Abstract
Although previous studies have shown inverse associations between nut consumption and mortality, the associations between nut consumption and less common causes of mortality have not been investigated. Additionally, about 50% of peanut consumption in the US is through peanut butter but the association between peanut butter consumption and mortality has not been thoroughly evaluated. The National Institutes of Health-AARP (NIH-AARP) Diet and Health Study recruited 566,398 individuals aged 50–71 at baseline in 1995–1996. A food-frequency questionnaire was used to evaluate nut and peanut butter consumption. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for mortality using the non-consumers as reference groups and three categories of consumption. After excluding subjects with chronic diseases at baseline, there were 64,464 deaths with a median follow-up time of 15.5 years. We observed a significant inverse association between nut consumption and overall mortality (HR C4 vs C1 = 0.78, 95% CI = 0.76, 0.81, p ≤ 0.001). Nut consumption was significantly associated with reduced risk of cancer, cardiovascular, respiratory, infectious, renal and liver disease mortality but not with diabetes or Alzheimer’s disease mortality. We observed no significant associations between peanut butter consumption and all-cause (HR C4 vs C1 = 1.00, 95% CI = 0.98, 1.04, p = 0.001) and cause-specific mortality. In a middle-aged US population, nut intake was inversely associated with all-cause mortality and certain types of cause-specific mortality. However, peanut butter consumption was not associated with differential mortality.
Highlights
50% of peanut consumption in the United States is through peanut butter [21], few studies have examined health outcomes related to the popular food
We investigated the association between nut and peanut butter consumption with mortality using data from the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study (ClinicalTrial.gov # NCT00340015), which had more than 128,000 deaths
We comprehensively assessed potential confounders using the data available in the NIH-AARP questionnaire that have been associated with mortality and assessed whether these factors confounded the association between nut intake and mortality
Summary
Previous studies have found significant inverse associations between nut consumption and overall mortality [1,2,3,4,5,6,7,8,9,10,11,12,13,14] as well as between nut consumption and cardiovascular (CVD) disease [6,8,9,12,15]and multiple cancers including pancreatic [16], colorectal [17], esophageal squamous cell carcinoma [18]and gastric noncardiac adenocarcinoma [19,20]. A past review study on nut intake and mortality reported all-cause and common causes of mortality such as cardiovascular and cancer mortality [5]. The association between nut consumption and less common causes of mortality has not been investigated. We investigated the association between nut and peanut butter consumption with mortality using data from the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study (ClinicalTrial.gov # NCT00340015), which had more than 128,000 deaths. This is comparable to a recent metanalysis on nut consumption and mortality [8]. Due to the large size of the study, we were able to exclude participants with self-reported chronic diseases at baseline as they could have altered diets and conduct subgroup analysis by key variables such as sex, education and body-mass index (BMI)
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