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Title: Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: NHANES 1999-2004

Author
item O'NEIL, CAROL - LSU Agcenter
item KEAST, DEBRA - Food And Nutrition Database Research, Inc
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item FULGONI III, VICTOR - Nutrition Impact, Llc

Submitted to: Nutrition Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/24/2012
Publication Date: 3/24/2012
Citation: O'Neil, C.E., Keast, D.R., Nicklas, T.A., Fulgoni III, V.L. 2012. Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: NHANES 1999-2004. Nutrition Research. 32:185-194.

Interpretive Summary: Nuts provide rich sources of vegetable protein, monosaturated and polyunsaturated fatty acids, dietary fiber, vitamin E and K, folate, magnesium, copper, selenium, and potassium. Nuts are also naturally low in saturated fatty acids and sodium. The nutrient content of nuts has been shown to favorably influence health outcomes. However there are no studies using a nationally representative US population that have examined the association of nut consumption with diet quality and health risk factors. We conducted a study to determine the association of nut consumption with nutrient intake, diet quality and the prevalence of risk factors for cardiovascular disease in children and adults. The prevalence of out-of-hand nut (OOHN) consumers in the population was low; however, consumption was associated with better nutrient intake, diet quality, and health risk parameters than nonconsumers. On a population basis, these lower risk factors could lead to better health and lower long-term health care costs. Those consuming OOHN had a better diet quality than those not consuming OOHN; health professionals, especially registered dietitians, and nutrition education programs that increase awareness, health benefits, and consumption of all nuts should be designed. This study also raises the possibility that future dietary recommendations should include a separate nut category to encourage consumption.

Technical Abstract: The purpose of this study was to determine the association of out-of-hand nut (OOHN) consumption with nutrient intake, diet quality, and the prevalence of risk factors for cardiovascular disease and metabolic syndrome. Data from 24-hour recalls from individuals aged 2+ years (n = 24,385) participating in the 1999-2004 National Health and Nutrition Examination Survey were used. The population was divided into nut consumers and nonconsumers. Nut consumers were defined as those individuals consuming 0.25 oz of nuts or more per day. Means, standard errors, and covariate-adjusted analyses of variance were determined using appropriate sample weights. Diet quality was determined using the Healthy Eating Index-2005. Consumers of nuts from all age groups had higher intakes of energy, monounsaturated and polyunsaturated fatty acids, dietary fiber, copper, and magnesium, and lower intakes of carbohydrates, cholesterol, and sodium than did nonconsumers. Diet quality was higher in nut consumers than non-consumers. Adult consumers had higher high-density lipoprotein cholesterol, red blood cell folate, and serum folate levels, and lower insulin, glycohemoglobin, and C-reactive protein levels than did nonconsumers. Adult consumers also had a 19% decreased risk of hypertension and a 21% decreased risk of low high-density lipoprotein cholesterol levels. Data suggested that nut consumption was associated with improved nutrient intake, diet quality, and, in adults, a lower prevalence of two risk factors for metabolic syndrome. Consumption of nut should be encouraged by health professionals.