scholarly journals Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Women and Men

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 226-226
Author(s):  
Xiaoran Liu ◽  
Marta Liu Guasch-Ferré ◽  
Deirdre Liu ◽  
Yanping Li

Abstract Objectives We aim to 1) examine the association between walnut consumption and subsequent total and cause-specific mortality; 2) to estimate life expectancy that would be potentially gained by varying intake of walnuts in U.S. women and men. Methods Walnut consumption was assessed using validated food frequency questionnaires in 1998 (baseline year) and updated every 4 years. We included data from 68,308 women of the Nurses’ Health Study (1998–2016) and 26,760 men of the Health Professionals Follow-up Study (1998–2016) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models adjusting for confounders to estimate mortality risk associated with walnut consumption stratified by sex and dietary quality. We used population based multistate life tables to calculate the differences in life expectancy and years lived in relation to walnut consumption. Results During up to 18 years of follow-up, we documented 30,502 deaths from any cause. The multivariable-adjusted hazard ratios (HRs) for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.91 (95% confidence interval [CI], 0.89–0.94), for <1 serving/week, 0.87 (95% CI, 0.83–0.92) for 1 serving/week, 0.79 (95% CI, 0.75–0.85), for 2–4 servings/week, and 0.77 (95% CI,: 0.71–0.81) for >= 5 servings/week (P for trend <0.0001). Per 0.5 serving/day walnut consumption was associated of a reduced risk of total mortality (HR: 0.82, 95% CI,: 0.77–0.88), CVD mortality (HR: 0.78, 95% CI,: 0.67–0.33), and cancer mortality (HR: 0.93, 95% CI:, 0.81–1.07) in participants with a suboptimal diet (AHEI score <60% of cohort distribution). A greater life expectancy of 1.78 years in women and 1.94 years in men was observed among those who consumed walnuts more than 5 servings/week, compared to non-consumers at age 60. Conclusions Higher walnut consumption was associated with lower risk for total mortality and longer estimated life expectancy among U.S. men and women of two prospective cohort studies. Our results provide evidence on the potential role of walnut in the prevention of premature death. Funding Sources UM1 CA186107, UM1 CA176726, UM1 CA167552 Y.L. was partly funded by the California Walnut Commission. The funders have no roles in the design and conduct of the study.

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2699
Author(s):  
Xiaoran Liu ◽  
Marta Guasch-Ferré ◽  
Deirdre K. Tobias ◽  
Yanping Li

Walnut consumption is associated with health benefits. We aimed to (1) examine the association between walnut consumption and mortality and (2) estimate life expectancy in relation to walnut consumption in U.S. adults. We included 67,014 women of the Nurses’ Health Study (1998–2018) and 26,326 men of the Health Professionals Follow-up Study (1998–2018) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During up to 20 years of follow-up, we documented 30,263 deaths. The hazard ratios for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.95 (95% confidence interval (CI), 0.91, 0.98) for <1 serving/week, 0.94 (95% CI, 0.89, 0.99) for 1 serving/week, 0.87 (95% CI, 0.82, 0.93) for 2–4 servings/week, and 0.86 (95% CI, 0.79, 0.93) for >=5 servings/week (p for trend <0.0001). A greater life expectancy at age 60 (1.30 years in women and 1.26 years in men) was observed among those who consumed walnuts more than 5 servings/week compared to non-consumers. Higher walnut consumption was associated with a lower risk of total and CVD mortality and a greater gained life expectancy among U.S. elder adults.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Paulette D Chandler ◽  
Deirdre Tobias ◽  
Jule E Buring ◽  
I-Min Lee ◽  
Daniel Chasman ◽  
...  

