Nut consumption and risk of heart failure in the Physicians' Health Study I.
BACKGROUND
Heart failure is highly prevalent among older adults and is associated with high cost and societal burden. Although previous studies have reported beneficial effects of dietary factors on heart failure predictors, no previous study has examined whether frequent consumption of nuts is associated with a lower risk of heart failure in a large prospective cohort.


OBJECTIVE
We examined the association between nut consumption and incident heart failure to determine whether such a relation is modified by overweight or obesity.


METHODS
This was a prospective cohort study of 20,976 participants from the Physicians' Health Study I. Nut consumption was assessed with a simple abbreviated food questionnaire, and self-reported heart failure was ascertained by follow-up questionnaires. We used Cox regression to estimate relative risks of heart failure.


RESULTS
After an average follow-up of 19.6 y, 1,093 new cases of heart failure occurred. Nut consumption was not associated with the risk of developing heart failure in this cohort: multivariable adjusted hazard ratios were 1.0 (reference), 0.98 (95% CI: 0.83, 1.15), 1.06 (95% CI: 0.89, 1.27), and 1.01 (95% CI: 0.84, 1.22) for nut consumption of <1, 1, and > or =2 servings/wk, respectively (P for linear trend: 0.64). The lack of a meaningful relation between nut intake and incident heart failure was seen in both lean and overweight or obese participants (P for interaction: 0.96).


CONCLUSIONS
Our data do not provide evidence for an association between nut consumption and incident heart failure in US male physicians. However, our data cannot rule out possible benefits of nut consumption on subtypes of heart failure not prevalent in this cohort.
Division of Aging and Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. ldjousse@rics.bwh.harvard.edu
Luc
L
Djoussé
Tamara
T
Rudich
J Michael
JM
Gaziano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D004032:Diet; D005247:Feeding Behavior; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009754:Nuts; D016017:Odds Ratio; D010820:Physicians / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology