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Am J Clin Nutr. 2015 Feb;101(2):407-12. doi: 10.3945/ajcn.114.099846. Epub 2014 Dec 17.

Nut consumption and risk of mortality in the Physicians' Health Study.

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From the Divisions of Aging (TTH, ABP, JMG, and LD) and Preventive Medicine (JMG), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; the Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA (TTH); and the Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Geriatric Research (GRECC) and VA Boston Healthcare System, Boston, MA (JMG and LD).



Previous studies have suggested that nut consumption is associated with beneficial cardiovascular outcomes. However, limited data are available on the association between nut intake and all-cause mortality.


Our aim was to test the hypothesis that nut consumption is inversely associated with the risk of all-cause mortality.


In this prospective cohort study in 20,742 male physicians, we assessed nut intake between 1999 and 2002 via a food-frequency questionnaire and ascertained deaths through an endpoint committee. We used Cox regression to estimate multivariable-adjusted HRs for death according to nut consumption. In secondary analyses, we evaluated associations of nut consumption with cause-specific mortality.


During a mean follow-up of 9.6 y, there were 2732 deaths. The mean (±SD) age at baseline was 66.6 ± 9.3 y. Median nut consumption was 1 serving/wk. Multivariable-adjusted HRs (95% CIs) were 1.0 (reference), 0.92 (0.83, 1.01), 0.85 (0.76, 0.96), 0.86 (0.75, 0.98), and 0.74 (0.63, 0.87) for nut consumption of never or <1 serving/mo, 1-3 servings/mo, 1 serving/wk, 2-4 servings/wk, and ≥5 servings/wk, respectively (P-linear trend < 0.0001), after adjustment for age, body mass index, alcohol use, smoking, exercise, prevalent diabetes and hypertension, and intakes of energy, saturated fat, fruit and vegetables, and red meat. In a secondary analysis, results were consistent for cardiovascular disease mortality but only suggestive and non-statistically significant for coronary artery disease and cancer mortality.


Our data are consistent with an inverse association between nut consumption and the risk of all-cause and cardiovascular disease mortality in US male physicians.


cardiovascular disease; coronary artery disease; mortality; nut consumption; nuts

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