Table 3

Hazard ratios of cardiovascular mortality according to the frequency of nut consumption (including and not including walnuts)
Cardiovascular mortality Never 1 to 3 servings/week >3 servings/week P for trend
Frequency of total nut consumption: n = 2,118 n = 2,803 n = 2,295
Cardiovascular death, % (n) 1.7 (36) 0.8 (23) 1.0 (22)
Person-years, n 8,724 12,168 10,185
Crude model 1 (Reference) 0.44 (0.26 to 0.74) 0.50 (0.29 to 0.85) 0.101
Multivariable model 1 1 (Reference) 0.44 (0.26 to 0.76) 0.47 (0.27 to 0.82) 0.075
Multivariable model 2 1 (Reference) 0.41 (0.24 to 0.71) 0.41 (0.23 to 0.73) 0.042
Multivariable model 3 1 (Reference) 0.42 (0.24 to 0.74) 0.45 (0.25 to 0.81) 0.091
Frequency of walnut consumption: n = 2,916 n = 2,547 n = 1,753
Cardiovascular death, % (n) 1.6 (46) 0.7 (18) 1.0 (17)
Person-years, n 12,124 11,122 7,825
Crude model 1 (Reference) 0.41 (0.24 to 0.71) 0.55 (0.31 to 0.96) 0.037
Multivariable model 1 1 (Reference) 0.42 (0.24 to 0.74) 0.54 (0.30 to 0.95) 0.040
Multivariable model 2 1 (Reference) 0.39 (0.22 to 0.69) 0.49 (0.27 to 0.88) 0.022
Multivariable model 3 1 (Reference) 0.41 (0.23 to 0.73) 0.53 (0.29 to 0.98) 0.047
Frequency of consumption of other nuts (excluding walnuts): n = 3,308 n = 2,643 n = 1,265
Cardiovascular death, % (n) 1.3 (43) 1.1 (28) 0.8 (10)
Person-years, n 13,936 11,573 5,566
Crude model 1 (Reference) 0.76 (0.47 to 1.22) 0.57 (0.28 to 1.13) 0.129
Multivariable model 1 1 (Reference) 0.73 (0.45 to 1.20) 0.48 (0.23 to 0.97) 0.056
Multivariable model 2 1 (Reference) 0.70 (0.43 to 1.15) 0.40 (0.19 to 0.83) 0.021
Multivariable model 3 1 (Reference) 0.74 (0.45 to 1.23) 0.42 (0.20 to 0.89) 0.031

One serving of nuts equals 28 g. Cox regression models were used to assess the risk of cardiovascular mortality by frequency of nut consumption. Multivariable model 1 was adjusted for age (years), sex, and intervention group. Model 2 was additionally adjusted for BMI (kg/m2), smoking status (never, former, current smoker), educational level (illiterate/primary education, secondary education, academic/graduate), leisure time physical activity (MET-min/day), history of diabetes (yes/no), history of hypercholesterolemia (yes/no), use of oral antidiabetic medication (yes/no), use of antihypertensive medication (yes/no), use of statins (yes/no), and total energy intake (kcal/day). Model 3 was also adjusted for dietary variables in quintiles (vegetables, fruits, red meat, eggs, and fish), alcohol intake (continuous, adding a quadratic term) and Mediterranean diet adherence (13-point score). All models were stratified by recruitment centre. Extremes of total energy intake were excluded.

Guasch-Ferré et al.

Guasch-Ferré et al. BMC Medicine 2013 11:164   doi:10.1186/1741-7015-11-164

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