Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study
- 856 Downloads
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.
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).
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).
Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.
KeywordsNut intake Weight gain Obesity Energy balance Adults Europe
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.
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
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.
- 8.Jenab M, Ferrari P, Slimani N et al (2004) Association of nut and seed intake with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev 13:1595–1603Google Scholar
- 12.Estruch R, Martínez-González MA, Corella D et al (2016) Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial. Lancet Diabetes Endocrinol 4:666–676. doi:10.1016/S2213-8587(16)30085-7 CrossRefGoogle Scholar
- 18.O’Neil CE, Keast DR, Fulgoni VL, Nicklas T (2010) Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of national health and nutrition examination survey (NHANES) 1999–2004. Asia Pac J Clin Nutr 19:142–150Google Scholar
- 21.Vergnaud AC, Norat T, Romaguera D et al (2012) Fruit and vegetable consumption and prospective weight change in participants of the European prospective investigation into cancer and nutrition-physical activity, nutrition, alcohol, cessation of smoking, eating out of home, and obesity study. Am J Clin Nutr 95:184–193. doi:10.3945/ajcn.111.019968 CrossRefGoogle Scholar
- 26.Orsini N, Greenland S (2011) A procedure to tabulate and plot results after flexible modeling of a quantitative covariate. Stata J 11:1–29Google Scholar