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Tao X, Liu L, Ma P, Hu J, Ming Z, Dang K, Zhang Y, Li Y. Association of Circulating Very Long-Chain Saturated Fatty Acids With Cardiovascular Mortality in NHANES 2003-2004, 2011-2012. J Clin Endocrinol Metab 2024; 109:e633-e645. [PMID: 37738581 PMCID: PMC10795918 DOI: 10.1210/clinem/dgad561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/25/2023] [Accepted: 09/20/2023] [Indexed: 09/24/2023]
Abstract
CONTEXT Limited studies have shown a protective effect of very long-chain saturated fatty acids (VLSFAs) on healthy aging, diabetes, heart failure, and risk factors related to cardiovascular disease (CVD), but the role of VLSFAs on mortality risk is unclear. OBJECTIVE We aimed to investigate the association of serum docosanoic acid (C22:0) and serum lignoceric acid (C24:0) with all-cause and disease-specific mortality and to confirm the effect of VLSFAs on mortality risk in the whole, hyperlipidemia, and hypertensive populations. METHODS A total of 4132 individuals from the 2003-2004, 2011-2012 National Health and Nutrition Examination Survey (NHANES) were included in this study. There were 1326 and 1456 participants in the hyperlipidemia and hypertensive population, respectively. Mortality information was confirmed using the National Death Index (NDI). Multiple model calibration was performed using Cox regression analysis for known risk factors to explore the association between circulating VLSFAs and all-cause or CVD or coronary heart disease (CHD) mortality. RESULTS In the whole population, individuals with higher circulating C22:0 and C24:0 as a percentage of total serum fatty acid levels reduced the risks of mortality of all-cause (C22:0: HR = .409; 95% CI, 0.271-0.618; C24:0: HR = 0.430; 95% CI, 0.283-0.651), CVD (C22:0: HR = 0.286; 95% CI, 0.134-0.612; C24:0: HR = 0.233; 95% CI, 0.101-0.538), and CHD (C22:0: HR = 0.401; 95% CI, 0.187-0.913; C24:0: HR = 0.263; 95% CI, 0.082-0.846). Similar to the whole population, individuals with higher circulating C22:0 and C24:0 as a percentage of total serum fatty acid levels in the hyperlipidemia and hypertensive populations were also protective for all-cause, CHD, and CVD mortality. CONCLUSION Our results confirm the protective effect of high levels of circulating VLSFAs (C22:0 and C24:0) on CVD, CHD, and all causes of death in the whole, hyperlipidemia, and hypertensive populations.
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Affiliation(s)
- Xinmiao Tao
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Lin Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Pingnan Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Jinxia Hu
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Zhu Ming
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Keke Dang
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
| | - Yuntao Zhang
- MED-X Institute, Center for Immunological and Metabolic Diseases (CIMD), First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710000, China
| | - Ying Li
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, 150000, China
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Bolling BW, Aune D, Noh H, Petersen KS, Freisling H. Dried Fruits, Nuts, and Cancer Risk and Survival: A Review of the Evidence and Future Research Directions. Nutrients 2023; 15:1443. [PMID: 36986173 PMCID: PMC10051070 DOI: 10.3390/nu15061443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023] Open
Abstract
Dried fruits and nuts contain high amounts of nutrients and phytochemicals-all of which may have anticarcinogenic, anti-inflammatory, and antioxidant properties. This narrative review summarizes the evidence for dried fruits and nuts and cancer incidence, mortality, and survival and their potential anticancer properties. The evidence for dried fruits in cancer outcomes is limited, but existing studies have suggested an inverse relationship between total dried fruit consumption and cancer risk. A higher consumption of nuts has been associated with a reduced risk of several site-specific cancers in prospective cohort studies, including cancers of the colon, lung, and pancreas, with relative risks per 5 g/day increment equal to 0.75 (95% CI 0.60, 0.94), 0.97 (95% CI 0.95, 0.98), and 0.94 (95% CI 0.89, 0.99), respectively. A daily intake of total nuts of 28 g/day has also been associated with a 21% reduction in the rate of cancer mortality. There is also some evidence that frequent nut consumption is associated with improved survival outcomes among patients with colorectal, breast, and prostate cancer; however, further studies are needed. Future research directions include the investigation of additional cancer types, including rare types of cancer. For cancer prognosis, additional studies with pre- and postdiagnosis dietary assessment are warranted.