Background: Given the increased prevalence of cancer survivors in the United States, it is imperative to define risk factors for potential reductions in total and cause-specific mortality. Physical activity (PA) represents a promising target for intervention. Design: We prospectively evaluated PA from questionnaires before and after cancer diagnosis with total and cause-specific mortality among 13,297 subjects diagnosed with invasive cancer combined from the Physicians’ Health Study (PHS) (n=6328), Physicians’ Health Study II (PHS II) (n=912), and Women's Health Study (WHS) (n=6057). WHS and PHS participants were free of baseline cancer; PHS II participants reported no active cancer at baseline. We ascertained PA before and after an incident cancer diagnosis based on reports on repeated follow-up questionnaires. Death was ascertained by medical records and death certificates. Cox regression estimated combined hazard ratios (HRs) of mortality by PA adjusted for age, randomized treatments, BMI, and other lifestyle/demographic factors. We evaluated the interaction between PA before and after cancer diagnosis by comparing PA ≤1 versus ≥2 times/wk. Results: The mean follow-up after cancer diagnosis was 8.0, 7.5, and 5.2 y for WHS, PHS, and PHS II, respectively, during which there were 5623 deaths (WHS, 2164; PHS, 3269; PHS II; 190). Higher PA before cancer diagnosis was associated with significantly lower mortality. Compared with PA ≤ once/wk, the HRs (95% CIs) associated with PA 2-4 and >4 times/wk were 0.87 (0.82-0.93) and 0.88 (0.82-0.94) for total mortality; 0.77 (0.63-0.95) and 0.79 (0.62-0.997) for CVD mortality, and 0.90 (0.83-0.98) and 0.90 (0.83-0.98) for cancer mortality. Higher PA after cancer diagnosis was associated with significantly lower total and cancer mortality and non-significantly lower CVD mortality, with HRs (95% CIs) of 0.65 (0.58-0.72) and 0.66 (0.59-0.73) for total mortality; 0.78 (0.59-1.03) and 0.82 (0.61-1.10) for CVD mortality, and 0.66 (0.57-0.77) and 0.64 (0.55-0.74) for cancer mortality. There was a significant interaction of PA before and after cancer diagnosis for total (p int =0.02) and cancer (p int =0.007) mortality, but not CVD mortality (p int =0.38). Conclusions: Greater PA both before and after cancer diagnosis were significantly associated with lower total and cancer mortality. Higher PA before cancer diagnosis was also associated with lower CVD mortality. PA may be an important target for lower mortality after cancer diagnosis.


Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1036-1036
Author(s):  
Marta Guasch-Ferre ◽  
Yanping Li ◽  
Walter Willett ◽  
Qi Sun ◽  
Laura Sampson ◽  
...  

Abstract Objectives The association between olive oil intake and the risk of mortality has not been evaluated before in the US population. Our objective was to examine whether olive oil intake is associated with total and cause-specific mortality in two prospective cohorts of US men and women. We hypothesize that higher olive oil consumption is associated with lower risk of total and cause-specific mortality. Methods We followed 61,096 women (Nurses’ Health Study, 1990–2016) and 31,936 men (Health Professionals Follow-up Study, 1990–2016) who were free of diabetes, cardiovascular disease and cancer at baseline. Diet was assessed by a semi quantitative food frequency questionnaire at baseline and then every 4 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During 26 years of follow-up, 32,868 deaths occurred. Compared with those participants who never consumed olive oil, those with higher olive oil intake (&gt;1/2 tablespoon/d or &gt;8g/d) had 15% lower risk of total mortality [pooled hazard ratio (95% confidence interval): 0.85 (0.81, 0.88)] after adjustment for potential confounders. Higher olive oil intake was associated with 15% lower risk of CVD death [0.85 (0.78, 0.92)], 38% lower risk of neurodegenerative disease death [0.62 (0.54, 0.71)], and 12% lower risk of respiratory death [0.88 (0.77, 1.00)]. Replacing 10 g of margarine, mayonnaise, and dairy fat with the equivalent amount of olive oil was associated with 7–20% lower risk of total mortality, and death from CVD, cancer, neurodegenerative, and respiratory diseases. No significant associations were observed when olive oil was replacing other vegetable oils combined (corn, safflower, soybean and canola oil). Conclusions We observed that higher olive oil intake was associated with a lower risk of total mortality and cause-specific mortality in a large prospective cohort of U.S. men and women. The substitution of margarine, mayonnaise, and dairy fat with olive oil was associated with a reduced risk of mortality. Funding Sources This work was supported by grants from the National Institutes of Health.


Circulation ◽  
2019 ◽  
Vol 140 (12) ◽  
pp. 979-991 ◽  
Author(s):  
Megu Y. Baden ◽  
Gang Liu ◽  
Ambika Satija ◽  
Yanping Li ◽  
Qi Sun ◽  
...  

