Mohammadifard Noushin, Ghaderian Niloufar, Hassannejad Razieh, Sajjadi Firouzeh, Sadeghi Masoumeh, Roohafza Hamidreza, Salas-Salvadó Jordi, Sarrafzadegan Nizal
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Front Nutr. 2021 Jan 21;7:610467. doi: 10.3389/fnut.2020.610467. eCollection 2020.
There are few pieces of evidence on the association between nut consumption and the risk of cardiovascular disease (CVD) in the Eastern Mediterranean Region. This study investigated the relationship of nut consumption with the risk of CVD and all-cause mortality in the Iranian population. This population-based prospective cohort study was carried out in 6,504 randomly selected participants aged ≥35 years in central Iran (2001-2013) in the framework of the Isfahan Cohort Study. Dietary data were collected by a validated 48-item food frequency questionnaire. Subjects or their next of kin were interviewed biannually, looking for the possible occurrence of cardiovascular events and all-cause mortality. During the median follow-up of 135 months and 52,704.3 person-years, we found a total of 751 CVD events. In unadjusted model, participants in the highest quartile of nut intake had a lower CVD risk {hazard ratio (HR) [95% confidence interval (CI)]: 0.57(0.47-0.70); for trend < 0.001}, CVD mortality [HR (95% CI): 0.54 (0.33-0.72); for trend < 0.001], and all-cause mortality [HR (95% CI): 0.24 (0.14-0.42); for trend < 0.001]. In the fully adjusted model, the association was diluted, and no significant relationship was found between nut intake and CVD events and all-cause mortality, except for CVD mortality in the highest quartile vs. the lowest one [HR (95% CI): 0.55 (0.30-0.98)]. Nut intake had an inverse association with the risk of CVD mortality. It is suggested to perform studies to examine the association of individual types of nuts and different preparation methods on CVD risk and mortality.
关于地中海东部地区食用坚果与心血管疾病（CVD）风险之间的关联，相关证据较少。本研究调查了伊朗人群中食用坚果与CVD风险及全因死亡率之间的关系。这项基于人群的前瞻性队列研究是在伊朗中部6504名年龄≥35岁的随机选取参与者中进行的（2001 - 2013年），属于伊斯法罕队列研究的一部分。通过一份经验证的48项食物频率问卷收集饮食数据。每半年对受试者或其近亲进行一次访谈，了解心血管事件和全因死亡的可能发生情况。在135个月的中位随访期和52704.3人年期间，我们共发现751例CVD事件。在未调整模型中，坚果摄入量最高四分位数的参与者CVD风险较低{风险比（HR）[95%置信区间（CI）]：0.57（0.47 - 0.70）；趋势<0.001}，CVD死亡率[HR（95%CI）：0.54（0.33 - 0.72）；趋势<0.001]，以及全因死亡率[HR（95%CI）：0.24（0.14 - 0.42）；趋势<0.001]。在完全调整模型中，这种关联被削弱，除了最高四分位数与最低四分位数的CVD死亡率[HR（95%CI）：0.55（0.30 - 0.98）]外，未发现坚果摄入量与CVD事件及全因死亡率之间存在显著关系。坚果摄入量与CVD死亡率风险呈负相关。建议开展研究以检验不同种类坚果及不同制备方法与CVD风险和死亡率之间的关联。
