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Risks and Benefits of Increased Nut Consumption: Cardiovascular Health Benefits Outweigh the Burden of Carcinogenic Effects Attributed to Aflatoxin B1 Exposure
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
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2017 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, no 12, article id 1355Article in journal (Refereed) Published
Abstract [en]

Nuts are rich in nutrients and mounting evidence shows that consumption reduces cardiovascular disease (CVD) incidence. Nuts may also be a major source of aflatoxin B₁, a potent liver carcinogen and the risk/benefit balance is unknown. Based on national statistics and data from the PREDIMED intervention trial, we estimated the potential CVD-reduction if Swedes aged 55-79 consumed 30 g nuts/day, instead of the current national average of five grams per day. We also assessed the reduction in disability-adjusted life years (DALYs) due to myocardial infarction (MI) and stroke. We estimated the aflatoxin B₁ exposure from nuts and calculated the margin of exposure. The approximation that one nanogram aflatoxin B₁/kg body weight/day results in one additional liver cancer case/10 million person-years was used to estimate the number of liver cancer cases. The increased nut consumption scenario prevented more than 7000 CVDs in 2013 (306/100,000 person-years) and contributed to about 55,000 saved DALYs for stroke and 22,000 for MI. The concomitant increase in aflatoxin B₁ exposure caused an estimated zero to three additional cases of liver cancer, corresponding to 159 DALYs spent, emphasizing the associated risks. Increased nut consumption, as part of a varied healthy diet, is warranted even when aflatoxin B₁ exposure is taken into account. However, efforts to reduce aflatoxin exposure from food are essential.

Place, publisher, year, edition, pages
2017. Vol. 9, no 12, article id 1355
Keyword [en]
nuts, healthy diet, risk-and benefit assessment, cardiovascular disease, myocardial infarction, stroke, aflatoxin, liver cancer, disability-adjusted life years
National Category
Occupational Health and Environmental Health Nutrition and Dietetics
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URN: urn:nbn:se:umu:diva-142975DOI: 10.3390/nu9121355ISI: 000419188600080PubMedID: 29236075OAI: oai:DiVA.org:umu-142975DiVA, id: diva2:1165930
Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2018-02-09Bibliographically approved

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