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Nut Consumption and Decreased Risk of Sudden Cardiac Death in the Physicians' Health Study
Christine M. Albert, MD, MPH;
J. Michael Gaziano, MD, MPH;
Walter C. Willett, MD, DrPH;
JoAnn E. Manson, MD, DrPH
Arch Intern Med. 2002;162:1382-1387.
Background Dietary nut intake has been associated with a reduced risk of coronary
heart disease mortality; however, the mechanism is unclear. Since components
of nuts may have antiarrhythmic properties, part of the benefit may be due
to a reduction in sudden cardiac death.
Methods We prospectively assessed whether increasing frequency of nut consumption,
as ascertained by an abbreviated food frequency questionnaire at 12 months
of follow-up, was associated with a lower risk of sudden cardiac death and
other coronary heart disease end points among 21 454 male participants
enrolled in the US Physicians' Health Study. Participants were followed up
for an average of 17 years.
Results Dietary nut intake was associated with a significantly reduced risk
of sudden cardiac death after controlling for known cardiac risk factors and
other dietary habits (P for trend, .01). Compared
with men who rarely or never consumed nuts, those who consumed nuts 2 or more
times per week had reduced risks of sudden cardiac death (relative risk, 0.53;
95% confidence interval, 0.30-0.92) and total coronary heart disease death
(relative risk, 0.70; 95% confidence interval, 0.50-0.98). In contrast, nut
intake was not associated with significantly reduced risks of nonsudden coronary
heart disease death or nonfatal myocardial infarction.
Conclusion These prospective data in US male physicians suggest that the inverse
association between nut consumption and total coronary heart disease death
is primarily due to a reduction in the risk of sudden cardiac death.
From the Division of Preventive Medicine (Drs Albert, Gaziano, Manson),
Channing Laboratory (Drs Willett and Manson), and Cardiovascular Medicine
(Dr Gaziano), Department of Medicine, Brigham and Women's Hospital; Cardiovascular
Division, Department of Medicine, Massachusetts General Hospital (Dr Albert);
and Departments of Epidemiology (Drs Willett and Manson) and Nutrition (Dr
Willett), Harvard School of Public Health, Boston, Mass.
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