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PubMed2002

Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study.

BACKGROUND: Dietary nut intake has been associated with a reduced risk of coronary heart disease mortality; however, the mechanism is unclear. Since components of nuts may have antiarrhythmic properties, part of the benefit may be due to a reduction in sudden cardiac death. METHODS: We prospectively assessed whether increasing frequency of nut consumption, as ascertained by an abbreviated food frequency questionnaire at 12 months of follow-up, was associated with a lower risk of sudden cardiac death and other coronary heart disease end points among 21 454 male participants enrolled in the US Physicians' Health Study. Participants were followed up for an average of 17 years. RESULTS: Dietary nut intake was associated with a significantly reduced risk of sudden cardiac death after controlling for known cardiac risk factors and other dietary habits (P for trend,.01). Compared with men who rarely or never consumed nuts, those who consumed nuts 2 or more times per week had reduced risks of sudden cardiac death (relative risk, 0.53; 95% confidence interval, 0.30-0.92) and total coronary heart disease death (relative risk, 0.70; 95% confidence interval, 0.50-0.98). In contrast, nut intake was not associated with significantly reduced risks of nonsudden coronary heart disease death or nonfatal myocardial infarction. CONCLUSION: These prospective data in US male physicians suggest that the inverse association between nut consumption and total coronary heart disease death is primarily due to a reduction in the risk of sudden cardiac death.

Adult↗

PubMed1989

Evaluation of the carcinogenicity of different preparations of areca nut in mice.

Areca nut has been used as a masticatory since antiquity and it is estimated that more than 10% of the world population chews it in a variety of forms. We have evaluated the carcinogenicity of different preparations of areca nut: ripe-unprocessed-sundried nut (R-UP-SD), ripe-processed-sundried nut (R-P-SD), unripe-processed-sundried nut (UR-P-SD), ripe-unprocessed-sundried-water-soaked nut (R-UP-SD-WS) and ripe-unprocessed-undried-water-soaked nut (R-UP-UD-WS) in mice following diet-feeding or oral feeding for 12 months. Only unprocessed areca nuts (R-UP-SD, R-UP-SD-WS and R-UP-UD-WS), at high doses, displayed a very weak carcinogenicity.

Administration, Oral↗

PubMed2001

Long-term prospective observational study of patients with peanut and nut allergy after participation in a management plan.

BACKGROUND: Peanut and nut allergy is common and the most frequent cause of severe or fatal reactions to foods. Current advice is poor--doctors give an epinephrine injector to patients, without training or advice on nut avoidance--so that further reactions are common and deaths occur. We devised and assessed a management programme providing advice on nut avoidance and emergency medication. METHODS: Unselected referrals with confirmed peanut or tree-nut allergy were recruited. Severity of nut allergy was graded 1-5 and emergency medication allocated accordingly: oral antihistamine with or without inhaled or injected epinephrine. Patients, parents, and school staff received verbal and written advice on nut avoidance as well as training in recognition and self-treatment of reactions, with a written treatment plan. At follow-up (more than 13610 patient months) retraining was given and details of further reactions obtained. FINDINGS: 88 (15%) of 567 patients had a follow-up reaction of reduced severity. 62 of 88 were mild (grades 1-3, mainly cutaneous) and 49 patients used oral antihistamine, six inhaled adrenaline, and ten took no treatment. 12 of 12 patients with a moderate follow-up reaction improved after inhaled epinephrine. Only three (0.5%) of 567 patients, aged 27-40 years, had a severe follow-up reaction (involving dyspnoea) compared with 12% initially. Only one of 567 changed from a mild index reaction to a severe follow-up reaction. Patients with a moderate/severe (grade 4-5) reaction were older (median 18 years vs 9 years; p=0.03) and nine of 26 received injected epinephrine which was always effective. 85% of patients had no further reactions. Severity was related to the amount of nut eaten. INTERPRETATION: Self-treatment was effective (inhaled epinephrine for early laryngeal oedema and an epinephrine injector for severe reactions) but provision of this treatment, including who should carry epinephrine, required assessment of allergy severity. Our management plan was effective, and our results indicate that patients should be referred to specialist allergy centres for advice on nut avoidance.

