Heinz Freisling1, Hwayoung Noh2, Nadia Slimani3, Véronique Chajès3, Anne M May4, Petra H Peeters4,5, Elisabete Weiderpass6,7,8,9, Amanda J Cross5, Guri Skeie6, Mazda Jenab3, Francesca R Mancini10,11, Marie-Christine Boutron-Ruault10,11, Guy Fagherazzi10,11, Verena A Katzke12, Tilman Kühn12, Annika Steffen13, Heiner Boeing13, Anne Tjønneland14, Cecilie Kyrø14, Camilla P Hansen15, Kim Overvad15, Eric J Duell16, Daniel Redondo-Sánchez17,18, Pilar Amiano18,19, Carmen Navarro18,20,21, Aurelio Barricarte18,22,23, Aurora Perez-Cornago24, Konstantinos K Tsilidis5,25, Dagfinn Aune5,26, Heather Ward5, Antonia Trichopoulou27,28, Androniki Naska27,28, Philippos Orfanos27,28, Giovanna Masala29, Claudia Agnoli30, Franco Berrino30, Rosario Tumino31, Carlotta Sacerdote32, Amalia Mattiello33, H Bas Bueno-de-Mesquita5,34,35, Ulrika Ericson36, Emily Sonestedt36, Anna Winkvist37, Tonje Braaten6, Isabelle Romieu3, Joan Sabaté38. 1. Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. freislingh@iarc.fr. 2. Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. 3. Nutritional Epidemiology Group, Section of Nutrition and Metabolism, International Agency for Research On Cancer (IARC-WHO), Lyon, France. 4. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. 5. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 6. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. 7. Department of Research, Cancer Registry of Norway, Oslo, Norway. 8. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 9. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. 10. Inserm U1018, Gustave Roussy Institute, CESP, Villejuif, France. 11. University Paris-Saclay, University Paris-Sud, Villejuif, France. 12. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. 13. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. 14. Danish Cancer Society Research Center, Copenhagen, Denmark. 15. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. 16. Unit of Nutrition and Cancer, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain. 17. Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. 18. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 19. Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. 20. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. 21. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. 22. Navarra Public Health Institute, Pamplona, Spain. 23. Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain. 24. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 25. Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece. 26. Bjørknes University College, Oslo, Norway. 27. Hellenic Health Foundation, Athens, Greece. 28. 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 Medicine, National and Kapodistrian University of Athens, Athens, Greece. 29. Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute, ISPO, Florence, Italy. 30. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 31. Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP Ragusa, Ragusa, Italy. 32. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy. 33. Dipartimento di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy. 34. Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 35. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 36. Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden. 37. Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 38. Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, USA.
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.
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.
Entities:
Keywords:
Adults; Energy balance; Europe; Nut intake; Obesity; Weight gain
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