
Nut consumption reduces risk of death - pg
http://news.harvard.edu/gazette/story/2013/11/eating-nuts-reduces-risk-of-death/
======
wjnc
Socio-economic status was not used as a covariate in this study. They report
that this issue is smaller than in other studies because only health-
professionals were in the study. Well at least for the economic part, there
are pretty huge disparities within healthcare.

And then my other remark. In the appendix. Table S4: most of the confidence
intervals overlap all the way from the 'no nuts'-group to the 'daily
nuts'-group. I know you shouldn't focus overly on those intervals. But those
splines don't look that convincing to me.

So considering you have a measured effect that is not that clear, where you
really expect the "true" effect to be orders smaller than the reported 20%
reduction in mortality, without proper controls in the studies for one of the
largest effects (higher income >> longer life) and with lots of overlapping
confidence intervals, I wouldn't bet my nuts on this study.

~~~
spodek
As much as I love the findings since I replaced nearly all my junk food with
eating nuts I get at the bulk food store near me, you don't have to look into
any detail to challenge the report. The funding would seem to indicate bias.
From the article: " _The study was supported by National Institutes of Health
and a research grant from the International Tree Nut Council Nutrition
Research & Education Foundation._"

That said, if you eat chips, pretzels, candy and such and want to cut down,
nuts work great. You can get them bulk online if no stores near you have them.
At first they don't have the intense flavors and crunch of typical junk, but
the more you eat them the more you find the subtleties in their flavors and
textures, much richer and complex than chips and candy.
[http://joshuaspodek.com/variety-choice-manufactured-
illusion](http://joshuaspodek.com/variety-choice-manufactured-illusion)

This fall I noticed the nuts I normally got tasted a lot more flavorful. I
checked and it turns out nuts are seasonal, so they'll taste different at
different times of the year, depending on where you source them. I should have
known that, but I enjoyed learning it by noticing the taste. I wouldn't have
noticed such subtlety without stopping eating junk food and I find catching
those subtle complexities more pleasing than the intensities of junk food.

I throw a bunch on my oatmeal with chopped fruit and chia seeds for a great
breakfast that takes less than a minute to prepare.
[http://joshuaspodek.com/fitness-beliefs-habits-
part-2](http://joshuaspodek.com/fitness-beliefs-habits-part-2)

The mix I get has cashews, almonds, hazelnuts, brazil nuts, and pecans. So
much better than pretzels, chips, or candy.

The pecans I don't put in the cereal or eat with the rest. They taste so much
better to me. I eat them one at a time so I can savor them specially.

------
jey
Has a causal relationship been demonstrated from nuts to health, or is this
only a correlation? Couldn't it be that health-conscious people are healthier
on average, and they usually choose to snack on nuts instead of snacking on
something unhealthy?

The line "individuals who ate more nuts were leaner, less likely to smoke, and
more likely to exercise, use multivitamin supplements, consume more fruits and
vegetables, and drink more alcohol" further reinforces my belief that there's
just a confounder here, e.g. maybe being affluent and educated explains all of
those. (Yes, including alcohol consumption:
[http://blogs.discovermagazine.com/gnxp/2010/05/people-of-
cla...](http://blogs.discovermagazine.com/gnxp/2010/05/people-of-class-drink-
alcohol/))

~~~
mikehotel
_Reverse causality is another possible explanation for our findings, because
people with chronic disease and poor health might abstain from nut
consumption. However, we excluded participants with a history of cancer, heart
disease, or stroke at baseline, and we suspended further updating of all
dietary variables when participants reported a diagnosis of stroke, heart
disease, angina, or cancer. Moreover, the results remained significant when we
excluded the first 2 years of follow-up and added a 2-year lag period between
nut-intake assessment and each follow-up period._

 _Indeed, clinical trials have shown that nut consumption has beneficial
effects on some intermediate markers of chronic diseases, such as high
cholesterol levels,3 oxidation,6,7 endothelial dysfunction,13
hyperglycemia,6,10 and insulin resistance.11,12_

The above quotes from the NEJM article imply more than simple correlation, but
the conclusion of that article stops short of stating that, specifically, "
_Nonetheless, epidemiologic observations establish associations, not
causality, and not all findings from observational studies have been confirmed
in controlled, randomized clinical trials._ "

