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Cumulative average nut consumption in relation to lower incidence of hypertension: a prospective cohort study of 10,347 adults

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Maintaining optimal blood pressure (BP) levels can be an effective preventive strategy for reducing disease burden. Nut consumption may play a preventive role against hypertension, which is a lifelong condition. We aimed to prospectively examine the association between cumulative average nut consumption and the incidence of hypertension in Korean adults aged 40 years and older.

Methods

A total of 10,347 participants who were free of hypertension at baseline, were included. Hypertension was defined as having a physician diagnosis and taking antihypertensive medications or having abnormal BP (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg). As an exposure, cumulative average nut consumption was calculated using repeated food-frequency questionnaires (mean: 2.1). We used a modified Poisson regression model with a robust error estimator to estimate the incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for hypertension.

Results

We identified 2047 incident cases of hypertension during 44,614 person-years of follow-up. Among both men and women, an average nut consumption of ≥ 1 serving/week (15 g/week]) was inversely associated with hypertension incidence (IRR = 0.74, 95% CI = 0.58–0.96, p for trend = 0.013 for men; IRR = 0.72, 95% CI = 0.59–0.88, p for trend = 0.002 for women) and these significant associations were consistently observed across the strata of potential confounders.

Conclusion

An average consumption of at least one serving (15 g) per week of peanuts, almonds, and/or pine nuts may be inversely associated with the risk of hypertension among Korean adults aged 40 years and older, in a dose–response manner.

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Abbreviations

BP:

Blood pressure

BMI:

Body mass index

CAVAS:

Cardiovascular disease association study

CI:

Confidence interval

DALY:

Disability-adjusted life-years

DASH:

Dietary approaches to stop hypertension

DBP:

Diastolic blood pressure

FFQ:

Food frequency questionnaire

GLM:

General linear model

IRR:

Incidence rate ratio

KoGES:

Korean genome and epidemiology study

RCT:

Randomized controlled trial

SBP:

Systolic blood pressure

SD:

Standard deviation

SE:

Standard error

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Funding

This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2004-E71004-00, 2005-E71011-00, 2006-E71009-00, 2007-E71002-00, 2008-E71004-00, 2009-E71006-00, 2010-E71003-00, 2011-E71002-00, 2012-E71007-00, 2013-E71008-00, 2014-E71006-01, 2016-E71001-00, 2017N-E71001-00), and by the National Research Foundation of Korea grant funded by the Korean Government (Ministry of Science, ICT & Future Planning) (No. NRF-2020R1A2C1004815). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA

    Sukyoung Jung

  2. Institute for Health and Society, Hanyang University, Seoul, South Korea

    Sukyoung Jung, Hye Won Woo, Yu-Mi Kim & Mi Kyung Kim

  3. Department of Preventive Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Medical School Building A-Room 517-2, Sungdong-gu, 04763, Seoul, South Korea

    Hye Won Woo, Yu-Mi Kim & Mi Kyung Kim

  4. Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Jinho Shin

  5. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea

    Min-Ho Shin

  6. Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea

    Sang-Baek Koh

  7. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Hyeon Chang Kim

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  1. Sukyoung Jung
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Contributions

SJ: formal analysis, visualization, writing—original draft preparation, writing—reviewing and editing; HWW: data curation; JS: investigation, project administration; Y-MK: investigation, project administration; S-BK: investigation, project administration; HCK: investigation, project administration; MKK: conceptualization, funding acquisition, investigation, project administration, methodology, supervision, writing—reviewing and editing. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Mi Kyung Kim.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Institutional Review Boards of the Hanyang University, Chonnam University, Keimyung University, Yonsei Wonju College of Medicine, and Yonsei University) and with the Helsinki Declaration of 1964, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

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Jung, S., Woo, H.W., Shin, J. et al. Cumulative average nut consumption in relation to lower incidence of hypertension: a prospective cohort study of 10,347 adults. Eur J Nutr 61, 1571–1583 (2022). https://doi.org/10.1007/s00394-021-02743-5

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