Background: Plant-based diets have been associated with lower risk of type 2 diabetes mellitus and cardiovascular disease (CVD) and are recommended for both health and environmental benefits. However, the association between changes in plant-based diet quality and mortality remains unclear. Methods: We investigated the associations between 12-year changes (from 1986 to 1998) in plant-based diet quality assessed by 3 plant-based diet indices (score range, 18–90)—an overall plant-based diet index (PDI), a healthful PDI, and an unhealthful PDI—and subsequent total and cause-specific mortality (1998–2014). Participants were 49 407 women in the Nurses’ Health Study (NHS) and 25 907 men in the Health Professionals Follow-Up Study (HPFS) who were free from CVD and cancer in 1998. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results: We documented 10 686 deaths including 2046 CVD deaths and 3091 cancer deaths in the NHS over 725 316 person-years of follow-up and 6490 deaths including 1872 CVD deaths and 1772 cancer deaths in the HPFS over 371 322 person-years of follow-up. Compared with participants whose indices remained stable, among those with the greatest increases in diet scores (highest quintile), the pooled multivariable-adjusted HRs for total mortality were 0.95 (95% CI, 0.90–1.00) for PDI, 0.90 (95% CI, 0.85–0.95) for healthful PDI, and 1.12 (95% CI, 1.07–1.18) for unhealthful PDI. Among participants with the greatest decrease (lowest quintile), the multivariable-adjusted HRs were 1.09 (95% CI, 1.04–1.15) for PDI, 1.10 (95% CI, 1.05–1.15) for healthful PDI, and 0.93 (95% CI, 0.88–0.98) for unhealthful PDI. For CVD mortality, the risk associated with a 10-point increase in each PDI was 7% lower (95% CI, 1–12%) for PDI, 9% lower (95% CI, 4–14%) for healthful PDI, and 8% higher (95% CI, 2–14%) for unhealthful PDI. There were no consistent associations between changes in plant-based diet indices and cancer mortality. Conclusions: Improving plant-based diet quality over a 12-year period was associated with a lower risk of total and CVD mortality, whereas increased consumption of an unhealthful plant-based diet was associated with a higher risk of total and CVD mortality.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Mercedes Sotos-Prieto ◽  
Howard D Sesso ◽  
Frank B Hu ◽  
Walter C Willett ◽  
Stephanie E Chiuve

Background: The previously validated Healthy Heart Score, based on modifiable health behaviors (diet, physical activity, alcohol intake, smoking, and body weight), effectively predicted the 20-year risk of CVD in mid-adulthood. While these lifestyle behaviors are independently associated with many chronic diseases, it remains unknown whether the Healthy Heart Score may extend to an association with overall mortality risk. Thus, we examined the Healthy Heart Score and total and cause-specific mortality in the Nurses’ Health Study (NHS) and Health Professional Follow-up Study (HPFS). Methods: We conducted a prospective analysis among 58,319 women in the NHS (1984-2010) aged 30-55 y and 30,713 in men in the HPFS (1986-2010) aged 40-75 y free of cancer and CVD at baseline. The Healthy Heart Score was calculated at baseline and included 9 factors that best estimated CVD risk: current smoking, higher BMI, low physical activity, lack of moderate alcohol consumption, low intakes of fruits and vegetables, cereal fiber, and nuts, and high intakes of sugar-sweetened beverages and red and processed meats). Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) and adjusted for various demographics, medical history, medication use and total energy. Results: During 2,075,504 years of follow-up, there were 19,181 total deaths, including 11,464 in women and 7,717 in men. Compared to participants with the lowest predicted 20-year CVD risk based on the Healthy Heart Score (1 st quintile, median CVD risk: 0.01%), participants with the highest predictive CVD risk (5 th quintile, median CVD risk: 0.03%) had a pooled HR (95%CI) of 2.26 (1.86, 2.13) for total mortality; 2.89 (95 CI%, 1.93, 4.32) for CVD mortality; and 2.55 (95% CI 2.39, 2.72) for cancer mortality. Participants in the 5 th quintile vs . the 1 st quintile of the Healthy Heart Score had also a significantly greater risk of death due to CHD (3.40 [2.20, 5.26]), stroke (1.77 [1.00, 3.14]), lung cancer (6.02 [2.83, 12.79]), breast cancer (1.45 [1.13, 1.85]), colon cancer (1.51 (1.17, 1.94)), respiratory disease (3.94 (1.03, 15.14)), and diabetes (3.63 (2.00, 6.59)). Conclusion: The Healthy Heart Score, comprised of 9 self-reported, modifiable lifestyle predictors of CVD, is strongly associated with a greater risk of all-cause and cause-specific mortality. This risk score is a potentially useful tool for risk assessment and counseling of healthy lifestyles to promote longevity


