Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study
Open accessAbstract
OBJECTIVE: To examine the relation between nut consumption and risk of coronary heart disease in a cohort of women from the Nurses' Health Study. DESIGN: Prospective cohort study. SETTING: Nurses' Health Study. SUBJECTS: 86 016 women from 34 to 59 years of age without previously diagnosed coronary heart disease, stroke, or cancer at baseline in 1980. MAIN OUTCOME MEASURES: Major coronary heart disease including non-fatal myocardial infarction and fatal coronary heart disease. RESULTS: 1255 major coronary disease events (861 cases of non-fatal myocardial infarction and 394 cases of fatal coronary heart disease) occurred during 14 years of follow up. After adjusting for age, smoking, and other known risk factors for coronary heart disease, women who ate more than five units of nuts (one unit equivalent to 1 oz of nuts) a week (frequent consumption) had a significantly lower risk of total coronary heart disease (relative risk 0.65, 95% confidence interval 0.47 to 0.89, P for trend=0.0009) than women who never ate nuts or who ate less than one unit a month (rare consumption). The magnitude of risk reduction was similar for both fatal coronary heart disease (0.61, 0.35 to 1.05, P for trend=0.007) and non-fatal myocardial infarction (0.68, 0.47 to 1.00, P for trend=0.04). Further adjustment for intakes of dietary fats, fibre, vegetables, and fruits did not alter these results. The inverse association persisted in subgroups stratified by levels of smoking,use of alcohol, use of multivitamin and vitamin E supplements, body mass index, exercise, and intake of vegetables or fruits. CONCLUSIONS: Frequent nut consumption was associated with a reduced risk of both fatal coronary heart disease and non-fatal myocardial infarction. These data, and those from other epidemiological and clinical studies, support a role for nuts in reducing the risk of coronary heart disease.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Prospective studies have shown that eating 5 servings of nuts per week is associated with a 40% to 60% decrease in coronary heart disease events.
“Prospective studies have shown that eating 5 servings of nuts per week is associated with a 40% to 60% decrease in coronary heart disease events (38,39).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [38]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The United States Department of Agriculture
True, A. C. (1912) · The Annals of the American Academy of Political and Social Science · doi:10.1177/000271621204000113 · Cited by 5,152 · see citing works
Cardiovascular Survey Methods.
Rose, G., & Blackburn, H. (1968) · Annals of Internal Medicine · doi:10.7326/0003-4819-69-6-1335_2 · Cited by 3,065 · see citing works
Dietary Fat Intake and the Risk of Coronary Heart Disease in Women
Hu, F. B., Stampfer, M. J., Manson, J. E., Rimm, E. B., Colditz, G. A., ROSNER, B. A., Hennekens, C. H., & Willett, W. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199711203372102 · Cited by 1,774 · see citing works
Self-citation(1990) · Choice Reviews Online · doi:10.5860/choice.27-5795 · Cited by 1,049 · see citing works
Dietary influences on serum lipids and lipoproteins.
Grundy, S. M., & Denke, M. (1990) · Journal of Lipid Research · doi:10.1016/s0022-2275(20)42625-2 · Cited by 1,044 · see citing works
Salvini, S., Hunter, D. J., SAMPSON, L., Stampfer, M. J., Colditz, G. A., ROSNER, B. A., & Willett, W. C. (1989) · International Journal of Epidemiology · doi:10.1093/ije/18.4.858 · Cited by 1,038 · see citing works
Self-citationDiet and Health: What Should We Eat?
