Nut consumption and the risk of oesophageal squamous cell carcinoma in the Golestan Cohort Study

Maryam Hashemian,Arash Etemadi,Christian C Abnet,Paolo Boffetta,Azita Hekmatdoost,Farin Kamangar,Paul J Brennan,Masoud Khoshnia,Gwen Murphy,Sanford M Dawsey,Abdolsamad Gharavi,Hossein Poustchi,Maryam Sharafkhah,Akbar Fazeltabar Malekshah,Akram Pourshams,Reza Malekzadeh

doi:10.1038/s41416-018-0148-0

Abstract

BackgroundNut consumption has been inversely associated with gastric cancer incidence in US-based studies, but not with oesophageal cancer. However, there is aetiologic heterogeneity, among oesophageal squamous cell carcinoma (ESCC) cases in low-risk vs. high-risk populations. The objective of this study was to evaluate the association between nut consumption and risk of ESCC in a high-risk population.MethodsThe Golestan Cohort Study enroled 50,045 participants in Northeastern Iran, between 2004 and 2008. Intake of peanuts, walnuts and mixed nuts (including seeds) were assessed using a validated food frequency questionnaire at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals for subsequent ESCC adjusted for potential confounders. Non-consumers of nuts were used as the reference category and the consumers were categorised into tertiles.ResultsWe accrued 280 incident ESCC cases during 337,983 person-years of follow up. Individuals in the highest tertiles of total nut consumption, and mixed nut consumption were significantly associated with lower risk of developing ESCC compared to non-consumers (HR = 0.60, 95% CI = 0.39–0.93, p-trend = 0.02, and HR = 0.52, 95% CI = 0.32–0.84, p trend = 0.002, respectively).ConclusionsWe found a statistically significant inverse association between total nut consumption and the risk of ESCC in this high-risk population.

Highlights

Nuts appear to have beneficial effects on all cause and cancerspecific mortality,[1, 2] and are part of the recommended Mediterranean diet.[3]
The highest tertile of total nut consumption was associated with lower risk of developing ESCC compared to non-consumers
A similar inverse association was observed between mixed nut and seed consumption and risk of ESCC

Summary

Introduction

Nuts appear to have beneficial effects on all cause and cancerspecific mortality,[1, 2] and are part of the recommended Mediterranean diet.[3]. Previous studies have demonstrated that nut consumption is associated with a decreased risk of gastric, colorectal, and pancreatic cancers,[6, 7] and cancer-specific mortality.[1] all nuts are nutritious foods, there are some differences in their vitamin, mineral and fatty acid composition. Nut consumption has been inversely associated with gastric cancer incidence in US-based studies, but not with oesophageal cancer. The objective of this study was to evaluate the association between nut consumption and risk of ESCC in a high-risk population. CONCLUSIONS: We found a statistically significant inverse association between total nut consumption and the risk of ESCC in this high-risk population

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Conclusion