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Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies.

Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Unit of Human Nutrition, Reus, Spain. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. Consorcio Centro de Investigaciones Biomédicas en Red, M.P (CIBERObn), Institute of Health Carlos III (ISCIII), Madrid, Spain. Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain. Department of Cellular and Molecular Endocrinology, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), Malaga, Spain. Departments of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain.

The American journal of clinical nutrition. 2021;(4):960-971
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Abstract

BACKGROUND Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results, making desirable the performance of an updated meta-analysis. OBJECTIVES We aimed to systematically review and meta-analyze all the published studies investigating the relations of total nuts and different types of nuts-i.e., walnuts, peanuts, peanut butter, and total tree nuts-with the prevalence and incidence of T2D. METHODS A systematic search was conducted in the PubMed and Cochrane databases through 12 August, 2020. The inverse variance method with fixed-effect models was used to pool data across studies, expressed as risk ratios (RRs) or ORs and 95% CIs for prospective cohort and cross-sectional studies, respectively. The Cochran Q test and I2 statistics were used to test and quantify heterogeneity, respectively. Dose-response meta-analysis was also conducted. RESULTS Eight studies (5 prospective and 3 cross-sectional) were included in the quantitative synthesis. Meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and T2D. Meta-analyses of prospective cohort studies showed an inverse association between peanut butter consumption and T2D incidence (RR: 0.87; 95% CI: 0.77, 0.98; I2 = 50.6%; Pheterogeneity = 0.16), whereas no association was observed between peanuts or tree nuts and T2D. There was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies. The certainty of the evidence using NutriGrade was very low for all the exposures. CONCLUSIONS Current results do not demonstrate an association of total nut, peanut, or tree nut consumption with T2D. Peanut butter consumption may be inversely associated with this disease.This review protocol was registered at www.crd.york.ac.uk/prospero/ as CRD42020149756.

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Publication Type : Meta-Analysis

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