Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study

  • Heinz Freisling
  • Hwayoung Noh
  • Nadia Slimani
  • Véronique Chajès
  • Anne M. May
  • Petra H. Peeters
  • Elisabete Weiderpass
  • Amanda J. Cross
  • Guri Skeie
  • Mazda Jenab
  • Francesca R. Mancini
  • Marie-Christine Boutron-Ruault
  • Guy Fagherazzi
  • Verena A. Katzke
  • Tilman Kühn
  • Annika Steffen
  • Heiner Boeing
  • Anne Tjønneland
  • Cecilie Kyrø
  • Camilla P. Hansen
  • Kim Overvad
  • Eric J. Duell
  • Daniel Redondo-Sánchez
  • Pilar Amiano
  • Carmen Navarro
  • Aurelio Barricarte
  • Aurora Perez-Cornago
  • Konstantinos K. Tsilidis
  • Dagfinn Aune
  • Heather Ward
  • Antonia Trichopoulou
  • Androniki Naska
  • Philippos Orfanos
  • Giovanna Masala
  • Claudia Agnoli
  • Franco Berrino
  • Rosario Tumino
  • Carlotta Sacerdote
  • Amalia Mattiello
  • H. Bas Bueno-de-Mesquita
  • Ulrika Ericson
  • Emily Sonestedt
  • Anna Winkvist
  • Tonje Braaten
  • Isabelle Romieu
  • Joan Sabaté
Original Contribution

Abstract

Purpose

There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years.

Methods

This study includes 373,293 men and women, 25–70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI).

Results

On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (−0.07 kg; 95% CI −0.12 to −0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92–0.98) or obese (RR 0.95; 95% CI 0.90–0.99) (both P trend <0.008).

Conclusions

Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.

Keywords

Nut intake Weight gain Obesity Energy balance Adults Europe 

Notes

Acknowledgements

This publication arises from the project PANACEA, which has received funding from the European Union, in the framework of the Public Health Programme (Project Number: 2005328). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), PI13/00061 to Granada; PI13/01162 to EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom). The current study was financially supported by Loma Linda University (LLU Contract No. 2150183). JS received funding from the INC International Nut and Dried Fruit Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

We thank all EPIC participants and staff for their contribution to the study. For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php.

Compliance with ethical standards

Ethical standards

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and obtained ethical approval from participating centres and IARC ethics committees. Informed consent was given by all study participants.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

