Long-term consumption of nuts (including peanuts, peanut butter, walnuts, and other nuts) in relation to the risk of frailty in older women: evidence from a cohort study

Year Published: 2023


J Nutr


RuibinWangM.H.S, Ph.D.aMarian T.HannanD.Sc., M.P.H.abMolinWangPh.D.acdAndrea W.SchwartzM.D., M.P.H.aefgEstherLopez-GarciaPh.D, M.P.H., MPharmhijFrancineGrodsteinSc.D.k


Objective To evaluate the association between nut consumption and frailty in an aging female population. Methods This population-based observational study included non-frail women (≥60 years old) in the Nurses’ Health Study from eleven states of the United States. Outcome was incident frailty, defined as having ≥3 of the FRAIL components (fatigue, lower strength, reduced aerobic capacity, multiple chronic conditions, significant weight loss) and assessed every four years from 1992 to 2016. From 1990 to 2014, food frequency questionnaires were used to assess the intakes of peanuts, peanut butter, walnuts (added in 1998) and other nuts at four-year intervals. Exposure was total nut consumption, calculated as the sum of intakes of peanuts, peanut butter, walnuts and other nuts and categorized into <1 serving/mo, 1-3 servings/mo, 1 serving/wk, 2-4 servings/wk and ≥5 servings/wk. The relations of intakes of peanuts, peanut butter, and walnuts with frailty were also investigated separately. Cox proportional hazards models were used to assess the associations between nut consumption and frailty after adjusting for age, smoking, body mass index, energy intake, diet quality and medication use.

Key Findings

Key Findings: Results Among 71,704 participants, 14,195 incident frailty cases occurred over 1,165,290 person-years. The adjusted hazard ratio (95% confidence interval) for consuming ≥5 servings/wk of nuts was 0.80 (0.73, 0.87), as compared to <1 serving/mo. Higher intakes of peanuts and walnuts, but not peanut butter, were also inversely associated with frailty. Conclusions This large prospective cohort study showed a strong and consistent inverse association between regular nut consumption and incident frailty. This suggests that nut consumption should be further tested as a convenient public health intervention for the preservation of health and well-being in older adults.