title: Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies.
abstract: BACKGROUND
  Many prospective cohort studies have investigated the association between nut consumption and risk of coronary artery disease (CAD), stroke, hypertension, and type 2 diabetes (T2D). However, results have been inconsistent.
  
  
  OBJECTIVE
  We aimed to investigate the association between nut consumption and risk of CAD, stroke, hypertension, and T2D.
  
  
  METHODS
  PubMed and EMBASE databases were searched up to October 2013. All prospective cohort studies of nut consumption and risk of CAD, stroke, hypertension, and T2D were included. Summary RRs with 95% CIs were estimated by using a fixed- or random-effects model.
  
  
  RESULTS
  A total of 23 prospective studies (9 studies for CAD, 4 studies for stroke, 4 studies for hypertension, and 6 studies for T2D) from 19 publications were included in the meta-analysis. There were 179,885 participants and 7236 CAD cases, 182,730 participants and 5669 stroke cases, 40,102 participants and 12,814 hypertension cases, and 342,213 participants and 14,400 T2D cases. The consumption of each 1 serving of nuts/d was significantly associated with incident CAD (RR: 0.81; 95% CI: 0.72, 0.91; P < 0.001) and hypertension (RR: 0.66; 95% CI: 0.44, 1.00; P = 0.049). However, there was no association between the consumption of each 1 serving of nuts/d and risk of stroke (RR: 0.90; 95% CI: 0.71, 1.14) or T2D (RR: 0.80; 95% CI: 0.57, 1.14).
  
  
  CONCLUSIONS
  A higher consumption of nuts was associated with reduced risk of CAD and hypertension but not stroke or T2D. Large randomized controlled trials are warranted to confirm the observed associations.
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Donghao
authors.initials: D
authors.lastname: Zhou
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Haibing
authors.initials: H
authors.lastname: Yu
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: He
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Kathleen Heather
authors.initials: KH
authors.lastname: Reilly
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Jingling
authors.initials: J
authors.lastname: Zhang
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Shuangshuang
authors.initials: S
authors.lastname: Li
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Baozhen
authors.initials: B
authors.lastname: Wang
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Yuanlin
authors.initials: Y
authors.lastname: Ding
authors.affiliation: From the Department of Endocrinology, Linyi People's Hospital, Linyi, China (DZ and JZ); the School of Public Health, Southern Medical University, Guangzhou, China (HY); the Institute of Medical Systems Biology, School of Public Health, Guangdong Medical College, Dongguan, China (HY and YD); the Department of Internal Medicine, Linyi People's Hospital, Linyi, China (FH); Independent Consultant, New York (KHR); the Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China (SL, TZ, and BX); and the Department of Nutrition and Food Hygiene (BW), School of Public Health, Shandong University, Jinan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xi
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004032:Diet; D006801:Humans; D009754:Nuts; D012307:Risk Factors; D040242:Risk Reduction Behavior