Brazil nut oil, when consumed regularly and associated with a balanced diet, can improve lipid profile, attenuate inflammatory response, and improve oxidative stress through increased activity and gene expression of antioxidant enzymes. However, further studies are recommended to better understand the mechanisms of action.
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A 4-Week Pecan-Enriched Diet Improves Postprandial Lipid Peroxidation in Aging Adults
Article
  • Aug 2023
  • J MED FOOD
Pecans are rich in bioactive compounds known to reduce oxidative stress and provide glucoregulatory benefits. Few studies assessing the effect of a pecan-enriched diet on such health outcomes suggest potential improvements to cardiometabolic health; however, this has not been studied in an older adult population. Thus, we aimed to examine the effect of daily pecan consumption for 4-weeks on fasting and postmeal antioxidant status, oxidative stress, and markers of glycemia in healthy aging adults. In this randomized, parallel, controlled trial, 41 healthy adults (50-75 years) either consumed 68 g of pecans/day (pecan; n = 21) or avoided all nuts (control; n = 20). At pre- (V1) and postintervention visits (V2), blood samples were obtained at fasting, and 30, 60, and 120 min following a high saturated fat meal to assess changes in malondialdehyde, which is a measure of lipid peroxidation, total antioxidant capacity (TAC), glucose, and insulin. Across the intervention, there were no differences in fasting or postprandial TAC, glucose, or insulin for pecan versus control. There was a trend for a difference in fasting lipid peroxidation from V1 to V2 by treatment (P = .06) driven by a slight reduction for pecan versus control (Δpecan: -2.0 ± 1.1 vs. Δcontrol: +0.6 ± 0.8 μM). In addition, postprandial lipid peroxidation was suppressed at V2 for pecan, and this was different from control (pecan areas under the curve (AUC): 10.6 ± 1.3 μM/h to 9.1 ± 1.2 μM/h vs. control AUC: 8.9 ± 1.3 μM/h to 9.2 ± 1.1 μM/h; P = .03). These findings suggest that a 1 month, pecan-enriched diet is protective against postmeal oxidative stress. Longer interventions or a diabetic population may be needed to observe glucoregulatory benefits. Clinical Trial Registration: NCT04385537.
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Almonds vs. carbohydrate snacks in an energy-restricted diet: Weight and cardiometabolic outcomes from a randomized trial
Article
  • Aug 2023
  • OBESITY
Objective: This study evaluated weight and cardiometabolic outcomes after a 3-month energy-restricted diet (-30%) containing almonds (almond-enriched diet [AED]) or containing carbohydrate-rich snacks (nut-free control diet [NFD]) (Phase 1), followed by 6 months of weight maintenance (Phase 2). Methods: Participants (25-65 years old) with overweight or obesity (BMI 27.5-34.9 kg/m2 ) were randomly allocated to AED (n = 68) or NFD (n = 72). Results: Both groups lost weight during Phase 1 (p < 0.001) (mean [SE], -7.0 [0.5] kg AED vs. -7.0 [0.5] kg NFD, p = 0.858) and Phase 2 (p = 0.009) (-1.1 [0.5] kg AED vs. -1.3 [0.6] NFD, p = 0.756), with improvements in percentage lean mass after Phase 2 (4.8% [0.3%], p < 0.001). Reductions occurred in fasting glucose (-0.2 [0.07] mmol/L, p = 0.003), insulin (-8.1 [4.0] pmol/L, p = 0.036), blood pressure (-4.9 [0.8] mm/Hg systolic, -5.0 [0.5] mm/Hg diastolic, p < 0.001), total cholesterol (-0.3 [0.1] mmol/L), low-density lipoprotein (LDL) (-0.2 [0.1] mmol/L), very low-density lipoprotein (-0.1 [0.03] mmol/L), and triglycerides (-0.3 [0.06] mmol/L) (all p < 0.001), and high-density lipoprotein increased (0.1 [0.02] mmol/L, p = 0.011) by the end of Phase 2 in both groups. There were group by time interactions for lipoprotein particle concentrations: very small triglyceride-rich (-31.0 [7.7] nmol/L AED vs. -4.8 [7.9] nmol/L NFD, p = 0.007), small LDL (-109.3 [40.5] nmol/L AED vs. -20.7 [41.6] nmol/L NFD, p = 0.017), and medium LDL (-24.4 [43.4] nmol/L AED vs. -130.5 [44.4] nmol/L NFD, p = 0.045). Conclusions: An energy-restricted AED resulted in weight loss and weight loss maintenance comparable to an energy-restricted NFD, and both diets supported cardiometabolic health. The AED resulted in greater improvements in some lipoprotein subfractions, which may enhance reductions in cardiovascular risk.
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Nut Consumption and Weight Gain in a Mediterranean Cohort: The SUN Study*
Article
Full-text available
  • Jan 2007
Objective: To assess the association, in a Mediterranean population, between nut consumption and risk of weight gain (at least 5 kg) or the risk of becoming overweight/obese. Research Methods and Procedures: The Seguimiento Universidad de Navarra project is a prospective cohort of 8865 adult men and women who completed a follow-up questionnaire after a median of 28 months. Dietary habits were assessed with a previously validated semiquantitative food-frequency questionnaire. Results: Nine hundred thirty-seven participants reported a weight gain of ≥5 kg at follow-up. After adjusting for age, sex, smoking, leisure time physical activity, and other known risk factors for obesity, participants who ate nuts two or more times per week had a significantly lower risk of weight gain (odds ratio: 0.69; 95% confidence interval: 0.53 to 0.90, p for trend = 0.006) than those who never or almost never ate nuts. Participants with little nut consumption (never/almost never) gained an average of 424 grams (95% confidence interval: 102 to 746) more than frequent nut eaters. Nut consumption was not significantly associated with incident overweight/obesity in the cohort. Discussion: Frequent nut consumption was associated with a reduced risk of weight gain (5 kg or more). These results support the recommendation of nut consumption as an important component of a cardioprotective diet and also allay fears of possible weight gain.
