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American Journal of Clinical Nutrition, Vol. 70, No. 3, 500S-503S, September 1999
© 1999 American Society for Clinical Nutrition


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Nut consumption, vegetarian diets, ischemic heart disease risk, and all-cause mortality: evidence from epidemiologic studies1,2

Joan Sabaté

1 From the Departments of Nutrition and Epidemiology and Biostatistics, School of Public Health, Loma Linda University, CA.

Perhaps one of the most unexpected and novel findings in nutritional epidemiology in the past 5 y has been that nut consumption seems to protect against ischemic heart disease (IHD). Frequency and quantity of nut consumption have been documented to be higher in vegetarian than in nonvegetarian populations. Nuts also constitute an important part of other plant-based diets, such as Mediterranean and Asian diets. In a large, prospective epidemiologic study of Seventh-day Adventists in California, we found that frequency of nut consumption had a substantial and highly significant inverse association with risk of myocardial infarction and death from IHD. The Iowa Women's Health Study also documented an association between nut consumption and decreased risk of IHD. The protective effect of nuts on IHD has been found in men and women and in the elderly. Importantly, nuts have similar associations in both vegetarians and nonvegetarians. The protective effect of nut consumption on IHD is not offset by increased mortality from other causes. Moreover, frequency of nut consumption has been found to be inversely related to all-cause mortality in several population groups such as whites, blacks, and the elderly. Thus, nut consumption may not only offer protection against IHD, but also increase longevity.

Key Words: Nuts • vegetarian diets • vegetarianism • confounding • ischemic heart disease • coronary risk • IHD risk • all-cause mortality • epidemiologic studies • Adventist Health Study • Seventh-day Adventists • California




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