Abstract
Nuts are often considered beneficial for health, yet few studies have examined determinants of their intake and the associations between nut consumption and various cardiovascular disease risk factors. The aim of this study was to identify factors associated with nut intake in a Mediterranean population, in Croatia, and to investigate the association of nut intake and various cardiovascular risk factors. Methods: Subjects from the Island of Vis, Island of Korčula and the City of Split were included in this cross-sectional study (n = 4416 in total; 4011 without known cardiovascular disease). Survey responses, medical records and clinically relevant measurements were utilized. Multivariate ordinal and logistic regression models were used in the analysis, adjusting for known confounding factors. Results: As low as 5% of all subjects reported daily, and 11% reported weekly, nut consumption. The characteristics associated with more frequent nut intake were female gender (Odds ratio (OR) = 1.39; 95% confidence interval (CI) 1.19–1.62), highest level of education (1.42; 1.15–1.76) and material status (1.58; 1.29–1.93), smoking abstinence (1.21; 1.04–1.42 in never-smokers and 1.22; 1.02–1.46 in ex-smokers), Mediterranean diet adherence (1.87; 1.62–2.15), and absence of central obesity (1.29; 1.09–1.53), absence of diabetes (1.30; 1.02–1.66) and metabolic syndrome (1.17; 1.01–1.36). Subjects who consumed nuts had more favorable waist-to-height (overall p = 0.036) and waist-to-hip ratios (0.033), lesser odds of elevated fibrinogen (p < 0.001 in both weekly and monthly nut consumers) and reduced high-density lipoprotein (HDL) cholesterol (p = 0.026), compared to non-consumers. Conclusions: It appears that frequent nut consumption is an integral part of a healthy lifestyle and better socioeconomic status. A beneficial association of nut intake with cardiovascular risk factors was confirmed in this study.
Highlights
Nuts have been identified as one of the most nutrient dense foods, rich in monounsaturated and polyunsaturated fatty acids, protein, fiber, vitamins and minerals [1]
The aim of this study was to determine the factors associated with nut consumption, as well as to investigate the association between nut consumption and various cardiovascular risk factors, namely central obesity indices, dyslipidemia, elevated fibrinogen, hypertension, diabetes, elevated glycated haemoglobin (HbA1c), metabolic syndrome and gout, in a population-based sample in
Almost all of the characteristics differed between the sub-samples according to the place of residence, except the gender composition, Mediterranean diet serving score (MDSS), and cerebrovascular insult (CVI) in the medical history (Table 1)
Summary
Nuts have been identified as one of the most nutrient dense foods, rich in monounsaturated and polyunsaturated fatty acids, protein, fiber, vitamins and minerals [1]. Nut consumption decreased the all-cause mortality risk by 20% in large cohort studies from the United States of America (USA) [7], and a combined cohort study performed both in the USA and China [8]. This finding was confirmed in other recent meta-analyses [9,10]. Specific mortalities due to diabetes, respiratory diseases and infectious diseases were inversely associated with nut consumption in a meta-analysis, which included 20 cohort studies [3]
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