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American Journal of Epidemiology Advance Access originally published online on December 15, 2005
American Journal of Epidemiology 2006 163(3):222-231; doi:10.1093/aje/kwj033
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

Nut and Seed Consumption and Inflammatory Markers in the Multi-Ethnic Study of Atherosclerosis

Rui Jiang1, David R. Jacobs, Jr.2,3, Elizabeth Mayer-Davis4, Moyses Szklo5, David Herrington6, Nancy S. Jenny7, Richard Kronmal8 and R. Graham Barr1,9

1 Division of General Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
2 Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN
3 Department of Nutrition, Institute of Basal Medical Sciences, University of Oslo, Oslo, Norway
4 Center for Research in Nutrition and Health Disparities and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
5 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
6 Department of Internal Medicine/Cardiology, School of Medicine, Wake Forest University, Winston-Salem, NC
7 Department of Pathology, College of Medicine, University of Vermont, Colchester, VT
8 Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
9 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY

Correspondence to Dr. R. Graham Barr, PH-9 East, Room 105, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032 (e-mail: rgb9{at}columbia.edu).

Nuts and seeds are rich in unsaturated fat and other nutrients that may reduce inflammation. Frequent nut consumption is associated with lower risk of cardiovascular disease and type 2 diabetes. The authors examined associations between nut and seed consumption and C-reactive protein, interleukin-6, and fibrinogen in the Multi-Ethnic Study of Atherosclerosis. This 2000 cross-sectional analysis included 6,080 US participants aged 45–84 years with adequate information on diet and biomarkers. Nut and seed consumption was categorized as never/rare, less than once/week, 1–4 times/week, and five or more times/week. After adjustment for age, gender, race/ethnicity, site, education, income, smoking, physical activity, use of fish oil supplements, and other dietary factors, mean biomarker levels in categories of increasing consumption were as follows: C-reactive protein—1.98, 1.97, 1.80, and 1.72 mg/liter; interleukin-6—1.25, 1.24, 1.21, and 1.15 pg/ml; and fibrinogen—343, 338, 338, and 331 mg/dl (all p's for trend < 0.01). Further adjustment for hypertension, diabetes, medication use, and lipid levels yielded similar results. Additional adjustment for body mass index moderately attenuated the magnitude of the associations, yielding borderline statistical significance. Associations of nut and seed consumption with these biomarkers were not modified by body mass index, waist:hip ratio, or race/ethnicity. Frequent nut and seed consumption was associated with lower levels of inflammatory markers, which may partially explain the inverse association of nut consumption with cardiovascular disease and diabetes risk.

Arachis hypogaea; C-reactive protein; fibrinogen; inflammation; interleukin-6; nuts; seeds


Abbreviations: FFQ, food frequency questionnaire; IRAS, Insulin Resistance Atherosclerosis Study; MESA, Multi-Ethnic Study of Atherosclerosis


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