Nut Consumption and Risk of Cardiovascular Disease

Background The associations between specific types of nuts, specifically peanuts and walnuts, and cardiovascular disease remains unclear. Objectives To analyze the associations between the intake of total and specific types of nuts and cardiovascular disease, coronary heart disease, and stroke risk. Methods We included 76,364 women from the Nurses’ Health Study (1980–2012), 92,946 women from the Nurses’ Health Study II (1991–2013), and 41,526 men from the Health Professionals Follow-up Study (1986–2012) who were free of cancer, heart disease, and stroke at baseline. Nut consumption was assessed using food frequency questionnaires at baseline and updated every 4 years. Results During 5,063,439 person-years of follow-up, we documented 14,136 incident cardiovascular disease cases, including 8,390 coronary heart disease cases and 5,910 stroke cases. Total nut consumption was inversely associated with total cardiovascular disease and coronary heart disease after adjustment for cardiovascular risk factors. The pooled multivariable hazard ratios for cardiovascular disease and coronary heart disease among participants who consumed one serving of nuts (28 g) five or more times per week, compared to the reference category (never or almost never), were 0.86 [95% confidence interval (CI), 0.79–0.93, P trend 0.0002] and 0.80 [95% CI, 0.72–0.89, P trend <0.001], respectively. Consumption of peanuts and tree nuts (two or more times/week) and walnuts (one or more times/week), was associated with a 13%-19% lower risk of total cardiovascular disease and 15–23% lower risk of coronary heart disease. Conclusions In 3 large prospective cohort studies, higher consumption of total and specific types of nuts was inversely associated with total cardiovascular disease and coronary heart disease.