nuts and coronary heart disease

Doug Skrecky (
Mon, 7 Dec 1998 20:05:13 -0800 (PST)

"Frequent Nut Consumption and Risk of Coronary Heart Disease in Women: Prospective Cohort Study"
British Medical Journal 317: 1341-1345 November 14, 1998


Objective: To examine the relation between nut consumption and risk of coronary heart disease in a cohort of women from the Nurses' Health Study. Design: Prospective cohort study.
Setting: Nurses' Health Study.
Subjects: 86,016 women from 34 to 59 years of age without previously diagnosed coronary heart disease. stroke or cancer at baseline in 1980. Main outcome measures: Major coronary heart disease including non-fatal myocardial infarction and coronary heart disease. Results: 1255 major coronary disease events (861 cases of non-fatal myocardial infarction and 394 cases of fatal coronary heart disease) occurred during 14 years of follow up. After adjusting for age, smoking, and other known risk factors for coronary heart disease, women who ate more than five units of nuts (one unit equivalent to 1 oz of nuts) a week (frequent consumption) had a significantly lower risk of total coronary heart disease (relative risk 0.65, 95% confidence interval 0.47 to 0.89, P for trend = 0.0009) than women who never ate nuts or who ate less than one unit a month (rare consumption). The magnitude of risk reduction was similar for both fatal coronary heart disease (0.61, 0.35 to 1.05, P for trend = 0.007) and non-fatal myocardial infarction (0.68, 0.47 to 1.00, P for trend = 0.04). Further adjustment for intakes of dietary fats, fibre, vegetables, and fruits did not alter these results. The inverse association persisted in subgroups stratified by levels of smoking, use of alcohol, use of multivitamin and vitamin E supplements, body mass index, exercise, and intake of vegetables or fruits.
Conclusions: Frequent nut consumption was associated with a reduced risk of both fatal coronary heart disease and non-fatal mycardial infarction. These data, and those from other epidemiological and clinical studies, support a role for nuts in reducing the risk of coronary heart disease.

Additional quotes from text of the report:

"When the analysis was restricted to non-smokers and women who were teetotaller or who drank occasionally (<=1 drink per week), the inverse association was particularly strong (relative risk of coronary heart disease for consumption of nuts >=5 times per week was 0.48 (0.27 to 0.84, P for trend 0.008)).
In analyses of peanuts and other nuts (assessed in 1986 separately, we combined the two highest categories because of small number of cases. After adjusting for age, consumption of peanuts and other nuts were both inversely associated with risk of coronary heart disease. Consumption of peanut butter was only weakly associated with risk of coronary heart (multivariate relative risk comparing women consuming peanut butter was 0.92 (0.74 to 1.15, P for trend 0.94). The relative risk was slightly stronger for fatal coronary heart disease (0.76, 0.50 to 1.15, P for trend = 0.09).
Peanut butter was only weakly associated with a risk of coronary heart disease, but this may be due to the addition of hydrogenated fat to major American brands."