2021 ◽  
pp. 1-18
Author(s):  
Sanne Pagh Møller ◽  
Heddie Mejborn ◽  
Anja Biltoft-Jensen ◽  
Anne Illemann Christensen ◽  
Lau Caspar Thygesen

Abstract Associations between meat consumption and heart disease have been assessed in several studies but it has been suggested that other dietary factors influence these associations. The aim of this study was to assess whether meat consumption is associated with ischemic heart disease (IHD), and if the association is modified by dietary quality. The analyses were based on the cohort of adult participants in The Danish National Survey on Diet and Physical Activity in 2000-2002, 2003-2008, and 2011-2013. From these surveys, information on meat consumption and dietary quality were extracted. The cohort was followed in national registers to identify incident IHD. Associations were estimated using Cox regression analyses adjusting for sociodemographic and lifestyle factors. Analyses of associations between meat consumption and IHD stratified by dietary quality were subsequently evaluated. Among the 8,007 participants, the median follow-up was 9.8 years and 439 cases of IHD were recorded. The results suggested a trend between consumption increments of 100g/day of red meat (HR=1.23; 95%CI:0.99-1.53) or of 50 g/day of processed meat (HR=1.09; 95%CI:0.93-1.29) and higher risk of IHD. The trends were, however, not statistically significant. Stratification by dietary quality did not suggest that associations between meat consumption and risk of IHD were modified by dietary quality. This population-based cohort study with detailed dietary information, suggested a trend with higher meat consumption being associated with higher risk of IHD, but the association was not statistically significant. Results did not indicate that dietary quality modifies such associations.


2021 ◽  
Author(s):  
Yi Wan ◽  
Fred K. Tabung ◽  
Dong Hoon Lee ◽  
Teresa T. Fung ◽  
Walter C. Willett ◽  
...  

<b>Objective: </b>Insulin response is related to overall health. Diet modulates insulin response. We aimed to investigate whether insulinemic potential of diet are associated with risk of all-cause and cause-specific mortality. <p><b>Research Design and Methods: </b>We prospectively followed 63,464 women from the Nurses’ Health Study (1986-2016) and 42,880 men from the Health Professionals Follow-up Study (1986-2016). Diet was assessed by food frequency questionnaires every 4 years. The insulinemic potential of diet was evaluated using a food-based empirical dietary index for hyperinsulinemia (EDIH), which was pre-defined based on predicting circulating C-peptide concentrations.</p> <p><b>Results</b>:<b> </b>During <a>2,792,550</a> person-years of follow-up, 38,329 deaths occurred. In the pooled multivariable-adjusted analyses, a higher dietary insulinemic potential was associated with an increased risk of mortality from all-cause (hazard ratio [HR] comparing extreme quintiles: 1.33; 95% confidence interval [CI]: 1.29, 1.38; P-trend<0.001), cardiovascular disease (CVD) (HR: 1.37; 95% CI: 1.27, 1.46; P-trend<0.001), and cancers (HR: 1,20; 95% CI: 1.13, 1.28; P-trend<0.001). <a>These associations were independent of body mass index and remained significant after further adjustment for other well-known dietary indices. </a>Furthermore, <a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a>compared with participants whose EDIH scores were stable over an 8-year period, those with the greatest increases had a higher subsequent risk of all-cause (HR: 1.13; 95%CI: 1.09, 1.18; P-trend<0.001)</a> and CVD (HR: 1.10; 95% CI: 1.01, 1.21; P-trend=0.006) mortality.</p> <p><b>Conclusions:</b> Higher insulinemic potential of diet was associated with increased risk of all-cause, CVD, and cancer mortality. Adopting a diet with low insulinemic potential might be an effective approach to improve overall health and prevent premature death.</p>


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jason H Wu ◽  
Rozenn Lemaitre ◽  
Irena King ◽  
Xiaoling Song ◽  
David Siscovick ◽  
...  