Willett, W. C. (1994) · Science · doi:10.1126/science.8160011 · Cited by 1,008 · see citing works
Self-citationD'Agostino, R. B., Lee, M., Belanger, A. J., Cupples, L. A., Anderson, K., & Kannel, W. B. (1990) · Statistics in Medicine · doi:10.1002/sim.4780091214 · Cited by 798 · see citing works
TEST OF THE NATIONAL DEATH INDEX
Stampfer, M. J., Willett, W. C., Speizer, F. E., DYSERT, D. C., LIPNICK, R. J., ROSNER, B. A., & Hennekens, C. H. (1984) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113804 · Cited by 791 · see citing works
Self-citationThe Nurses' Health Study: 20-Year Contribution to the Understanding of Health Among Women
Colditz, G. A., Manson, J. E., & Hankinson, S. E. (1997) · Journal of Women s Health · doi:10.1089/jwh.1997.6.49 · Cited by 739 · see citing works
Self-citationDietary fat and risk of coronary heart disease in men: cohort follow up study in the United States
Ascherio, A., Rimm, E. B., Giovannucci, E. L., Spiegelman, D. L., Stampfer, M. J., & Willett, W. C. (1996) · BMJ · doi:10.1136/bmj.313.7049.84 · Cited by 732 · see citing works
Self-citationA Possible Protective Effect of Nut Consumption on Risk of Coronary Heart Disease
Fraser, G. E. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.152.7.1416 · Cited by 730 · see citing works
Fraser, G., Sabaté, J., Beeson, W., & Strahan, T. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.1992.00400190054010 · Cited by 727 · see citing works
Dolecek, T. A. (1992) · Experimental Biology and Medicine · doi:10.3181/00379727-200-43413 · Cited by 410 · see citing works
Effects of Walnuts on Serum Lipid Levels and Blood Pressure in Normal Men
Sabaté, J., Fraser, G. E., Burke, K. I., Knutsen, S. F., Bennett, H., & Lindsted, K. D. (1993) · New England Journal of Medicine · doi:10.1056/nejm199303043280902 · Cited by 397 · see citing works
Abbey, M., Noakes, M., Belling, G. B., & Nestel, P. (1994) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/59.5.995 · Cited by 251 · see citing works
Low fat‐monounsaturated rich diets containing high‐oleic peanuts improve serum lipoprotein profiles
O’Byrne, D., Knauft, D. A., & Shireman, R. B. (1997) · Lipids · doi:10.1007/s11745-997-0088-y · Cited by 199 · see citing works
The Traditional and Emerging Role of Nuts in Healthful Diets
Dreher, M. L., Maher, C. V., & Kearney, P. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.1996.tb03941.x · Cited by 154 · see citing works
Effect of a Diet High in Monounsaturated Fat From Almonds on Plasma Cholesterol and Lipoproteins
Spiller, G. A., Jenkins, D. J. A., Cragen, L. N., Gates, J. E., Bosello, O., Berra, K. A., Rudd, C. M., Stevenson, M., & Superko, H. R. (1992) · Journal of the American College of Nutrition · doi:10.1080/07315724.1992.12098233 · Cited by 113 · see citing works
Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol
Fraser, G. (1994) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/59.5.1117s · Cited by 97 · see citing works
Prineas, R. J., Kushi, L. H., Folsom, A. R., et al. (1993) · New England Journal of Medicine · doi:10.1056/nejm199307293290513 · Cited by 56 · see citing works
Does nut consumption protect against ischaemic heart disease?
Sabaté, J. (1993) · PubMed · Cited by 46 · see citing works
Anti-Atherogenic Effect of Nuts: Is the Answer NO?
Cooke, J. P. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.1993.00410070076013 · Cited by 38 · see citing works
Peanut oil reduces diet-induced atherosclerosis in cynomolgus monkeys.
Alderson, L., Hayes, K. C., & Nicolosi, R. J. (1986) · Arteriosclerosis An Official Journal of the American Heart Association Inc · doi:10.1161/01.atv.6.5.465 · Cited by 28 · see citing works
Dietary fat and experimental atherosclerosis.
Kritchevsky, D. (1991) · PubMed · Cited by 24 · see citing works
Anti-atherogenic effect of nuts: is the answer NO?
Cooke, J. P. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.153.7.896b · Cited by 9 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Sabate J. Does nut consumption protest against ischemic heart disease. Eur J Clin Nutr 1993;47:71-5S.
Cited by
Sorted by citations
Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle
Stampfer, M. J., Hu, F. B., Manson, J. E., Rimm, E. B., & Willett, W. C. (2000) · New England Journal of Medicine · doi:10.1056/nejm200007063430103 · Cited by 1,794 · see citing works
Self-citationAdherence to a DASH-Style Diet and Risk of Coronary Heart Disease and Stroke in Women
Fung, T. T. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.7.713 · Cited by 1,567 · see citing works
McCullough, M. L., Feskanich, D., Stampfer, M. J., Giovannucci, E. L., Rimm, E. B., Hu, F. B., Spiegelman, D., Hunter, D. J., Colditz, G. A., & Willett, W. C. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.6.1261 · Cited by 1,191 · see citing works