Adolescent↗

PubMed2006

Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries.

Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts = 4. 4%, peanuts = 2.3 % and seeds = 1.3 %. The data show a clear northern (Sweden: mean intake = 0.15 g/d, average portion size = 15.1 g/d) to southern (Spain: mean intake = 2.99 g/d, average portion size = 34.7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28.5 v. 23.1 g/d, P<0.01) and peanuts (46.1 v. 35.1 g/d, P<0.01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group.

Arachis↗

PubMed2006

Nuts: source of energy and macronutrients.

On the basis of the high fat content of nuts, they are traditionally considered as foods that provide a high amount of energy. However, epidemiologic and clinical observations do not indicate an association between nut intake and increased BMI. There is a notorious variability in macronutrient composition among nuts, although they have some consistent patterns. Nuts contain all major macronutrients: protein, carbohydrate, and fat. The total protein content is relatively high, which makes them a good source of plant protein (especially for vegetarians). Although nuts contain low amounts of some essential amino acids, this is not a nutritional concern due to the complement of protein. In addition, nuts have a low lysine:arginine ratio, which is inversely associated with the risk of developing hypercholesterolemia and atherosclerosis. Carbohydrates are the second highest macronutrient in nuts in terms of total calories provided. The fat fraction is characterized by a high amount of unsaturated fatty acids and a low content of saturated fatty acids. In conclusion, the high content in unsaturated fatty acids, the low lysine:arginine ratio, and the presence of other bioactive molecules (such as fibre, phytosterols, vitamin and other antioxidants, and minerals) make the addition of nuts to healthy diets a useful tool for the prevention of cardiovascular heart diseases.

Amino Acids, Essential↗

PubMed2006

Other relevant components of nuts: phytosterols, folate and minerals.

Nuts contain significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. Nuts do not contain cholesterol, but they are rich in chemically related phytosterols, a class of compounds that interfere with intestinal cholesterol absorption and thus help lower blood cholesterol. Nuts also contain folate, a B-vitamin necessary for normal cellular function that plays an important role in detoxifying homocysteine, a sulphur-containing amino acid with atherothrombotic properties that accumulates in plasma when folate status is subnormal. Compared to other common foodstuffs, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium and potassium. Like that of most vegetables, the sodium content of nuts is very low. A high intake of calcium, magnesium and potassium, together with a low sodium intake, is associated with protection against bone demineralisation, arterial hypertension, insulin resistance, and overall cardiovascular risk. Phytosterols might justify part of the cholesterol-lowering effect of nut intake beyond that attributable to fatty acid exchange, while the mineral richness of nuts probably contributes to the prevention of diabetes and coronary heart disease observed in epidemiological studies in association with frequent nut consumption.

Calcium↗

PubMed2007

Nut consumption and weight gain in a Mediterranean cohort: The SUN study.

OBJECTIVE: To assess the association, in a Mediterranean population, between nut consumption and risk of weight gain (at least 5 kg) or the risk of becoming overweight/obese. RESEARCH METHODS AND PROCEDURES: The Seguimiento Universidad de Navarra project is a prospective cohort of 8865 adult men and women who completed a follow-up questionnaire after a median of 28 months. Dietary habits were assessed with a previously validated semiquantitative food-frequency questionnaire. RESULTS: Nine hundred thirty-seven participants reported a weight gain of > or =5 kg at follow-up. After adjusting for age, sex, smoking, leisure time physical activity, and other known risk factors for obesity, participants who ate nuts two or more times per week had a significantly lower risk of weight gain (odds ratio: 0.69; 95% confidence interval: 0.53 to 0.90, p for trend = 0.006) than those who never or almost never ate nuts. Participants with little nut consumption (never/almost never) gained an average of 424 grams (95% confidence interval: 102 to 746) more than frequent nut eaters. Nut consumption was not significantly associated with incident overweight/obesity in the cohort. DISCUSSION: Frequent nut consumption was associated with a reduced risk of weight gain (5 kg or more). These results support the recommendation of nut consumption as an important component of a cardioprotective diet and also allay fears of possible weight gain.