Source:
[http://www.nejm.org/doi/full/10.1056/NEJMoa1307352#t=article](http://www.nejm.org/doi/full/10.1056/NEJMoa1307352#t=article)

~~~
mtdewcmu
This study sounds like a waste of time. How you could ever follow up and prove
that nuts have all those protective effects is beyond me -- as is why you
would even think they do in the first place.

 _However, we excluded participants with a history of cancer, heart disease,
or stroke at baseline..._

Sounds like multiple regression, which is used to make insignificant
statistics sound more plausible, by reducing the effect of a handful of
confounding variables that the researchers happened to think of. That leaves
behind any significant correlations plus the infinite number of confounding
variables they didn't think of.

~~~
pyduan
I wouldn't be so categorical. Regarding assessing causality, with an
appropriate choice of instruments (food prices, tax on specific food
categories) one could use instrumental variable regression to disambiguate the
relationship. I'm not sure if this is standard practice in this field but a
quick search seems to indicate this has been done before.

As to why one would think nuts have protective effects at all -- I'm not a
nutritionist, but from what I gather nuts do seem to have some desirable
nutritional properties (high on unsaturated fats, protein and minerals), so
that assertion doesn't seem that far-fetched to me.

~~~
mtdewcmu
Observational studies like this could conceivably be useful under different
circumstances. I think the chances of distinguishing meaningful from
meaningless correlations would probably be higher if the variable being
studied wasn't as ubiquitous as eating nuts and the causes of death weren't
ordinary diseases of aging. For instance, an observational study could help
determine the risk of disease from living in a specific area that was
contaminated with a specific toxic substance. In order to make a very
convincing case that the toxin had caused the diseases, you'd want to support
it with stronger kinds of studies, that, say, demonstrated that that chemical
was capable of causing the diseases that were observed.

 _nuts do seem to have some desirable nutritional properties (high on
unsaturated fats, protein and minerals)_

The problem is that none of those other components of food have been shown to
prevent death, either, except in weak studies like this one. It's all very
circular.

------
leeoniya
Tomorrow: "Nut consumption linked to obesity and depression"

Please, just let me live and die without reading another <some food> linked to
<some health or disease> article. I don't mind stuff like "tuna shows elevated
and unsafe mercury levels", but this constant stream of weakly correlated,
never conclusive, always contradictory shit is mind numbing.

I don't understand why this is on HN front page...and getting upvotes!

[EDIT] ah, pg posted this.

~~~
kalleboo
I think it was when I read that eggs will both kill you and prolong your life
in the same day in two different newspapers that I stopped reading any "food
health" articles. You can find contradictory articles for each and every
claim, often based upon the same study!

~~~
pantalaimon
But did you not take into account that they might prolong your life and _then_
kill you?

------
ekianjo
The title is a joke, again. _" Nuts consumption reduces risk of death"_
hinting at direct causation, and later in the article _" The authors noted
that this large study cannot definitively prove cause and effect"_. Can
journalists stop linkbait titles ?

~~~
jonrimmer
Maybe some do, but their articles don't get popular on Hacker News and other
aggregators, for some reason :-P

------
jbert
It's interesting that the population seems to be very critical of any food-
health articles, presumably from over-saturation of poor science reporting.
(Best example of this I know of - [http://kill-or-
cure.herokuapp.com/](http://kill-or-cure.herokuapp.com/) \- a study of things
the UK's "Daily Mail" "newspaper" has claimed cause or cure cancer, many are
in both categories).

But it is also clear that what and how we eat has a significant effect on our
health, which is interesting and relevant to us.

How to sort the wheat from the chaff?

