Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Adv Nutr. 2021 Jun 1;12(3):793-808. doi: 10.1093/advances/nmaa152.
Data on the association of nut intake with risk of cancer and its mortality are conflicting. Although previous meta-analyses summarized available findings in this regard, some limitations may distort their findings. Moreover, none of these meta-analyses examined the dose-response associations of total nut intake with the risk of specific cancers as well as associations between specific types of nuts and cancer mortality. Therefore, this study aimed to summarize available findings on the associations of total nut (tree nuts and peanuts), tree nut (walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts), peanut (whole peanuts without considering peanut butter), and peanut butter consumption with risk of cancer and its mortality by considering the above-mentioned points. We searched the online databases until March 2020 to identify eligible articles. In total, 43 articles on cancer risk and 9 articles on cancer mortality were included in the current systematic review and meta-analysis. The summary effect size (ES) for risk of cancer, comparing the highest with lowest intakes of total nuts, was 0.86 (95% CI: 0.81, 0.92, P < 0.001, I2 = 58.1%; P < 0.01), indicating a significant inverse association. Such a significant inverse association was also seen for tree nut intake (pooled ES: 0.87, 95% CI: 0.78-0.96, P < 0.01, I2 = 15.8%; P = 0.28). Based on the dose-response analysis, a 5-g/d increase in total nut intake was associated with 3%, 6%, and 25% lower risks of overall, pancreatic, and colon cancers, respectively. In terms of cancer mortality, we found 13%, 18%, and 8% risk reductions with higher intakes of total nuts, tree nuts, and peanuts, respectively. In addition, a 5-g/d increase in total nut intake was associated with a 4% lower risk of cancer mortality. In conclusion, our findings support the protective association between total nut and tree nut intake and the risk of cancer and its mortality.
关于坚果摄入与癌症风险和死亡率之间的关联的数据存在争议。尽管之前的荟萃分析总结了这方面的现有发现，但一些局限性可能会扭曲他们的发现。此外，这些荟萃分析都没有检查总坚果摄入量与特定癌症风险的剂量反应关系，以及特定类型的坚果与癌症死亡率之间的关系。因此，本研究旨在总结关于总坚果（核桃和花生）、树坚果（核桃、开心果、夏威夷果、山核桃、腰果、杏仁、榛子和巴西坚果）、花生（不考虑花生酱的整个花生）和花生酱摄入与癌症风险和死亡率之间关联的现有发现，同时考虑到上述几点。我们检索了在线数据库，直到 2020 年 3 月，以确定符合条件的文章。共有 43 篇关于癌症风险的文章和 9 篇关于癌症死亡率的文章被纳入本系统综述和荟萃分析。比较最高和最低总坚果摄入量的癌症风险的汇总效应大小（ES）为 0.86（95%CI：0.81，0.92，P<0.001，I2=58.1%；P<0.01），表明存在显著的负相关关系。树坚果摄入也存在显著的负相关关系（合并 ES：0.87，95%CI：0.78-0.96，P<0.01，I2=15.8%；P=0.28）。基于剂量-反应分析，总坚果摄入量增加 5g/d，分别与总体、胰腺癌和结肠癌风险降低 3%、6%和 25%相关。就癌症死亡率而言，我们发现总坚果、树坚果和花生的摄入量较高时，风险分别降低 13%、18%和 8%。此外，总坚果摄入量增加 5g/d 与癌症死亡率降低 4%相关。总之，我们的研究结果支持总坚果和树坚果摄入与癌症风险和死亡率之间的保护关联。
