title: Nut consumption and 5-y all-cause mortality in a Mediterranean cohort: the SUN project.
abstract: OBJECTIVE
  The aim of this study was to assess the association between nut consumption and all-cause mortality after 5-y follow-up in a Spanish cohort.
  
  
  METHODS
  The SUN (Seguimiento Universidad de Navarra, University of Navarra Follow-up) project is a prospective cohort study, formed by Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. In all, 17 184 participants were followed for up to 5 y. Baseline nut consumption was collected by self-reported data, using a validated 136-item semi-quantitative food frequency questionnaire. Information on mortality was collected by permanent contact with the SUN participants and their families, postal authorities, and the National Death Index. The association between baseline nut consumption and all-cause mortality was assessed using Cox proportional hazards models to adjust for potential confounding. Baseline nut consumption was categorized in two ways. In a first analysis energy-adjusted quintiles of nut consumption (measured in g/d) were used. To adjust for total energy intake the residuals method was used. In a second analysis, participants were categorized into four groups according to pre-established categories of nut consumption (servings/d or servings/wk). Both analyses were adjusted for potential confounding factors.
  
  
  RESULTS
  Participants who consumed nuts ≥2/wk had a 56% lower risk for all-cause mortality than those who never or almost never consumed nuts (adjusted hazard ratio, 0.44; 95% confidence intervals, 0.23-0.86).
  
  
  CONCLUSIONS
  Nut consumption was significantly associated with a reduced risk for all-cause mortality after the first 5 y of follow-up in the SUN project.
authors: Department of Occupational Medicine, University of Navarra Clinic, Pamplona, Spain. Electronic address: afmontero@unav.es.
authors: A
authors: A
authors: Fernández-Montero
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors: M
authors: M
authors: Bes-Rastrollo
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.
authors: M T
authors: MT
authors: Barrio-López
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors: C de la
authors: Cde L
authors: Fuente-Arrillaga
authors: Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; The Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere i Virgili, Universitat Rovira i Virgili, Reus, Spain.
authors: J
authors: J
authors: Salas-Salvadó
authors: Pediatrics Service, Complejo Hospital de Navarra B, Servicio Navarro de Salud, Pamplona, Spain.
authors: L
authors: L
authors: Moreno-Galarraga
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors: M A
authors: MA
authors: Martínez-González
mesh_terms: D000328:Adult; D002423:Cause of Death; D004032:Diet; D038441:Diet, Mediterranean; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D013030:Spain; D011795:Surveys and Questionnaires; D014495:Universities
keywords: Nut consumption; SUN project; Total mortality