A "truth database" or factchecking site might be pretty useful. Or would it
just boil down to "eat your vegetables and do a bit of exercise"?

~~~
eurg
Don't forget: Eat not too much, and not too little. Sulfuric acid is not
healthy.

Yes, it's mostly that. When I started reading around in preparation of living
vegan, I was slightly surprised how well people can live from different diets.
From almost pure meat-based, to pure plant-based, much fat, little fat, one
meal a day, five meals a day, much carbs, few carbs...

It seems that the modern US-European food-style is one of the few diets which
mixed and matched together stuff in a really bad way.

------
mikehotel
Thanks for posting! The article from NEJM is at
[http://www.nejm.org/doi/full/10.1056/NEJMoa1307352#t=article](http://www.nejm.org/doi/full/10.1056/NEJMoa1307352#t=article).
I didn't see a direct link to it in the Harvard Gazette news story.

------
recursify
"Risk of Death"... pretty sure it's still 100% :)

~~~
mertd
Instead of being snarky, you could have read the first sentence, which gives
the time interval of the mortality risk.

~~~
recursify
It was a joke. I did read the article.

------
clumsysmurf
"Because we lacked data on how nuts were prepared (e.g., salted, spiced,
roasted, or raw), we were unable to examine the influence of preparation
method on mortality."

Acrylamide forms on almonds when they are roasted ... not sure about other
nuts. Its probably a safer bet that raw nuts are healthiest.

~~~
smackay
Maybe, maybe not...

[https://en.wikipedia.org/wiki/Aflatoxin](https://en.wikipedia.org/wiki/Aflatoxin)

[http://www.foodproductiondaily.com/Processing/Extrusion-
cook...](http://www.foodproductiondaily.com/Processing/Extrusion-cooking-may-
lower-aflatoxins-in-peanuts)

The real issue with advice on foods is that it requires a great deal of
judgement. Definitive statements that are actionable are relatively rare, and
even then with a few years more research the advice can be turned completely
on it's head, low-fat diets being the canonical example.

------
adventured
I always wonder how much substitution benefit plays into studies of this sort.
That is, does just not eating really unhealthy foods get you 85% of the way
there (with little doubt that the healthy fat in eg almonds, and the protein
benefit, add positive value).

------
thepoet
Although this study was done on US population, nuts are costly here in India
so a large section of population cannot afford to eat it on a regular basis.
Could it be remotely possible that poverty lead to diseases, improper or no
treatments, more accidents etc. lower life expectancy rather than "not eating
enough nuts".

Mr. Gates would surely start a Nuts for India campaign to increase life
expectancy.

~~~
johnpowell
Nuts are expensive in the USA too. The same goes for anything grown here that
isn't frozen.

I can get a big pizza from the freezer for six bucks. It is double that for
individual ingredients to make a salad. And we wonder why healthcare costs are
absurd.

~~~
_delirium
Peanuts are dirt-cheap in the U.S., one of the cheapest sources of calories
and protein (they're not a proper nut, but included in this study anyway).

~~~
memracom
According to Joel Fuhrman, MD, it is not nuts that are healthy, but seeds that
are eaten raw. This includes things like sunflower, sesame and chia seeds.
Peanuts is a bit different because it is a legume, but Fuhrman does include
beans and lentils on his healthy list.

He even promotes healthy eating using the acronym GOMBBS: Greens, Onions,
Mushrooms, Berries, Beans, and Seeds which you should eat every day.

But roasted peanuts, like any roasted nuts, have acrylamides which are bad.
Better to boil the raw peanuts in a stew.

------
pawelkomarnicki
Eating nuts people have no time to do stupid things, simple ;)

------
jgeerts
I'm allergic to nuts, either way I'm screwed.

------
code_duck
Mmm... Haha. Not for me. I'm allergic to all the tree nuts they list.

------
bobowzki
Risk of death still 100%

------
LearnYouALisp
Studies show that consumption of air prevents death. As long as you are
consuming air, you will be alive.

~~~
mtdewcmu
Maybe they're comparing eating nuts with eating nothing. I would not doubt
that nuts reduce risk of death under those circumstances.

------
ck2
correlation != causation

[http://en.wikipedia.org/wiki/Correlation_does_not_imply_caus...](http://en.wikipedia.org/wiki/Correlation_does_not_imply_causation)

------
tarekmoz
This is nuts!

------
jhuckestein
In other words, the amount of nuts you eat correlates highly with the number
of years you're alive.

------
dschiptsov
My ass, it is nuts we all need, Harvard says so!

Tibetans who never saw a tree in a whole life must be died away long ago
without a proper nut supply.)

Yet another example of a meme-based science.

~~~
dschiptsov
OK, ok, a non-falsifiable claim (which cannot be tested) of a assumed
correlation (probably due to statistical error) instead of causation, without
a proper cross-cultural validation.

