Abstract
IntroductionProspective 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.ObjectiveTo 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.Materials and MethodsCross-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.ResultsCompared 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.ConclusionsNut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.
Highlights
Prospective studies have consistently suggested that nut consumption is inversely related to fatal and nonfatal coronary heart disease
Higher nut consumption was associated with lower risk of the abdominal obesity metabolic syndrome (MetS) criterion
Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk
Summary
Prospective studies have consistently suggested that nut consumption is inversely related to fatal and nonfatal coronary heart disease. The worldwide prevalence of obesity, the metabolic syndrome (MetS), and associated comorbidities with a high risk of disability and death, such as type-2 diabetes, hypertension and cardiovascular disease (CVD), is steadily increasing and has become a major public health problem. As recently reviewed [4], landmark clinical trials of lifestyle changes in overweight or obesity subjects with prediabetes, most of whom had MetS, have shown that diet and exercise leading to weight loss consistently reduce cardiometabolic risk factors and the incidence of diabetes. There is epidemiological and clinical trial evidence supporting that increased adherence to the Mediterranean diet (MedDiet) [5] and consumption of foods rich in antioxidants, n-3 fatty acids, or minerals other than sodium [6] relates to a reduced prevalence of the MetS
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