Christine M. Albert, Brigham and Women's Hosp, Boston, MA; Walter C. Willet, Harvard Univ., Boston, MA; JoAnn E. Mason, Brigham and Women's Hosp, Boston, MA; Charles H. Hennekens, Brigham and Women's Hosp, Harvard Med Sch., Boston, MA

Higher intakes of alpha-linolenic acid (an n-3 fatty acid0 have been associated with reduced risks of cardiac death, but epidemiological data are sparse. Some nuts are a source of alpha-linolenic acid and have been associated with a reduced risk of CHD death in one prospective study. Since n-3 fatty acids may have antiarrhythmic properties, nut consumption may reduce the risk of cardiac death, at least, in part by decreasing the risk of sudden death. To test this hypothesis, we examined the relationship of nut consumption with sudden and total cardiac death in the Physicians Health Study, a 12-year prospective study involving 22,071 US male physicians. Participants who completed a diet questionnaire one year after enrollment were included in the analysis. Over 11 years, there were 449 cardiac deaths, of which 133 were documented as sudden deaths, defined as death or cardiac arrest within one hour of symptom onset. As nut consumption increased, the risk of total cardiac death and sudden death decreased in a linear fashion. After adjusting for age and treatment assignment, there was a significant inverse association between the consumed quantity of nuts and the risk of cardiac death (P for trend, .003) and sudden death (P for trend, .046).

After adjusting for age and treatment assignment, there was a significant inverse association between the consumed quantity of nuts and the risk of cardiac death (P for trend, .003) and sudden death (P for trend, .046). After further adjustment for multiple potential confounders including vigorous exertion, hypertension, cholesterol, smoking, diabetes, alcohol use and other dietary habits including fish consumption, the linear relationship persisted for total cardiac (P for trend, .016) and for sudden death (P for trend, .066). Conclusion: These prospective data in US male physicians suggest that nut consumption is associated with a reduced risk of total and sudden cardiac death.

Abstract presented at the American Heart Association Conference, November 9-11, 1998.

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