I n the early 1990s, investigators from Loma Linda University published 2 landmark studies that placed nuts in the limelight as heart-healthy foods: the prospective Adventist Health Study (1), which for the first time related nut consumption to a reduced risk of coronary heart disease (CHD); and a randomized clinical trial (RCT) showing that a diet enriched with walnuts lowered blood cholesterol compared with a healthy control diet (2). Since then, epidemiological and clinical research on the health effects of nuts has increased exponentially, and results have supported the cardioprotective properties of nuts (3). Cohort studies have consistently shown that nut consumption relates to reduced rates of CHD, particularly fatal CHD, but evidence on stroke has been inconsistent (3–5). However, in the PREDIMED (PREvención con DIeta MEDiterránea [Prevention with Mediterranean Diet]) trial, a Mediterranean diet supplemented with 1 daily serving (30 g) of mixed nuts resulted in a 30% reduction in incident CVD, including a 46% reduction in stroke, thus providing first-level evidence of the cardiovascular benefit of nuts (6). Remarkably, cohort studies have also uncovered an inverse association between nut consumption and total cancer risk (4). Prospective studies have also provided suggestive evidence that nut consumption reduces total mortality and, in particular, cardiovascular and cancer mortality (4,5,7,8). Residual confounding is possible because

中文翻译：

---

吃坚果，活得更久*

1990 年代初期，罗马琳达大学的研究人员发表了 2 项里程碑式的研究，将坚果作为有益心脏健康的食物置于聚光灯下：前瞻性复临信徒健康研究 (1)，首次将食用坚果与降低冠心病风险相关联。心脏病 (CHD); 和一项随机临床试验 (RCT) 表明，与健康对照饮食相比，富含核桃的饮食可降低血液胆固醇 (2)。从那时起，关于坚果健康影响的流行病学和临床研究呈指数级增长，结果支持坚果的心脏保护特性 (3)。队列研究一致表明，食用坚果与降低 CHD 发病率有关，尤其是致命性 CHD，但关于中风的证据并不一致 (3-5)。然而，在 PREDIMED (PREvención con DIeta MEDiterránea [预防地中海饮食]) 试验中，地中海饮食辅以每日 1 份（30 克）混合坚果，可将 CVD 发生率降低 30%，包括中风降低 46%，因此提供了坚果对心血管有益的一级证据 (6)。值得注意的是，队列研究还发现了坚果消费与总癌症风险之间的负相关关系 (4)。前瞻性研究还提供了暗示性证据，表明食用坚果可降低总死亡率，尤其是心血管和癌症死亡率 (4,5,7,8)。残留混杂是可能的，因为 因此提供了坚果对心血管有益的一级证据 (6)。值得注意的是，队列研究还发现了坚果消费与总癌症风险之间的负相关关系 (4)。前瞻性研究还提供了暗示性证据，表明食用坚果可降低总死亡率，尤其是心血管和癌症死亡率 (4,5,7,8)。残留混杂是可能的，因为 因此提供了坚果对心血管有益的一级证据 (6)。值得注意的是，队列研究还发现了坚果消费与总癌症风险之间的负相关关系 (4)。前瞻性研究还提供了暗示性证据，表明食用坚果可降低总死亡率，尤其是心血管和癌症死亡率 (4,5,7,8)。残留混杂是可能的，因为