Adult↗

PubMed1995

Allergy to pistachio: crossreactivity between pistachio nut and other Anacardiaceae.

BACKGROUND: Anaphylaxis against Anacardiaceae nuts is uncommon and the allergens involved still poorly characterized. For this reason two patients with allergy towards pistachio nut (a member of the Anacardiaceae family) have been studied. OBJECTIVE: Identification of immunoallergens present in pistachio nut and analysis of crossreactive antigens in other members of the same plant family, specifically cashew and mango. METHODS: Presence of specific IgE for pistachio and cashew nut and for mango seed and pulp was determined by skin tests and radioallergosorbent assay (RAST). The allergenic profile of pistachio and cashew was analyzed by sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting. Crossreactivity between pistachio and the other Anacardiaceae was studied by RAST inhibition. RESULTS: Skin tests were positive for pistachio and cashew in the two children and for mango seed in one. RAST was positive for pistachio and cashew in both patients. On immunoblotting, serum from both patients recognized several pistachio and cashew allergens with a molecular weight ranging from < 14.2-70 kDa. RAST inhibition demonstrated common antigenic determinants between pistachio and cashew nut. Crossreactivity was also found between pistachio nut and mango seed but not with mango pulp. CONCLUSION: Pistachio nut contains several protein allergens able to trigger type I hypersensitivity reactions. These allergens can be found also in cashew nut and mango seed but not in mango pulp.

Anaphylaxis↗

PubMed2004

Human leucocyte antigen polymorphisms in nut-allergic patients in South Wales.

BACKGROUND: Peanuts and tree nuts are among the most common foods provoking severe allergic reactions including fatal anaphylaxis. However, little is known of the underlying genetic and immunological mechanisms involved. OBJECTIVE: Based on findings in other allergic diseases, we have investigated whether specific human leucocyte antigens (HLA) are associated with nut allergy. METHOD: Eighty-four patients presenting at the allergy clinic with symptoms of nut allergy were typed for the HLA Class I (HLA-A and B) and Class II (HLA-DRB1 and DQB1) loci by PCR using sequence-specific primers. Carriage frequencies were compared with 82 atopic non-nut-allergic subjects and 1798 random blood donors. RESULTS: The frequency of HLA-B(*)07 (28.57%) and DRB1(*)11 (15.48%) was increased in the nut-allergic patients compared to the atopic controls (12.20% and 3.66%, respectively) but not when compared to the blood donors (28.86% and 10.12%). DRB1(*)13 and DQB1(*)06 were both increased in frequency in the nut allergy patients over both the atopic and blood donor controls. However, none of these increased frequencies were significant when corrected for the number of comparisons undertaken. CONCLUSION: At HLA '2-digit resolution' and with undifferentiated patients with nut allergy, there are no major disturbances in the frequency of HLA-A, B, DRB1 or DQB1 types. However, the difference in frequency of HLA-DRB1(*)11 between the nut allergy patients and the atopic controls merits further investigation as this may represent an important phenotypic relationship.

Adolescent↗

PubMed2006

The diagnosis of Brazil nut allergy using history, skin prick tests, serum-specific immunoglobulin E and food challenges.

