Diabetespatienter T2DM verkar drabbas av färre kardiovaskulära händelser om de äter nötter flera gånger i veckan, enligt amerikansk data. Men kopplingen ses inte för jordnötter.

skriver Maria Gustavsson, www.dagensmedicin.se

De nya resultaten gäller vid typ 2-diabetes. Fynden antyder att den som äter en portion nötter – motsvarande 28 gram – vid minst fem tillfällen varje vecka har 34 procents lägre sannolikhet att dö i hjärt-kärlsjukdom och 17 procents lägre sannolikhet att drabbas av olika kardiovaskulära händelser, såsom kranskärlssjukdom. Detta jämfört med patienter som knappt äter en sådan portion nötter i månaden.  

Man fann att specifikt trädnötter – såsom hasselnötter och mandlar – kopplades till en större riskreduktion än jordnötter. Kanhända är den sistnämnda sorten fattigare på näringsämnen, föreslår de amerikanska forskarna bakom observationsstudien.

Underlaget utgörs av data från fler än 16 000 personer i USA som alla arbetade inom sjukvården, Nurses Health Study. Det är därmed inte säkert att fynden kan generaliseras till befolkningen i stort, skriver artikelförfattarna och lyfter det som en svaghet.

Resultaten justerades bland annat för BMI, livsstil samt hur länge patienterna hade haft sin typ 2-diabetes. Konsumtionen av nötter baserades på självrapporteringar och studien har publicerats i tidskriften Circulation Research.

Dagens Medicin har tidigare rapporterat om positiva hälsoeffekter av nötter, bland annat vid koloncancer.

Läs mer i abstrac och hela artikeln som pdf utan lösenord

ABSTRACT

Rationale:

The evidence regarding the potential health benefits of nut consumption among individuals with type 2 diabetes is limited.

Objective:

To examine intake of total and specific types of nuts, including tree nuts and peanuts, in relation to subsequent risk of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, and all-cause and cause-specific mortality among individuals with diabetes.

Methods and Results:

This prospective analysis included 16,217 men and women with diabetes at baseline or diagnosed during follow-up (Nurses’ Health Study: 1980-2014, Health Professionals Follow-Up Study: 1986-2014).

Nut consumption was assessed using a validated food frequency questionnaire and updated every 2-4 years. During 223,682 and 254,923 person-years of follow-up, there were 3,336 incident CVD cases and 5,682 deaths.

Higher total nut consumption was associated with a lower risk of CVD incidence and mortality. The multivariate-adjusted hazard ratios (95% confidence intervals) for participants who consumed 5 or more servings of total nuts per week (1 serving=28g), compared with those who consumed less than 1 serving per month, were 0.83 (0.71-0.98; P trend=0.01) for total CVD incidence, 0.80 (0.67- 0.96; P trend=0.005) for CHD incidence, 0.66 (0.52-0.84; P trend<0.001) for CVD mortality, and 0.69 (0.61-0.77; P trend<0.001) for all-cause mortality. Total nut consumption was not significantly associated with risk of stroke incidence or cancer mortality. For specific types of nuts, higher tree nut consumption was associated with lower risk of total CVD, CHD incidence, and mortality due to CVD, cancer, and all causes, while peanut consumption was associated with lower all-cause mortality only (all P trend<0.001).

In addition, compared with participants who did not change the consumption of total nuts from pre- to post- diabetes diagnosis, participants who increased consumption of total nuts after diabetes diagnosis had an 11% lower risk of CVD, a 15% lower CHD risk, a 25% lower CVD mortality, and a 27% lower all-cause mortality. The associations persisted in subgroup analyses stratified by sex/cohort, body mass index at diabetes diagnosis, smoking status, diabetes duration, nut consumption before diabetes diagnosis, or diet quality.

Conclusions:

Higher consumption of nuts, especially tree nuts, is associated with lower CVD incidence and mortality among participants with diabetes. These data provide novel evidence that supports the recommendation of incorporating nuts into healthy dietary patterns for the prevention of CVD complications and prem

 

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