http://www.biomedcentral.com/1741-7015/11/164
Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial
Abstract
Background
Prospective studies in non-Mediterranean populations have consistently related increasing
nut consumption to lower coronary heart disease mortality. A small protective effect
on all-cause and cancer mortality has also been suggested. To examine the association
between frequency of nut consumption and mortality in individuals at high cardiovascular
risk from Spain, a Mediterranean country with a relatively high average nut intake
per person.
Methods
We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions
(Mediterranean diets supplemented with nuts or olive oil and control diet) in the
PREDIMED (‘PREvención con DIeta MEDiterránea’) study. Nut consumption was assessed
at baseline and mortality was ascertained by medical records and linkage to the National
Death Index. Multivariable-adjusted Cox regression and multivariable analyses with
generalized estimating equation models were used to assess the association between
yearly repeated measurements of nut consumption and mortality.
Results
During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths
and 130 cancer deaths occurred. Nut consumption was associated with a significantly
reduced risk of all-cause mortality (P for trend <0.05, all). Compared to non-consumers, subjects consuming nuts >3 servings/week
(32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI
0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality
was observed. Participants allocated to the Mediterranean diet with nuts group who
consumed nuts >3 servings/week at baseline had the lowest total mortality risk (HR
0.37; 95% CI 0.22 to 0.66).
Conclusions
Increased frequency of nut consumption was associated with a significantly reduced
risk of mortality in a Mediterranean population at high cardiovascular risk.
http://ije.oxfordjournals.org/content/41/2/377.long
Who are the participants in the PREDIMED study?
Participants are men (55–80 years old) or
women (60–80 years old) who were free of CVD at baseline. Inclusion
criteria were
to have either type 2 diabetes or ≥3 major
cardiovascular risk factors, out of the following: current smoking
(>1 cig/day
during the last month); hypertension (systolic BP
≥140 mmHg or diastolic BP ≥90 mmHg or antihypertensive medication); LDL
cholesterol ≥160 mg/dl or lipid-lowering therapy;
HDL cholesterol ≤40 mg/dl in men or ≤50 mg/dl in women; body mass index
≥25 kg/m2; and family history of premature CHD.
Exclusion criteria were the previous
history of CVD (i.e. a previous medical diagnosis of CHD, stroke or
peripheral arterial
disease), any severe chronic illness,
immunodeficiency or human immunodeficiency virus (HIV) positive status,
illegal drug
or alcohol misuse, history of allergy to olive oil
or nuts and low predicted likelihood of changing dietary habits
according
to the Prochaska and DiClemente stages of change
model.21 Figure 1 provides further details on the selection procedure.
En résumé :
La consommation de 30g de fruits à coque (noix,amandes, noisettes) par jour, plus de 3 fois par semaine, réduit la mortalité globale de 50% en prévention primaire chez les patients à haut risque cardiovasculaire.
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