title: The association between nut consumption and the risk of total and ischemic stroke in a German cohort study.
abstract: OBJECTIVE
  Nuts have beneficial effects on coronary heart disease and many cardiovascular risk factors. However, their effect on stroke is less established, and no studies on the topic are available in Northern and Central European populations. Therefore, we aimed at investigating the association between nut consumption and the risk of stroke in a German population.
  
  
  METHODS
  We used data from a prospective cohort of 26,285 participants of the European Prospective Investigation into the Cancer and Nutrition Potsdam Study. During a median follow-up time of 8.3 years (interquartile range: 7.5-9.2), 288 incident cases of stroke occurred. Nut consumption (standard portion size of 50 g) was assessed at baseline with a semiquantitative food-frequency questionnaire.
  
  
  RESULTS
  The median nut intake was 0.82 g per day, interquartile range: 0.41-4.11. In the multivariable model, an increased risk of stroke was observed among participants who never consumed nuts (hazard ratio (HR): 1.56, 95% confidence interval: 1.17-2.08), compared with those consuming <½ portion/week. However, there was no evidence of a dose-response relationship between nut consumption and stroke. Compared with those who consumed <½ portion/week, the multivariable HR for total stroke was 1.06 (0.75-1.52) among those who consumed ½ to 1 portion/week and 1.37 (0.92-2.05) for those who consumed >1 portion/week. Similar nonsignificant associations were observed in stratified analysis for gender, or for fatal and nonfatal stroke.
  
  
  CONCLUSIONS
  We could not observe an association between nut consumption and the risk of developing stroke (fatal/nonfatal) in a population with low habitual nut consumption.
authors.affiliation: Research Group Cardiovascular Epidemiology, Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: R
authors.initials: R
authors.lastname: di Giuseppe
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: M K
authors.initials: MK
authors.lastname: Fjeld
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Dierkes
authors.affiliation: 1] Department of Clinical Science, University of Bergen, Bergen, Norway [2] Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: D
authors.initials: D
authors.lastname: Theoflylaktopoulou
authors.affiliation: Research Group Cardiovascular Epidemiology, Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Arregui
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Boeing
authors.affiliation: 1] Research Group Cardiovascular Epidemiology, Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany [2] Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Weikert
mesh_terms: D015992:Body Mass Index; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009754:Nuts; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D044465:White People