BACKGROUND: Allergy to Brazil nut is a relatively common nut allergy and can be fatal. However, the evidence is lacking regarding the best approach to its diagnosis. OBJECTIVE: We sought to determine the relative merits of history, skin prick testing, measurement of serum-specific IgE and challenge in the diagnosis of Brazil nut allergy. METHODS: Fifty-six children and adults with a history of an allergic reaction to Brazil nut or evidence of sensitization were investigated by questionnaire (n=56), skin prick tests (SPTs) (n=53), measurement of serum-specific IgE to Brazil nut (n=54) and double-blind, placebo-controlled labial, and if necessary oral, challenges (n=19). RESULTS: Brazil nut allergy occurred in highly atopic individuals of any age with a strong family history of atopy. In 24 of 56 (43%), the history of an immediate reaction was sufficient to make a diagnosis with confidence and an oral challenge was considered unsafe. Of the 19 subjects undertaking the 'gold standard' test of a double-blind, placebo-controlled, food challenge, all six subjects with a SPT of at least 6 mm had a positive challenge and all three subjects with a SPT of 0 mm had a negative challenge. In the remaining 10 (53%) subjects, where SPT was between 1 and 5 mm and serum-specific IgE was less than 3.5 kU/L, an oral challenge was performed resulting in three positive and seven negative challenges. CONCLUSION: A combination of history, SPT and serum-specific IgE was adequate in achieving a diagnosis in the majority (77%) patients with suspected Brazil nut allergy. However, a doubtful history with SPT between 1 and 5 mm, or a serum-specific IgE less than 3.5 kU/L may require an oral challenge to help determine the risk of a Brazil nut allergic reaction.

Administration, Oral↗

PubMed2007

Contamination of pine nuts by fumonisin produced by strains of Fusarium proliferatum isolated from Pinus pinea.

AIMS: To test the ability of Fusarium proliferatum strains isolated from Pinus pinea to synthesize fumonisin B(1) (FB(1)) in pine nuts. METHOD AND RESULTS: Eleven strains were inoculated in moist sterile shelled pine nuts and whole pine nuts, and incubated for 28 days. Moist sterile maize was inoculated in parallel as an optimum substrate for FB(1) production by Fusarium species. CONCLUSIONS: Six of the strains produced FB(1) in shelled pine nuts, and two of them did so in whole pine nuts. IMPACT AND SIGNIFICANCE OF THE STUDY: F. proliferatum is able to grow and produce FB(1) in the husk of pine nuts and the mycotoxin can be found in the nut once shelled. Consequently, FB(1) may be an important hazard in pine nuts.

Food Contamination↗

PubMed2004

[Nutrient content and health effects of nuts].

Nuts are foods with a high energy density, due in part to its small water content. They also present a low saturated fat content (<7%) but a high unsaturated fat contribution (40-60%). They represent one of the richest sources of dietary fiber, which is basically of the insoluble type. The effects of nut intake on health have been widely studied. Several prospective epidemiological studies performed on large cohorts have consistently shown that regular consumption of small amounts of nuts is negatively related to the risk of cardiovascular disease and to the risk of cardiovascular or all-cause mortality. From these studies can be concluded that regular consumption of small amounts of nuts leads to a 30-50% reduction in the risk of cardiovascular disease. Additionally, intervention studies have shown a positive effect of nut intake on lipid profile with significant reductions in total and LDL cholesterol levels and small or null effects on the HDL fraction. More recently, some studies have focused on the effect of nuts on body weight. At present, no evidences support a detrimental effect of nut consumption on body weight. On the contrary some weight loss studies suggest a beneficial effect of nut intake on body weight regulation.

Body Mass Index↗

PubMed1998

Allergy to pine nuts in children.

BACKGROUND: Allergy to nuts is a common and well-known disease. Despite the fact that pine nut is a widely eaten food, only nine cases have been described in literature. OBJECTIVE: To describe four paediatric patients suffering from allergy reaction on ingestion of pine nuts and compare them with cases described in literature, taking into account clinical symptoms, epidemiological and diagnostic methods. METHODS: The immuno-allergic study was carried out with skin tests (prick tests) using a commercial and native extract, and specific IgE serum test. An oral provocation test was performed in one case. RESULTS: Ages ranged from 12 months to 6 years. All patients had a personal history of atopy. Symptoms on ingesting pine nut were severe systemic reactions in three cases. Two of the children had allergic reactions to other nuts. In all cases, both the skin test and the specific IgE serum test were positive. The oral provocation was positive in the case for which it was performed. CONCLUSIONS: A typical clinical reaction of immediate hypersensitivity to this nut took place in all four children. The skin tests and in vitro studies confirm an IgE-mediated response. We currently have a commercial prick test for pine nut for the diagnosis, which has proven its sensitivity and specificity. In our region, due to the large consumption, the rate of allergic reactions to pine nuts would probably be greater and earlier on in life than in other areas.

