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Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study

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Abstract

Purpose

There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years.

Methods

This study includes 373,293 men and women, 25–70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI).

Results

On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (−0.07 kg; 95% CI −0.12 to −0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92–0.98) or obese (RR 0.95; 95% CI 0.90–0.99) (both P trend <0.008).

Conclusions

Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.

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Acknowledgements

This publication arises from the project PANACEA, which has received funding from the European Union, in the framework of the Public Health Programme (Project Number: 2005328). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), PI13/00061 to Granada; PI13/01162 to EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom). The current study was financially supported by Loma Linda University (LLU Contract No. 2150183). JS received funding from the INC International Nut and Dried Fruit Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France

    Heinz Freisling & Hwayoung Noh

  2. Nutritional Epidemiology Group, Section of Nutrition and Metabolism, International Agency for Research On Cancer (IARC-WHO), Lyon, France

    Nadia Slimani, Véronique Chajès, Mazda Jenab & Isabelle Romieu

  3. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands

    Anne M. May & Petra H. Peeters

  4. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK

    Petra H. Peeters, Amanda J. Cross, Konstantinos K. Tsilidis, Dagfinn Aune, Heather Ward & H. Bas Bueno-de-Mesquita

  5. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway

    Elisabete Weiderpass, Guri Skeie & Tonje Braaten

  6. Department of Research, Cancer Registry of Norway, Oslo, Norway

    Elisabete Weiderpass

  7. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Elisabete Weiderpass

  8. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland

    Elisabete Weiderpass

  9. Inserm U1018, Gustave Roussy Institute, CESP, Villejuif, France

    Francesca R. Mancini, Marie-Christine Boutron-Ruault & Guy Fagherazzi

  10. University Paris-Saclay, University Paris-Sud, Villejuif, France

    Francesca R. Mancini, Marie-Christine Boutron-Ruault & Guy Fagherazzi

  11. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Verena A. Katzke & Tilman Kühn

  12. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    Annika Steffen & Heiner Boeing

  13. Danish Cancer Society Research Center, Copenhagen, Denmark

    Anne Tjønneland & Cecilie Kyrø

  14. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark

    Camilla P. Hansen & Kim Overvad

  15. Unit of Nutrition and Cancer, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain

    Eric J. Duell

  16. Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain

    Daniel Redondo-Sánchez

  17. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Daniel Redondo-Sánchez, Pilar Amiano, Carmen Navarro & Aurelio Barricarte

  18. Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain

    Pilar Amiano

  19. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain

    Carmen Navarro

  20. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain

    Carmen Navarro

  21. Navarra Public Health Institute, Pamplona, Spain

    Aurelio Barricarte

  22. Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain

    Aurelio Barricarte

  23. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

    Aurora Perez-Cornago

  24. Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece

    Konstantinos K. Tsilidis

  25. Bjørknes University College, Oslo, Norway

    Dagfinn Aune

  26. Hellenic Health Foundation, Athens, Greece

    Antonia Trichopoulou, Androniki Naska & Philippos Orfanos

  27. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Antonia Trichopoulou, Androniki Naska & Philippos Orfanos

  28. Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute, ISPO, Florence, Italy

    Giovanna Masala

  29. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Claudia Agnoli & Franco Berrino

  30. Cancer Registry and Histopathology Unit, “Civic-M.P.Arezzo” Hospital, ASP Ragusa, Ragusa, Italy

    Rosario Tumino

  31. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy

    Carlotta Sacerdote

  32. Dipartimento di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy

    Amalia Mattiello

  33. Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H. Bas Bueno-de-Mesquita

  34. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    H. Bas Bueno-de-Mesquita

  35. Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

    Ulrika Ericson & Emily Sonestedt

  36. Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Anna Winkvist

  37. Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, USA

    Joan Sabaté

Authors
  1. Heinz Freisling
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  2. Hwayoung Noh
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  3. Nadia Slimani
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  4. Véronique Chajès
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  5. Anne M. May
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  6. Petra H. Peeters
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  7. Elisabete Weiderpass
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  8. Amanda J. Cross
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  9. Guri Skeie
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  10. Mazda Jenab
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  11. Francesca R. Mancini
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  12. Marie-Christine Boutron-Ruault
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  13. Guy Fagherazzi
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  14. Verena A. Katzke
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  15. Tilman Kühn
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  16. Annika Steffen
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  17. Heiner Boeing
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  18. Anne Tjønneland
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  19. Cecilie Kyrø
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  20. Camilla P. Hansen
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  21. Kim Overvad
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  22. Eric J. Duell
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  23. Daniel Redondo-Sánchez
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  24. Pilar Amiano
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  25. Carmen Navarro
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  26. Aurelio Barricarte
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  27. Aurora Perez-Cornago
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  28. Konstantinos K. Tsilidis
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  29. Dagfinn Aune
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  30. Heather Ward
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  31. Antonia Trichopoulou
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  32. Androniki Naska
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  33. Philippos Orfanos
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  34. Giovanna Masala
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  35. Claudia Agnoli
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  36. Franco Berrino
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  37. Rosario Tumino
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  38. Carlotta Sacerdote
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  39. Amalia Mattiello
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  40. H. Bas Bueno-de-Mesquita
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  41. Ulrika Ericson
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  42. Emily Sonestedt
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  43. Anna Winkvist
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  44. Tonje Braaten
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  45. Isabelle Romieu
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  46. Joan Sabaté
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Contributions

We thank all EPIC participants and staff for their contribution to the study. For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php.

Corresponding author

Correspondence to Heinz Freisling.

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Ethical standards

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and obtained ethical approval from participating centres and IARC ethics committees. Informed consent was given by all study participants.

Conflict of interest

The authors declare that they have no conflict of interest.

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Freisling, H., Noh, H., Slimani, N. et al. Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study. Eur J Nutr 57, 2399–2408 (2018). https://doi.org/10.1007/s00394-017-1513-0

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