Self-citationTypes of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review
Hu, F. B., Manson, J. E., & Willett, W. C. (2001) · Journal of the American College of Nutrition · doi:10.1080/07315724.2001.10719008 · Cited by 902 · see citing works
Self-citationNational Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2
Jacobson, T. A., Maki, K. C., Orringer, C. E., Jones, P. H., Kris-Etherton, P., Sikand, G., La Forge, R., Daniels, S. R., Wilson, D. P., Morris, P. B., et al. (2015) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.09.002 · Cited by 784 · see citing works
Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms
Tosti, V., Bertozzi, B., & Fontana, L. (2018) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glx227 · Cited by 762 · see citing works
Plant-based foods and prevention of cardiovascular disease: an overview
Hu, F. B. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.3.544s · Cited by 700 · see citing works
Self-citationJenkins, D. J. A. (2003) · JAMA · doi:10.1001/jama.290.4.502 · Cited by 620 · see citing works
Afshin, A., Micha, R., Khatibzadeh, S., & Mozaffarian, D. (2014) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.076901 · Cited by 509 · see citing works
Nut and peanut butter consumption and risk of type 2 diabetes in women
Jiang, R. (2002) · JAMA · doi:10.1001/jama.288.20.2554 · Cited by 489 · see citing works
Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials
Sabaté, J. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.79 · Cited by 422 · see citing works
Kris-Etherton, P. M., Hu, F. B., Ros, E., & Sabaté, J. (2008) · The Journal of Nutrition · doi:10.1093/jn/138.9.1746s · Cited by 410 · see citing works
Self-citationAdherence to the Dietary Guidelines for Americans and risk of major chronic disease in men
McCullough, M. L., Feskanich, D., Rimm, E. B., Giovannucci, E. L., Ascherio, A., Variyam, J. N., Spiegelman, D., Stampfer, M. J., & Willett, W. C. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.5.1223 · Cited by 403 · see citing works
Self-citationNut consumption and decreased risk of sudden cardiac death in the Physicians’ Health Study
Albert, C. M., Gaziano, J. M., Willett, W. C., & Manson, J. E. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.12.1382 · Cited by 396 · see citing works
Self-citationSeddon, J. M. (2003) · Archives of Ophthalmology · doi:10.1001/archopht.121.12.1728 · Cited by 384 · see citing works
The effects of nuts on coronary heart disease risk
Kris-Etherton, P. M., Zhao, G., Binkoski, A. E., Coval, S. M., & Etherton, T. D. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2001.tb06996.x · Cited by 328 · see citing works
Soltani, S., Shirani, F., Chitsazi, M. J., & Salehi‐Abargouei, A. (2016) · Obesity Reviews · doi:10.1111/obr.12391 · Cited by 251 · see citing works
Ten Years of Life: Is It a Matter of Choice?
Fraser, G. E., & Shavlik, D. J. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.13.1645 · Cited by 237 · see citing works
Chiavaroli, L., Nishi, S. K., Khan, T. A., Braunstein, C. R., Glenn, A. J., Mejia, S. B., Rahelić, D., Kahleová, H., Salas-Salvadó, J., Jenkins, D. J. A., et al. (2018) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2018.05.004 · Cited by 226 · see citing works
Functional foods, herbs and nutraceuticals: towards biochemical mechanisms of healthy aging
Ferrari, C. K. B. (2004) · Biogerontology · doi:10.1007/s10522-004-2566-z · Cited by 227 · see citing works
Almonds Decrease Postprandial Glycemia, Insulinemia, and Oxidative Damage in Healthy Individuals
Jenkins, D. J. A., Kendall, C. W. C., Josse, A. R., Salvatore, S., Brighenti, F., Augustin, L. S. A., Ellis, P. R., Vidgen, E., & Rao, A. V. (2006) · The Journal of Nutrition · doi:10.1093/jn/136.12.2987 · Cited by 226 · see citing works
Jenkins, D. J. A., Jones, P. J. H., Lamarche, B., Kendall, C. W. C., Faulkner, D., Cermakova, L., Gigleux, I., Ramprasath, V., de Souza, R., Ireland, C., et al. (2011) · JAMA · doi:10.1001/jama.2011.1202 · Cited by 218 · see citing works
Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort
Sánchez-Villegas, A., Bes-Rastrollo, M., Martínez-González, M. A., & Serra-Majem, L. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803118 · Cited by 200 · see citing works
Soy Protein Reduces Serum Cholesterol by Both Intrinsic and Food Displacement Mechanisms
Jenkins, D. J. A., Mirrahimi, A., Srichaikul, K., Berryman, C. E., Wang, L., Carleton, A., Abdulnour, S., Sievenpiper, J. L., Kendall, C. W. C., & Kris-Etherton, P. M. (2010) · The Journal of Nutrition · doi:10.3945/jn.110.124958 · Cited by 194 · see citing works
Nuts and coronary heart disease: an epidemiological perspective
Kelly, J. H., & Sabaté, J. (2006) · British Journal of Nutrition · doi:10.1017/bjn20061865 · Cited by 193 · see citing works
Nut intake and adiposity: meta-analysis of clinical trials