Allergens↗

PubMed2026

Acute and chronic effects of mixed nuts on energy metabolism in women at cardiometabolic risk: a randomized clinical trial.

BACKGROUND AND AIMS: The effect of consuming a mix of Brazilian nuts on energy metabolism has not been explored. Thus, the present study aimed to evaluate the effects of acute and chronic consumption of mixed nuts on markers of energy metabolism in women with overweight/obesity. METHODS AND RESULTS: This is a randomized, controlled, and parallel clinical trial with adult women. In an acute study, participants received a beverage containing mixed nuts (30 g of cashew nuts + 15 g of Brazil nuts) or a control beverage, and energy metabolism markers were assessed for up to 3 h postprandially. For the chronic study, participants received 45 g of a mix of nuts/day and a -500kcal energy-restricted diet (MNG) or only a -500kcal energy-restricted diet free of nuts (CTG) for 8 weeks, and energy metabolism was assessed before and after the intervention period. In the postprandial period, fat oxidation was higher in the MNG than in the CTG (piAUC: 47.53 ± 5.78 mg/min vs. 27.93 ± 6.98 mg/min; p = 0.048). After 8 weeks of the intervention, fasting fat oxidation increased in the MNG (+16.0 ± 7.0 mg/min) and decreased in the CTG (-5.0 ± 6.0 mg/min), with no significant difference between groups. Other acute and chronic markers also showed no significant changes between groups. CONCLUSION: The acute consumption of mixed nuts increased postprandial fat oxidation, whereas chronic intake within an energy-restricted diet did not affect energy metabolism markers in women at cardiometabolic risk. REGISTRATION NUMBER FOR BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-3ntxrm.

Humans↗

PubMed2006

Betel nut chewing and other risk factors associated with obesity among Taiwanese male adults.

OBJECTIVE: The research aimed at examining betel nut chewing and other risk factors associated with obesity among Taiwanese male adults. DESIGN: The research analyzed the data obtained by the 2001 National Health Interview Survey in Taiwan that covered all the administrative divisions in Taiwan. Multistage stratified systematic sampling design was adopted for survey. All members of a sampled household received the interview. SUBJECTS: The research analyzed questionnaires answered by nonaboriginal male respondents aged between 20 and 59 years old, and the total number of samples analyzed read 6126. Since very few female subjects chewed betel nut, they were excluded from the analysis. MEASUREMENTS: Criteria of obesity was defined as body mass index > or = 27 kg/m2. The variables incorporated for analysis included the respondents' status of betel nut chewing, age, educational background, presence of hypertension and diabetes mellitus, drinking and smoking status, exercise status, and demand for physical strength at job. Generalized estimating equations model was employed to estimate the odd ratios (with 95% CI) of obesity of each independent variable. RESULTS: Approximately 16.2% of respondents were obese. The distribution of betel nut chewing was current chewers 15.9%, ex-chewers 4.3%, and nonchewers 79.8%. After controlling above-mentioned independent variables, hypertension, diabetes mellitus, betel nut chewing, never exercising, and sedentary jobs were closely associated with obesity. CONCLUSION: The research found that betel nut chewing closely associated with obesity. The increased appetite of betel nut chewers is speculated as the underlying cause. The prospective study is needed to clarify this issue. In addition to increasing the risk of developing oral cancer, betel nut chewing seemed to be related with another health hazard: obesity.

Adult↗

PubMed1987

Tumorigenicity study in Syrian hamsters fed areca nut together with nitrite.

