Relationship of tree nut, peanut and peanut butter intake with total and cause-specific mortality: a cohort study and meta-analysis

Int J Epidemiol. 2015 Jun;44(3):1038-49. doi: 10.1093/ije/dyv039. Epub 2015 Jun 11.

Abstract

Background: Nut intake has been associated with lower mortality, but few studies have investigated causes of death other than cardiovascular disease, and dose-response relationships remain unclear.

Methods: We investigated the relationship of nut (tree nut, peanut) and peanut butter intake with overall and cause-specific mortality. In the Netherlands Cohort Study, 120,852 men and women aged 55-69 years provided information on dietary and lifestyle habits in 1986. Mortality follow-up until 1996 consisted of linkage to Statistics Netherlands. Multivariate case-cohort analyses were based on 8823 deaths and 3202 subcohort members with complete data on nuts and potential confounders. We also conducted meta-analyses of our results with those published from other cohort studies.

Results: Total nut intake was related to lower overall and cause-specific mortality (cancer, diabetes, cardiovascular, respiratory, neurodegenerative diseases, other causes) in men and women. When comparing those consuming 0.1-<5, 5-<10 and 10+ g nuts/day with non-consumers, multivariable hazard ratios for total mortality were 0.88, 0.74 and 0.77 [95% confidence interval (CI), 0.66-0.89], respectively (Ptrend = 0.003). Cause-specific hazard ratios comparing 10+ vs 0 g/day varied from 0.56 for neurodegenerative to 0.83 for cardiovascular disease mortality. Restricted cubic splines showed nonlinear dose-response relationships with mortality. Peanuts and tree nuts were inversely related to mortality, whereas peanut butter was not. In meta-analyses, summary hazard ratios for highest vs lowest nut consumption were 0.85 for cancer, and 0.71 for respiratory mortality.

Conclusions: Nut intake was related to lower overall and cause-specific mortality, with evidence for nonlinear dose-response relationships. Peanut butter was not related to mortality.

Keywords: Nuts; cohort studies; mortality; neoplasms; peanuts; respiratory tract diseases.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Arachis / adverse effects*
  • Cardiovascular Diseases / mortality*
  • Cohort Studies
  • Diet*
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / mortality*
  • Netherlands / epidemiology
  • Nuts / adverse effects*
  • Proportional Hazards Models
  • Respiratory Tract Diseases / mortality*
  • Surveys and Questionnaires