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Affiliation(s)
- Bradley W. Bolling
- Department of Food Science, University of Wisconsin-Madison, 1605 Linden Dr., Madison, WI 53706, USA
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
- Department of Nutrition, Oslo New University College, Lovisenberggata 13, 0456 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, 0424 Oslo, Norway
| | - Hwayoung Noh
- Department of Cancer Prevention and Environment, INSERM U1296, Léon Bérard Cancer Center, 28 Rue Laennec, 69008 Lyon, France
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, CEDEX 07, 69366 Lyon, France
| | - Kristina S. Petersen
- Department of Nutritional Sciences, Texas Tech University, 508 Human Sciences Building, Lubbock, TX 79409, USA
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, CEDEX 07, 69366 Lyon, France
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Arnesen EK, Thorisdottir B, Bärebring L, Söderlund F, Nwaru BI, Spielau U, Dierkes J, Ramel A, Lamberg-Allardt C, Åkesson A. Nuts and seeds consumption and risk of cardiovascular disease, type 2 diabetes and their risk factors: a systematic review and meta-analysis. Food Nutr Res 2023; 67:8961. [PMID: 36816545 PMCID: PMC9930735 DOI: 10.29219/fnr.v67.8961] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/04/2023] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Objectives We aimed to systematically review studies and evaluate the strength of the evidence on nuts/seeds consumption and cardiometabolic diseases and their risk factors among adults. Methods A protocol was pre-registered in PROSPERO (CRD42021270554). We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Scopus up to September 20, 2021 for prospective cohort studies and ≥12-week randomized controlled trials (RCTs). Main outcomes were cardiovascular disease (CVD), coronary heart disease (CHD), stroke and type 2 diabetes (T2D), secondary total-/low density lipoprotein (LDL)-cholesterol, blood pressure and glycaemic markers. Data extraction and risk of bias (RoB) assessments (using RoB 2.0 and RoB-NObS) were performed in duplicate. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk (RR) or weighted mean differences with 95% confidence intervals (CI); heterogeneity quantified as I 2. One-stage dose-response analyses assessed the linear and non-linear associations with CVD, CHD, stroke and T2D. The strength of evidence was classified per the World Cancer Research Fund criteria. Results After screening 23,244 references, we included 42 papers from cohort studies (28 unique cohorts, 1,890,573 participants) and 18 RCTs (2,266 participants). In the cohorts, mainly populations with low consumption, high versus low total nuts/seeds consumption was inversely associated with total CVD (RR 0.81; 95% CI 0.75, 0.86; I 2 = 67%), CVD mortality (0.77; 0.72, 0.82; I 2 = 59.3%), CHD (0.82; 0.76, 0.89; I 2 = 64%), CHD mortality (0.75; 0.65, 0.87; I 2 = 66.9%) and non-fatal CHD (0.85; 0.75, 0.96; I 2 = 62.2%). According to the non-linear dose-response analyses, consumption of 30 g/day of total nuts/seeds was associated with RRs of similar magnitude. For stroke and T2D the summary RR for high versus low intake was 0.91 (95% CI 0.85, 0.97; I 2 = 24.8%) and 0.95 (0.75, 1.21; I 2 = 82.2%). Intake of nuts (median ~50 g/day) lowered total (-0.15 mmol/L; -0.22, -0.08; I 2 = 31.2%) and LDL-cholesterol (-0.13 mmol/L; -0.21, -0.05; I 2 = 68.6%), but not blood pressure. Findings on fasting glucose, HbA1c and insulin resistance were conflicting. The results were robust to sensitivity and subgroup analyses. We rated the associations between nuts/seeds and both CVD and CHD as probable. There was limited but suggestive evidence for no association with stroke. No conclusion could be made for T2D. Conclusion There is a probable relationship between consumption of nuts/seeds and lower risk of CVD, mostly driven by CHD, possibly in part through effects on blood lipids. More research on stroke and T2D may affect the conclusions. The evidence of specific nuts should be further investigated.
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Affiliation(s)
- Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway,Erik Kristoffer Arnesen, Division of Clinical Nutrition, Institute of Basic Medical Science, University of Oslo, Box 1046 Blindern, NO-0317 Oslo, Norway.
| | | | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Söderlund
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ulrike Spielau
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway,Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jutta Dierkes
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway,Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Nuts: Natural Pleiotropic Nutraceuticals. Nutrients 2021; 13:nu13093269. [PMID: 34579146 PMCID: PMC8468443 DOI: 10.3390/nu13093269] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/01/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022] Open
Abstract
Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to favorably influence metabolic and vascular physiology pathways, ameliorate cardiovascular risk factors and improve cardiovascular prognosis. There is increasing evidence that nuts positively impact myriad other health outcomes as well. Nut consumption is correlated with lower cancer incidence and cancer mortality, and decreased all-cause mortality. Favorable effects on cognitive function and depression have also been reported. Randomized controlled trials consistently show nuts have a cholesterol-lowering effect. Nut consumption also confers modest improvements on glycemic control, blood pressure (BP), endothelial function, and inflammation. Although nuts are energy-dense foods, they do not predispose to obesity, and in fact may even help in weight loss. Tree nuts and peanuts, but not peanut butter, generally produce similar positive effects on outcomes. First level evidence from the PREDIMED trial shows that, in the context of a Mediterranean diet, consumption of 30 g/d of nuts (walnuts, almonds, and hazelnuts) significantly lowered the risk of a composite endpoint of major adverse cardiovascular events (myocardial infarction, stroke, and death from cardiovascular disease) by ≈30% after intervention for 5 y. Impressively, the nut-supplemented diet reduced stroke risk by 45%. As they are rich in salutary bioactive compounds and beneficially impact various health outcomes, nuts can be considered natural pleiotropic nutraceuticals.
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