In order to evaluate the effect of concurrent administration of areca nut and sodium nitrite, a long-term feeding study was conducted with 120 Syrian hamsters. The animals were divided into four treatment groups, each consisting of 15 males and 15 females, and received 2 g/kg diet of sodium nitrite (group I), 20 g/kg diet of powdered areca nut (group II), 2 g/kg diet of sodium nitrite plus 20 g/kg diet of areca nut (group III) or powdered diet only (group IV) throughout their lifetime. Urine samples from all groups were analysed for N-nitrosonipecotic acid (NNIP), a major urinary metabolite of areca-nut-derived nitrosamines. NNIP was only detected in the urine of hamsters fed nitrite plus areca nut (concentration: 1.9 +/- 0.9 ng/ml urine), indicating that areca nut alkaloids underwent in vivo nitrosation to form areca-nut-specific nitrosamines. The total tumour response was not significantly elevated in groups II and III. Hamsters of group III had a markedly, but also insignificantly higher frequency of malignant tumours than those of the other groups, with a statistically significant increase in malignant lymphomas in the males. Although limited by the low number of animals per group, these results indicate that exposure to nitrite together with areca nut constituents appears to enhance the risk of developing malignancies.

Animals↗

PubMed1998

Anterior vertebral body screw pullout testing. A comparison of Zeilke, Kaneda, Universal Spine System, and Universal Spine System with pullout-resistant nut.

STUDY DESIGN: A biomechanical study of pullout of anteriorly implanted screws in cadaveric vertebral bodies. OBJECTIVES: To investigate and compare the pullout strength of the Zielke, Kaneda, Universal Spine System (USS) pedicle screw, and USS pedicle screw with a new pullout-resistant nut. SUMMARY OF BACKGROUND DATA: A common problem with anterior purchase regardless of the implant system is screw pullout at the proximal and distal ends of multilevel constructs. There is limited information on a solution to this problem. METHODS: The L1 to L4 vertebral bodies from four cadavers had one each of Zielke and Kaneda pedicle screws (Acromed Corp., Cleveland, OH), USS pedicle screw (Synthes Spine, Paoli, PA), and USS pedicle screw with pullout-resistant nut implanted transversely across the center of the vertebral body with bicortical purchase in a similar fashion as would be used clinically. The screws were extracted using a servohydraulic material testing system. The maximum axial forces were recorded. RESULTS: The Zielke and Kaneda screws had no significant difference in mean pullout strength (P = 0.542). The USS screw alone was less strong (P = 0.009). The USS screw and pullout-resistant nut increased the pullout strength by twofold (P = 0.00006). In the screw pullout tests, the mode of failure was at the screw thread's interface. The USS screw and pullout-resistant nut failed by imploding the body around the nut. With the USS screw and pullout-resistant nut, the pullout strength was determined by the compressive strength of the bone. CONCLUSIONS: The addition of a pullout-resistant nut to an anterior vertebral body screw improves the pullout strength by twofold and changes the mode of failure to rely ultimately on the inherent vertebral body strength rather than the screw's characteristics. The addition of a pullout-resistant nut may be applicable to multilevel implant constructs to prevent screw pullout at the top and bottom.

Biomechanical Phenomena↗

PubMed1976

Areca nut: a review.

Areca cattechu Linn is commonly known as areca nut or betel nut. It is a very widely cultivated plant in eastern countries like India, Bangladesh, Ceylon, Malaya, the Philippines and Japan. The importance of this nut is due to its use for chewing purposes. It had an important place as a pharmaceutical in Ayurveda--the ancient Indian system of medicine--also in the Chinese medicinal practices. The pharmaceutical importance of areca nut is due to the presence of an alkaloid, arecoline. Synthetic arecoline hydrobromide is also shown to possess numerous pharmacological properties. Chewing of "betel quid" or areca nut is a typical oriental habit. Betel quid comprises betel leaf, areca nut, catechu, lime and sometimes also tobacco. It is shown that there exists a correlationship between betel quid or areca nut chewing habit and oral cancer. A number of investigators have been able to produce cellular changes such as leukoplakia by application of betel quid or areca nut extract to the buccal mucosa of different animal.

Alkaloids↗