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Tree nuts and peanuts as components of a healthy diet
Conference Paper
  • Sep 2008
Nuts have been part of the diet for thousands of years. In 2003, a Qualified Health Claim was approved, stating that eating 1.5 oz (42 g) of nuts per day may reduce the risk of heart disease. Usual intakes fall short of this recommendation. About one-third of Americans report consuming nuts (tree nuts or peanuts) on any one day. Seven percent of Europeans report eating nuts, but the amount eater by European nut consumers (31 g/d) is larger than that of Americans (21 g/d). Nuts are an excellent source of vitamin E and magnesium. Individuals consuming nuts also have higher intakes of folate,,beta-carotene, vitamin K, lutein+zeaxanthin, phosphorus, copper, selenium, potassium, and zinc per 1000 kcal. Regular nut consumption increases total energy intake by 250 kcal/d (1.05 MJ/d), but the body weight of nut consumers is not greater than that of nonconsumers. Nuts are an excellent source of phytochemicals (phyotsterols, phenolic acids, flavoncids, stilbenes, and carotenoids). The total phenolic constituents probably contribute to the total antioxidant capacity of nuts, which is comparable to broccoli and tornatoes. To improve guidance on the use of nuts in the diet, the position of nuts in typical food patterns needs to be addressed, The 2005 MyPyramid includes nuts in the meat and beans group. Yet, nuts are rarely consumed as meat substitutes. Because similar to 60% of the nuts consumed in the U.S. are eaten as snacks, emphasizing their use as a healthy snack may be more effective than inclusion within a food group.
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Nut and Peanut Butter Consumption and Risk of Type 2 Diabetes in Women
Article
  • Nov 2002
Context Nuts are high in unsaturated (polyunsaturated and monounsaturated) fat and other nutrients that may improve glucose and insulin homeostasis.Objective To examine prospectively the relationship between nut consumption and risk of type 2 diabetes.Design, Setting, and Participants Prospective cohort study of 83 818 women from 11 states in the Nurses' Health Study. The women were aged 34 to 59 years, had no history of diabetes, cardiovascular disease, or cancer, completed a validated dietary questionnaire at baseline in 1980, and were followed up for 16 years.Main Outcome Measure Incident cases of type 2 diabetes.Results We documented 3206 new cases of type 2 diabetes. Nut consumption was inversely associated with risk of type 2 diabetes after adjustment for age, body mass index (BMI), family history of diabetes, physical activity, smoking, alcohol use, and total energy intake. The multivariate relative risks (RRs) across categories of nut consumption (never/almost never, <once/week, 1-4 times/week, and ≥5 times/week) for a 28-g (1 oz) serving size were 1.0, 0.92 (95% confidence interval [CI], 0.85-1.00), 0.84 (0.95% CI, 0.76-0.93), and 0.73 (95% CI, 0.60-0.89) (P for trend <.001). Further adjustment for intakes of dietary fats, cereal fiber, and other dietary factors did not appreciably change the results. The inverse association persisted within strata defined by levels of BMI, smoking, alcohol use, and other diabetes risk factors. Consumption of peanut butter was also inversely associated with type 2 diabetes. The multivariate RR was 0.79 (95% CI, 0.68-0.91; P for trend <.001) in women consuming peanut butter 5 times or more a week (equivalent to ≥140 g [5 oz] of peanuts/week) compared with those who never/almost never ate peanut butter.Conclusions Our findings suggest potential benefits of higher nut and peanut butter consumption in lowering risk of type 2 diabetes in women. To avoid increasing caloric intake, regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats.
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Nut consumption and incidence of metabolic syndrome after 6-year follow-up: The SUN (Seguimiento Universidad de Navarra, University of Navarra Follow-up) cohort
Article
  • Oct 2012
  • PUBLIC HEALTH NUTR
Objective: To assess the long-term relationship between tree nut consumption and the risk of developing metabolic syndrome (MetS). Design: Nut consumption was collected using a validated 136-item FFQ. The MetS was defined according to the International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute harmonizing definition. The association between nut consumption and MetS was assessed with logistic regression models adjusting for potential confounders. We compared the incidence of MetS between extreme categories of nut intake (> or = 2 servings/week v. never/almost never) after 6 years of follow-up. Setting: The SUN Project (Seguimiento Universidad de Navarra, University of Navarra Follow-up) is a prospective cohort study, formed of Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. Nut consumption and MetS information was collected by self-reported data. Subjects: Participants (n 9887) initially free of MetS or diabetes and followed up for a minimum of 6 years were included. Results: We observed 567 new cases of MetS during follow-up. Participants who consumed nuts > or = 2 servings/week presented a 32% lower risk of developing MetS than those who never/almost never consumed (adjusted OR = 0.68, 95% CI 0.50, 0.92). The inverse association was stronger among participants who were health professionals. Conclusions: Nut consumption was significantly associated with lower risk of developing MetS after a 6-year follow-up period in a cohort of Spanish graduates.
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