Flores-Mateo, G., Rojas-Rueda, D., Basora, J., Ros, E., & Salas-Salvadó, J. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.031484 · Cited by 185 · see citing works
Impact of Peanuts and Tree Nuts on Body Weight and Healthy Weight Loss in Adults
Mattes, R. D., Kris-Etherton, P. M., & Foster, G. D. (2008) · The Journal of Nutrition · doi:10.1093/jn/138.9.1741s · Cited by 171 · see citing works
Red meat, diseases, and healthy alternatives: A critical review
Ekmekcioglu, C., Wallner, P., Kundi, M., Weisz, U., Haas, W., & Hutter, H.-P. (2018) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2016.1158148 · Cited by 173 · see citing works
Almonds and postprandial glycemia—a dose-response study
Josse, A. R., Kendall, C. W. C., Augustin, L. S. A., Ellis, P. R., & Jenkins, D. J. A. (2007) · Metabolism · doi:10.1016/j.metabol.2006.10.024 · Cited by 171 · see citing works
Proposal for a dietary “phytochemical index”
McCarty, M. F. (2004) · Medical Hypotheses · doi:10.1016/j.mehy.2002.11.004 · Cited by 166 · see citing works
Jenkins, D. J. A., Wong, J. M. W., Kendall, C. W. C., Esfahani, A., Ng, V. W. Y., Leong, T. C. K., Faulkner, D. A., Vidgen, E., Greaves, K. A., Paul, G., et al. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.115 · Cited by 160 · see citing works
Mayhew, A. J., de Souza, R. J., Meyre, D., Anand, S. S., & Mente, A. (2016) · British Journal Of Nutrition · doi:10.1017/s0007114515004316 · Cited by 147 · see citing works
Li, T. Y., Brennan, A. M., Wedick, N. M., Mantzoros, C., Rifai, N., & Hu, F. B. (2009) · The Journal of Nutrition · doi:10.3945/jn.108.103622 · Cited by 143 · see citing works
Self-citationJenkins, D. J. A., Kendall, C. W. C., Marchie, A., Faulkner, D., Vidgen, E., Lapsley, K. G., Trautwein, E. A., Parker, T. L., Josse, R. G., Leiter, L. A., et al. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00260-9 · Cited by 131 · see citing works
Nuts, metabolic syndrome and diabetes
Kendall, C. W. C., Josse, A. R., Esfahani, A., & Jenkins, D. J. A. (2010) · British Journal of Nutrition · doi:10.1017/s0007114510001546 · Cited by 127 · see citing works
Schoenaker, D. A., Soedamah-Muthu, S. S., Callaway, L. K., & Mishra, G. D. (2015) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.102475 · Cited by 124 · see citing works
Dietary protein and risk of ischemic heart disease in middle-aged men.
Preis, S. R., Stampfer, M. J., Spiegelman, D., Willett, W. C., & Rimm, E. B. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.29626 · Cited by 71 · see citing works
Self-citationKendall, C. W. C., West, S. G., Augustin, L. S., Esfahani, A., Vidgen, E., Bashyam, B., Sauder, K. A., Campbell, J., Chiavaroli, L., Jenkins, A. L., et al. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2013.275 · Cited by 72 · see citing works
Kendall, C. W. C., Josse, A. R., Esfahani, A., & Jenkins, D. J. A. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.12 · Cited by 69 · see citing works
Background paper on global trends in food production, intake and composition
Wolmarans, P. (2009) · Annals of Nutrition and Metabolism · doi:10.1159/000229005 · Cited by 55 · see citing works
Yu, E., Ruiz-Canela, M., Hu, F. B., Clish, C. B., Corella, D., Salas-Salvadó, J., Hruby, A., Fitó, M., Liang, L., Toledo, E., et al. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-3569 · Cited by 30 · see citing works
Self-citation
- Authors
- Hu, F. B., Stampfer, M. J., Manson, J. E., Rimm, E. B., Colditz, G. A., Rosner, B. A., Speizer, F. E., Hennekens, C. H., & Willett, W. C.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Hu, Frank B
- ORCID
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1998-11-14
- Volume
- 317
- Issue
- 7169
- Pages
- 1341-1345
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC28714
- OpenAlex
- W2162635512
- Cited by
- 597
- References
- 26
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 12 · 2023: 10 · 2022: 11 · 2021: 13 · 2020: 6 · 2019: 15 · 2018: 16 · 2017: 20 · 2016: 12 · 2015: 20 · 2014: 33 · 2013: 21 · 2012: 35
- FWCI
- 24.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL24074, HL34594, R01HL034594)
- National Cancer Institute (R01CA040356, CA-40356)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, T32DK007703)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nuts composition and effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- nut consumption, coronary artery disease, myocardial infarction, women, Nurses' Health Study, dietary fat, cardiovascular risk factors, dietary fiber, fruit and vegetable intake
- MeSH terms
- Adult, Coronary Disease, Diet, Female, Follow-Up Studies, Humans, Middle Aged, Myocardial Infarction, Nuts, Prospective Studies, Risk Factors, United States, Cohort Studies, Incidence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