394_2017_1513_MOESM1_ESM.pdf (551 kb)
Supplementary material 1 (PDF 550 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Heinz Freisling
    • 1
  • Hwayoung Noh
    • 1
  • Nadia Slimani
    • 2
  • Véronique Chajès
    • 2
  • Anne M. May
    • 3
  • Petra H. Peeters
    • 3
    • 4
  • Elisabete Weiderpass
    • 5
    • 6
    • 7
    • 8
  • Amanda J. Cross
    • 4
  • Guri Skeie
    • 5
  • Mazda Jenab
    • 2
  • Francesca R. Mancini
    • 9
    • 10
  • Marie-Christine Boutron-Ruault
    • 9
    • 10
  • Guy Fagherazzi
    • 9
    • 10
  • Verena A. Katzke
    • 11
  • Tilman Kühn
    • 11
  • Annika Steffen
    • 12
  • Heiner Boeing
    • 12
  • Anne Tjønneland
    • 13
  • Cecilie Kyrø
    • 13
  • Camilla P. Hansen
    • 14
  • Kim Overvad
    • 14
  • Eric J. Duell
    • 15
  • Daniel Redondo-Sánchez
    • 16
    • 17
  • Pilar Amiano
    • 17
    • 18
  • Carmen Navarro
    • 17
    • 19
    • 20
  • Aurelio Barricarte
    • 17
    • 21
    • 22
  • Aurora Perez-Cornago
    • 23
  • Konstantinos K. Tsilidis
    • 4
    • 24
  • Dagfinn Aune
    • 4
    • 25
  • Heather Ward
    • 4
  • Antonia Trichopoulou
    • 26
    • 27
  • Androniki Naska
    • 26
    • 27
  • Philippos Orfanos
    • 26
    • 27
  • Giovanna Masala
    • 28
  • Claudia Agnoli
    • 29
  • Franco Berrino
    • 29
  • Rosario Tumino
    • 30
  • Carlotta Sacerdote
    • 31
  • Amalia Mattiello
    • 32
  • H. Bas Bueno-de-Mesquita
    • 4
    • 33
    • 34
  • Ulrika Ericson
    • 35
  • Emily Sonestedt
    • 35
  • Anna Winkvist
    • 36
  • Tonje Braaten
    • 5
  • Isabelle Romieu
    • 2
  • Joan Sabaté
    • 37
  1. 1.Nutritional Methodology and Biostatistics Group, Section of Nutrition and MetabolismInternational Agency for Research on Cancer (IARC-WHO)Lyon Cedex 08France
  2. 2.Nutritional Epidemiology Group, Section of Nutrition and MetabolismInternational Agency for Research On Cancer (IARC-WHO)LyonFrance
  3. 3.Julius Centre for Health Sciences and Primary CareUniversity Medical Centre UtrechtUtrechtThe Netherlands
  4. 4.Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
  5. 5.Department of Community Medicine, Faculty of Health SciencesUniversity of Tromsø, The Arctic University of NorwayTromsøNorway
  6. 6.Department of ResearchCancer Registry of NorwayOsloNorway
  7. 7.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  8. 8.Genetic Epidemiology GroupFolkhälsan Research CenterHelsinkiFinland
  9. 9.Inserm U1018, Gustave Roussy Institute, CESPVillejuifFrance
  10. 10.University Paris-Saclay, University Paris-SudVillejuifFrance
  11. 11.Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
  12. 12.Department of EpidemiologyGerman Institute of Human Nutrition Potsdam-RehbrückeNuthetalGermany
  13. 13.Danish Cancer Society Research CenterCopenhagenDenmark
  14. 14.Department of Public Health, Section for EpidemiologyAarhus UniversityAarhusDenmark
  15. 15.Unit of Nutrition and CancerIDIBELL, Catalan Institute of OncologyBarcelonaSpain
  16. 16.Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADAHospitales Universitarios de Granada/Universidad de GranadaGranadaSpain
  17. 17.CIBER de Epidemiología y Salud Pública (CIBERESP)MadridSpain
  18. 18.Public Health Division of GipuzkoaBioDonostia Research InstituteSan SebastianSpain
  19. 19.Department of EpidemiologyMurcia Regional Health Council, IMIB-ArrixacaMurciaSpain
  20. 20.Department of Health and Social SciencesUniversidad de MurciaMurciaSpain
  21. 21.Navarra Public Health InstitutePamplonaSpain
  22. 22.Navarra Institute for Health Research (IdiSNA) PamplonaPamplonaSpain
  23. 23.Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
  24. 24.Department of Hygiene and Epidemiology, School of MedicineUniversity of IoanninaIoanninaGreece
  25. 25.Bjørknes University CollegeOsloNorway
  26. 26.Hellenic Health FoundationAthensGreece
  27. 27.WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of MedicineNational and Kapodistrian University of AthensAthensGreece
  28. 28.Cancer Risk Factors and Life-Style Epidemiology UnitCancer Research and Prevention Institute, ISPOFlorenceItaly
  29. 29.Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  30. 30.Cancer Registry and Histopathology Unit“Civic-M.P.Arezzo” Hospital, ASP RagusaRagusaItaly
  31. 31.Unit of Cancer EpidemiologyCittà della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO)TurinItaly
  32. 32.Dipartimento di Medicina Clinica E ChirurgiaFederico II UniversityNaplesItaly
  33. 33.Department for Determinants of Chronic DiseasesNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
  34. 34.Department of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  35. 35.Department of Clinical Sciences MalmöLund UniversityMalmöSweden
  36. 36.Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  37. 37.Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public HealthLoma Linda UniversityLoma LindaUSA

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