Nut Consumption and Effects on Chronic Kidney Disease and Mortality in the United States

Abstract

<b><i>Background:</i></b> Nuts have been found to have beneficial effects on some diseases, including cardiovascular disease and cancer, in several studies. However, there are few studies to show the effects of nuts on chronic kidney disease (CKD). Thus, we conducted this study to examine the association between the consumption frequency of nuts and the prevalence and mortality of CKD among adults in the USA. <b><i>Methods:</i></b> We analyzed data from 6,072 individuals (aged ≥20 years) who participated in the NHANES 2003–2006 following the scheduled procedure. Data on death were provided by the CDC. A logistic regression model was used to evaluate the association between nut consumption frequency and the prevalence of CKD. A Cox proportional hazards regression model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between nut consumption frequency and all-cause mortality and cardiovascular mortality in the CKD and non-CKD populations. <b><i>Results:</i></b> Consuming nuts 1–6 times per week was associated with a lower prevalence of CKD (model 3: OR: 0.67; 95% CI: 0.49–0.91). In addition, higher nut consumption was significantly associated with lower all-cause and cardiovascular mortality in the non-CKD population. For the CKD population, a consistently significant inverse association could be seen between consuming nuts 1–6 per week and all-cause mortality (model 3: HR: 0.63; 95% CI: 0.47–0.86). No groups showed a significant difference in cardiovascular mortality compared with the reference in the full model. <b><i>Conclusion:</i></b> We recommend the CKD population to have an adequate intake of nuts 1–6 times per week, while the consumption frequency can be more flexible for the non-CKD. Further prospective studies should be conducted to confirm this conclusion.

Adherence to Caloric and Protein Recommendations in Older Hemodialysis Patients: A Multicenter Study

“…This improves the condition of blood vessels, insulin resistance, and lipid disorders, which in turn leads to beneficial effects on many diseases, including cardiovascular diseases. On the other hand, patients who consumed nuts more than once a day consumed more calories, protein, mono- and polyunsaturated fatty acids as well as phosphorus and potassium compared to those who eat nuts less frequently [ 42 ].…”

Going Nuts to Protect Kidneys and to Live Longer with Kidney Disease

“…It also bears to mention that there are remaining knowledge gaps of the effects of different types of nut intake among NDD-CKD and dialysis-dependent CKD patients, rendering compelling need for future research in this area. Given the growing global CKD population and ongoing debate as to whether nut consumption is beneficial for CKD patients in light of their heart-healthy-nu-DOI: 10.1159/000524383 trient content as well as dietary elements that are typically avoided in advanced kidney disease, the study by Wang et al [1] is an important contribution to the field by underscoring nut consumption as a salutary food in the CKD diet. These data also highlight that portion size is a key consideration and that future research defining the optimal intake of nut consumption in CKD patients are needed.…”

“…According to the US Department of Agriculture’s Economic Research “Service Food Availability (Per Capita) Data System” (FADS), the annual consumption of nuts in the USA has grown from 1.38 pounds per person in 1970 to 3.69 pounds per person in 2016. In the general population, epidemiologic studies have shown that higher nut consumption is associated with better health outcomes, including lower risk of cancer, obesity, and all-cause and cardiovascular disease (CVD)-related mortality [1, 2].…”

“…In this issue of AJN , Wang et al [1] present data examining the association between frequency of nut consumption ascertained by Food Frequency Questionnaires (FFQs) with the prevalence of CKD as well as the risk of all-cause and CVD mortality among 6,072 adults, comprised of 1,203 participants with CKD and 4,869 participants without CKD, from the US National Health and Nutrition Examination Study (NHANES) cohort surveyed over 2003–2006. Frequency of nut consumption in the preceding 12 months was categorized as (1) never, (2) 1–11 times per year, (3) 1–3 times per month, (4) 1–6 times per week, and (5) more than once a day, with those who have never consumed nuts as the reference group.…”

“…The study by Wang et al [1] adds important knowledge to the field by demonstrating the favorable impact of nut intake on CKD progression as well as all-cause and CVD mortality risk, irrespective of underlying CKD status. Although there were consistently incremental trends between higher frequency of nut consumption and lower all-cause and CVD mortality in participants without CKD, this pattern of associations was not observed in those with CKD (i.e., non-dose dependent relationship between nut intake and mortality in CKD), emphasizing the importance of eating an appropriate amount of nuts once CKD has developed.…”