Nut Intake Is Associated with Lower Odds of Metabolic Syndrome in Adolescents

Program: Abstracts - Orals, Poster Previews, and Posters
Session: FRI 144-166-Pediatric Diabetes, Obesity & Metabolic Disorders
Friday, March 6, 2015: 1:00 PM-3:00 PM
Hall D-F, Pediatric Endocrinology (San Diego Convention Center)

Poster Board FRI-146
Roy Kim, MD, MPH1 and David Leonard, PhD2
1UT Southwestern Medical Center, Dallas, TX, 2Children's Medical Center, Dallas, TX

In adolescents, metabolic syndrome is associated with inflammation and an unfavorable cardiovascular risk profile. Promotion of a healthy diet is a management mainstay. Intake of nuts (tree nuts and peanuts) lowers the risk of cardiovascular morbidity in adults. Whether a relationship between nut intake and cardiovascular risk factors is present during adolescence is not known.


To examine the association between nut intake and prevalence of metabolic syndrome in US adolescents, and determine if this relationship varies by gender or race/ethnicity.


This is a cross sectional analysis of a national sample of adolescents. We used data from the National Health and Nutrition Examination Survey (NHANES), years 2003-2010. Data from 24-hour diet recall surveys, fasting blood tests, and anthropometric measurements were retrieved from NHANES participants, age 12 to 19 years (n=2,233). A threshold of 12.9 grams of nut intake per day was used to define significant nut intake, based on clinical trial literature (1). Metabolic syndrome was defined according to published pediatric criteria (2). Descriptive results for nut intake in the entire cohort, and gender and race/ethnic group-specific strata were generated. Crude and adjusted odds ratios (OR) and 95% confidence intervals for metabolic syndrome were estimated using nut intake as the exposure. Regression splines were used to examine the non-linear relationships between nut intake as a continuous variable and components of the metabolic syndrome.


Average nut intake was low (4.1g/d), and the median intake during the sampling periods was zero.  Caucasians had higher nut intake than non-Hispanic blacks and Latinos (6.1 g vs 3.1 g vs 3.0 g, respectively; ANOVA p < 0.001). Only 8.9% of all subjects had nut intake of more than 12.9 grams per day. The overall prevalence of metabolic syndrome was 7.4%. Higher nut intake was associated with a lower odds ratio for metabolic syndrome compared to low intake (crude OR=0.43; 95%CI 0.20 to 0.93). Controlling for age, gender, race/ethnic category, and household income resulted in an adjusted OR of 0.43 (95%CI 0.20 to 0.92).

In a regression model that included a term for total calories and a spline to capture nonlinear effects of continuous nut intake, each g/day of nut intake above zero was associated with lower odds of metabolic syndrome up to an intake of approximately 50g/d at which point the odds rose above 1. Nut consumption was directly associated with high density lipoprotein cholesterol (0.04 mg/dL/(g/d), p=0.032).


Modest intake of nuts was associated with a lower odds for having the metabolic syndrome in this cohort of adolescents.

1. Estruch et al. New Engl J Med 2013 Feb 25; 368(14): 1279-90 2. Li et al. J Peds 2011 Feb; 158(2): 201-7

Nothing to Disclose: RK, DL

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