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Atrial fibrillation risk lower with regular nut consumption

People who regularly eat nuts have lower risk of AF – and perhaps also heart failure

Louise Prime

Wednesday, 18 April 2018

People who regularly eat nuts have a lower risk of atrial fibrillation (AF) than those who don’t eat nuts, with an 18% relative risk reduction for those who eat them three times a week. According to the authors of a new study,* published in Heart, eating nuts up to twice a week was also associated with a reduction in the risk of heart failure, but there was no link between eating nuts and the risk of aortic valve stenosis, ischaemic stroke or intracerebral haemorrhage.

Although nut consumption has previously been found to be inversely associated with cardiovascular disease mortality, any association with incidence of specific cardiovascular diseases was unclear, so this team of researchers set up a study to examine the association between nut consumption and incidence of seven cardiovascular diseases.

They analysed data for 61,364 Swedish adults who had completed a food frequency questionnaire and had been followed up for 17 years through linkage with the Swedish National Patient and Death Registers.

They reported that nut consumption was inversely associated with risk of myocardial infarction, heart failure, atrial fibrillation and abdominal aortic aneurysm in the age-adjusted and sex-adjusted analysis. People who ate nuts tended also, on average, to be younger, to have lower body mass index and to have higher consumption of alcohol, fruits and vegetables compared with non-consumers of nuts.

Once the researchers had adjusted for potential confounding factors, many of the associations with nut consumption disappeared except for a linear, dose–response, association with atrial fibrillation and a non-linear association with heart failure. They found that compared with not eating nuts, the multivariable hazard ratios (HR) for AF across categories of nut consumption were 0.97 for 1–3 times/month, 0.88 for once or twice a week and 0.82 for ≥3 times/week. For heart failure, the corresponding HRs were 0.87, 0.80 and 0.98 respectively.

They noted that because their study was observational it could not show causation; furthermore, nut consumers entered the study with fewer cardiovascular risk factors; but they pointed out its strengths in being a large study with a large number of cases of cardiovascular disease during follow up.

They said: “Nut consumption or factors associated with this nutritional behaviour may play a role in reducing the risk of atrial fibrillation and possibly heart failure.”

And they concluded: “Nut consumption or factors associated with this nutritional behaviour may play a role in reducing the risk of atrial fibrillation and possibly heart failure. Since only a small proportion of this population had moderate (about 5%) or high (<2%) nut consumption, even a small increase in nut consumption may have large potential to lead to a reduction in incidence of atrial fibrillation and heart failure in this population.”


* Larsson SC, Drca N, Björck M, et al. Nut consumption and incidence of seven cardiovascular diseases. Heart Published Online First: 16 April 2018. doi: 10.1136/heartjnl-2017-312819.

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