Mayhew Alexandra J, de Souza Russell J, Meyre David, Anand Sonia S, Mente Andrew
1Department of Clinical Epidemiology and Biostatistics,McMaster University,Hamilton, ON,Canada, L8N 3Z5.
Br J Nutr. 2016 Jan 28;115(2):212-25. doi: 10.1017/S0007114515004316. Epub 2015 Nov 9.
Dietary patterns containing nuts are associated with a lower risk of CVD mortality, and increased nut consumption has been shown to have beneficial effects on CVD risk factors including serum lipid levels. Recent studies have reported on the relationship between nut intake and CVD outcomes and mortality. Our objective was to systematically review the literature and quantify associations between nut consumption and CVD outcomes and all-cause mortality. Five electronic databases (through July 2015), previous reviews and bibliographies of qualifying articles were searched. In the twenty included prospective cohort studies (n 467 389), nut consumption was significantly associated with a lower risk of all-cause mortality (ten studies; risk ratio (RR) 0·81; 95 % CI 0·77, 0·85 for highest v. lowest quantile of intake, P het=0·04, I 2=43 %), CVD mortality (five studies; RR 0·73; 95 % CI 0·68, 0·78; P het=0·31, I 2=16 %), all CHD (three studies; RR 0·66; 95 % CI 0·48, 0·91; P het=0·0002, I 2=88 %) and CHD mortality (seven studies; RR 0·70; 95 % CI 0·64, 0·76; P het=0·65, I 2=0 %), as well as a statistically non-significant reduction in the risk of non-fatal CHD (three studies; RR 0·71; 95 % CI 0·49, 1·03; P het=0·03, I 2=72 %) and stroke mortality (three studies; RR 0·83; 95 % CI 0·69, 1·00; P het=0·54, I 2=0 %). No evidence of association was found for total stroke (two studies; RR 1·05; 95 % CI 0·69, 1·61; P het=0·04, I 2=77 %). Data on total CVD and sudden cardiac death were available from one cohort study, and they were significantly inversely associated with nut consumption. In conclusion, we found that higher nut consumption is associated with a lower risk of all-cause mortality, total CVD, CVD mortality, total CHD, CHD mortality and sudden cardiac death.
包含坚果的饮食模式与较低的心血管疾病死亡率相关，并且已表明增加坚果摄入量对包括血脂水平在内的心血管疾病风险因素具有有益影响。最近的研究报告了坚果摄入量与心血管疾病结局及死亡率之间的关系。我们的目的是系统回顾文献并量化坚果摄入量与心血管疾病结局及全因死亡率之间的关联。检索了五个电子数据库（截至2015年7月）、之前的综述以及符合条件文章的参考文献。在纳入的20项前瞻性队列研究（n = 467389）中，坚果摄入量与较低的全因死亡率风险显著相关（10项研究；风险比（RR）0·81；摄入量最高与最低分位数相比，95%置信区间为0·77，0·85；P异质性 = 0·04，I² = 43%）、心血管疾病死亡率（5项研究；RR 0·73；95%置信区间为0·68，0·7⑧；P异质性 = 0·31，I² = 16%）、所有冠心病（3项研究；RR 0·66；95%置信区间为0·48，0·91；P异质性 = 0·0002，I² = 88%）和冠心病死亡率（7项研究；RR 0·70；95%置信区间为0·64，0·76；P异质性 = 0·65，I² = 0%），以及非致命性冠心病风险的统计学上不显著降低（3项研究；RR 0·71；95%置信区间为0·49，1·03；P异质性 = 0·03，I² = 72%）和中风死亡率（3项研究；RR 0·83；95%置信区间为0·69，1·00；P异质性 = 0·54，I² = 0%）。未发现总中风存在关联的证据（2项研究；RR 1·05；95%置信区间为0·69，1·61；P异质性 = 0·04，I² = 77%）。一项队列研究提供了关于总心血管疾病和心源性猝死的数据，它们与坚果摄入量显著负相关。总之，我们发现较高的坚果摄入量与较低的全因死亡率、总心血管疾病、心血管疾病死亡率、总冠心病、冠心病死亡率和心源性猝死风险相关。
