Liu G, et al. - In individuals with diabetes, researchers assessed the impact of total and specific consumption of nut types (eg, tree nuts and peanuts) on the subsequent risk of cardiovascular disease (CVD)—including coronary heart disease (CHD), stroke, and all-cause and cause-specific mortality. Overall, the investigators observed a lower CVD incidence and mortality rate in association with higher consumption of nuts, particularly tree nuts. Based on these findings, the inclusion of nuts into healthy dietary patterns was supported for the prevention of CVD-related complications and premature deaths among diabetics.

Methods

• This prospective analysis included a study sample of 16,217 adults with diabetes at baseline or diagnosed during follow-up (Nurses' Health Study: 1980-2014, Health Professionals Follow-Up Study: 1986-2014).
• A validated food frequency questionnaire was used to evaluate nut consumption among participants, which was updated every 2-4 years.

Results

• There were 3,336 incident CVD cases and 5,682 deaths during 223,682 and 254,923 person-years of follow-up.
• A lower risk of CVD incidence and mortality was reported in relation to a higher total nut intake.
• For participants who consumed ≥ 5 servings of total nuts per week (1 serving=28 g) vs those who consumed < 1 serving per month, the estimated multivariate-adjusted hazard ratios were 0.83, 0.80, 0.66, and 0.69 for total CVD incidence, CHD incidence, CVD mortality, and all-cause mortality, respectively.
• No significant link of total nut consumption to risk of stroke incidence or cancer mortality were evident.
• Regarding specific types of nuts, the investigators reported lower risk of total CVD, CHD incidence, and mortality due to CVD, cancer, and all causes, in association with higher tree nut consumption, while only lower all-cause mortality was noted in relation to peanut consumption.
• They reported an 11% lower risk of CVD, 15% lower CHD risk, 25% lower CVD mortality, and 27% lower all-cause mortality for those who increased intake of total nut intake following diabetes diagnosis vs those who did not change total nut intake from pre- to post-diabetes diagnosis.
• In subgroup analyses stratified by sex/cohort, body mass index at diabetes diagnosis, smoking status, diabetes duration, nut consumption before diabetes diagnosis, or diet quality, the observed links persisted.