Background: While omega-6 polyunsaturated fatty acids (n-6 PUFA) have been recommended to reduce CHD, controversy remains about benefits vs. harms, including depending on types of n-6 PUFA and diseases examined. Aims: To assess associations of circulating n-6 PUFA including linoleic acid (LA, the major dietary PUFA), Γ-linoleic acid (GLA), dihomo-Γ-linoleic acid (DGLA), and arachidonic acid (AA),with incident total and cause-specific mortality in the Cardiovascular Health Study (CHS), a community-based US cohort. Methods: Among 2,692 participants age≥65y and free of CVD at baseline, plasma phospholipid n-6 PUFA were measured at baseline using standardized methods. All-cause and cause-specific mortality, and total (fatal or nonfatal) incident CHD and stroke, were assessed and adjudicated centrally. Associations of PUFA biomarkers with risk were assessed by multivariable Cox regression. Results: During 33,091 person-years of follow-up (1992-2010), 1920 deaths occurred (including 660 cardiovascular deaths), as well as 414 fatal and 410 nonfatal CHD events, and 150 fatal and 384 nonfatal strokes. In multivariable models, higher LA was associated with lower risk of total mortality, with extreme quintile HR 0.84 (95% CI 0.71-0.98, P- trend 0.002). Lower death was largely attributable to CVD rather than non-CVD causes, especially nonarhythmic CHD mortality (HR 0.50, 95% CI 0.31-0.80, P- trend 0.001). Phospholipid GLA, DGLA, and AA levels were not associated with total or cause-specific mortality; e.g., for AA and CHD death, the extreme quintile HR was 0.98 (95% CI 0.71-1.37, P- trend 0.72). Evaluated semi-parametrically, LA showed graded (monotonic) inverse associations with total mortality ( Figure 1A ). There was little evidence that associations of n-6 PUFA with total mortality varied by age, sex, race, or plasma n-3 PUFA (Bonferroni corrected P =NS, Figure 1B ). Conclusion: Higher circulating LA, but not other n-6 PUFA, is inversely associated with total and CHD mortality in older adults.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Ming Ding ◽  
Ambika Satija ◽  
Shilpa Bhupathiraju ◽  
Qi Sun ◽  
Jiali Han ◽  
...  

BACKGROUND: Coffee is one of the most popular beverages worldwide; however, the association between coffee consumption and risk of mortality remains inconclusive. METHOD: We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 121,704 women in the Nurses’ Health Study (1984 - 2013), 116,683 women in the Nurses’ Health Study 2 (1991 - 2013), and 51,530 men in the Health Professionals Follow-up Study (1986 - 2013). Participants with a history of cancer, heart disease, or stroke at baseline were excluded. Coffee consumption was assessed at baseline using a semi-quantitative food frequency questionnaire. RESULTS: During 5,048,976 person-years of follow-up, 20,025 women and 13,391 men died. Consumption of total, caffeinated, and decaffeinated coffee were non-linearly associated with total mortality (P for non-linear trend < 0.001). The pooled hazard ratios (HRs) for death among participants who drank coffee, as compared with those who did not, were 0.96 (95% CI: 0.92 - 1.00) for coffee consumption less than one cup/d, 0.89 (95% CI: 0.86 - 0.92) for coffee consumption one to three cups/d, 0.91 (95% CI: 0.87 - 0.95) for coffee consumption three to five cups/d, and 1.01 (95% CI: 0.96 - 1.06) for coffee consumption more than five cups/d (p for non-linearity < 0.001; p for non-linear trend < 0.001). When restricting to never smokers, compared to non-drinkers, the multivariate adjusted HRs of total mortality across categories of total coffee consumption were 0.93 (0.86-1.02) for 1 cup/d, 0.87 (0.82-0.96) for 1-3 cups/d, 0.85 (0.77-0.94) for 3-5 cups/d, and 0.83 (0.71-0.97) for >5 cups/d (p for non-linearity = 0.15; p for linear trend <0.001). A significant inverse association was observed for both caffeinated coffee (p for trend < 0.001) and decaffeinated coffee (p for trend = 0.03). CONCLUSION: These data indicate higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality.


Sign in / Sign up

Export Citation Format

Share Document