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A large review of nut studies found that people eating a daily handful of nuts (about 20 g) have a lower risk of heart disease, cancer, stroke, premature death, and death from respiratory disease, type 2 diabetes, and infectious disease. Truly impressive. Benefits seem to be for all nuts, and also peanuts - which are called nuts, but are actually legumes (other posts about nut consumption benefits). An earlier post discussed how some of these effects could be to nuts lowering systemic inflammation throughout the body. Bottom line: try to eat a handful of nuts every day or most days a week for your health. And make it a variety of nuts - walnuts, almonds, hazelnuts, cashews, pistachios, pecans, Brazil nuts, and peanuts. From Science Daily:

A handful of nuts a day cuts the risk of a wide range of diseases

A large analysis of current research shows that people who eat at least 20g of nuts a day have a lower risk of heart disease, cancer and other diseases. The analysis of all current studies on nut consumption and disease risk has revealed that 20g a day -- equivalent to a handful -- can cut people's risk of coronary heart disease by nearly 30 percent, their risk of cancer by 15 percent, and their risk of premature death by 22 percent. An average of at least 20g of nut consumption was also associated with a reduced risk of dying from respiratory disease by about a half, and diabetes by nearly 40 percent, although the researchers note that there is less data about these diseases in relation to nut consumption.

The study, led by researchers from Imperial College London and the Norwegian University of Science and Technology, is published in the journal BMC Medicine. The research team analysed 29 published studies from around the world that involved up to 819,000 participants, including more than 12,000 cases of coronary heart disease, 9,000 cases of stroke, 18,000 cases of cardiovascular disease and cancer, and more than 85,000 deaths. While there was some variation between the populations that were studied....the researchers found that nut consumption was associated with a reduction in disease risk across most of them.

The study included all kinds of tree nuts, such as hazel nuts and walnuts, and also peanuts -- which are actually legumes. The results were in general similar whether total nut intake, tree nuts or peanuts were analysed. What makes nuts so potentially beneficial, said Aune, is their nutritional value: "Nuts and peanuts are high in fibre, magnesium, and polyunsaturated fats -- nutrients that are beneficial for cutting cardiovascular disease risk and which can reduce cholesterol levels. "Some nuts, particularly walnuts and pecan nuts are also high in antioxidants, which can fight oxidative stress and possibly reduce cancer risk. Even though nuts are quite high in fat, they are also high in fibre and protein, and there is some evidence that suggests nuts might actually reduce your risk of obesity over time."

The study also found that if people consumed on average more than 20g of nuts per day, there was little evidence of further improvement in health outcomes. [ORIGINAL STUDY]

Another interesting study looking at whether being overweight is linked to premature death, heart attacks, and diabetes. This study looked at sets of twins, in which one is heavier than the other, and followed them long-term (average 12.4 years) and found that NO - being overweight or obese (as measured by Body Mass Index or BMI) is NOT associated with premature death or heart attack (myocardial infarction), but it is associated with higher rates of type 2 diabetes. These results are in contrast with what a large study recently found. From Science Daily:

Higher BMI not associated with increased risk of heart attack or early death, twin study shows

A study of 4,046 genetically identical twin pairs with different amounts of body fat shows that twin siblings with a higher Body Mass Index, as a measure of obesity, do not have an increased risk of heart attack or mortality. The study, conducted by researchers at Umeå University in Sweden, also shows that a higher BMI is associated with an increased risk of type 2 diabetes...."The results suggest that lifestyle changes that reduce levels of obesity do not have an effect on the risk of death and heart attack, which contradicts conventional understandings of obesity-related health risks," says Peter Nordström, researcher at the Department of Community Medicine and Rehabilitation at Umeå University.

In the cohort study, Peter Nordström and research colleagues at Umeå University compared health data from 4,046 monozygotic twin pairs. All twins in the study had different levels of body fat, as measured in BMI....During a follow-up period of on average 12.4 years, differences between the twins were compared when it comes to incidents of mortality, heart attack and type 2 diabetes. The results clearly showed that twin siblings with a higher BMI did not have an increased risk of mortality or heart attack compared to their thinner counterparts. However, twins with a higher BMI did have an increased risk of developing type 2 diabetes.

The results showed that: - Among twin siblings with a higher BMI (mean value 25.1), there were 203 heart attacks (5 %) and 550 deaths (13.6 %) during the follow-up period. - Among twin siblings with a lower BMI (mean value 23.9), there were 209 heart attacks (5.2 %) and 633 deaths (15.6 %) during the same period. - Among the 65 twin pairs in the study who had a BMI difference of 7 or higher, and where the larger twin siblings had a BMI of 30 or higher, there were still no noticeably increased risk of mortality or heart attack associated with a higher BMI.

The study, described in the article Risks of Myocardinal Infarction, Death, and Diabetes in Identical Twin Pairs With Different Body Mass Index, is based on the Swedish Twin Registry, the largest of its kind in the world. The median age of the twins in the study was 57.5 and participants' ages ranged from 42-92. The cohort study was conducted between 1998 and 2003, with follow-ups regarding incident of mortality, heart attack and diabetes during a 10 year period until 2013. One study limitation was that weight and length (used to calculate BMI) was self-reported.

Yup, according to a new mega-study, being overweight or obese is linked to higher risk of dying prematurely than being normal weight.  And the more you weigh, the greater the risk. This mega-study that looked at data from many studies and countries, also found that being underweight is linked to a higher risk of premature death. What's the best weight to be? A BMI of 22.5-<25 kg/m2 is considered a healthy weight range, and had the lowest mortality risk in the study. Being overweight was linked to higher rates of death from "all causes", and also from 4 major causes: coronary heart disease, stroke, respiratory disease, and cancer.

However, note that while other studies also agree that being underweight or obese increases the rate of dying prematurely, there is still some debate over whether being just overweight with BMI 25–<30 kg/m2 , really has a higher risk of dying prematurely. This was pointed out in the accompanying editorial in the journal Lancet (but not mentioned below). From Science Daily:

As overweight and obesity increase, so does risk of dying prematurely: Major study

Being overweight or obese is associated with a higher risk of dying prematurely than being normal weight -- and the risk increases with additional pounds, according to a large international collaborative study led by researchers at the Harvard T.H. Chan School of Public Health and the University of Cambridge, UK. The findings contradict recent reports that suggest a survival advantage to being overweight -- the so-called "obesity paradox."

The deleterious effects of excess body weight on chronic disease have been well documented. Recent studies suggesting otherwise have resulted in confusion among the public about what is a healthy weight. According to the authors of the new study, those prior studies had serious methodological limitations. One common problem is called reverse causation, in which a low body weight is the result of underlying or preclinical illness rather than the cause. Another problem is confounding by smoking because smokers tend to weigh less than nonsmokers but have much higher mortality rates.....Hu stressed that doctors should continue to counsel patients regarding the deleterious effects of excess body weight, which include a higher risk of diabetes, cardiovascular disease, and cancer.

For the new study, consortium researchers looked at data from more than 10.6 million participants from 239 large studies, conducted between 1970 and 2015, in 32 countries. A combined 1.6 million deaths were recorded across these studies, in which participants were followed for an average of 14 years. For the primary analyses, to address potential biases caused by smoking and preexisting diseases, the researchers excluded participants who were current or former smokers, those who had chronic diseases at the beginning of the study, and any who died in the first five years of follow-up, so that the group they analyzed included 4 million adults. They looked at participants' body mass index (BMI) -- an indicator of body fat calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m2).

The results showed that participants with BMI of 22.5-<25 kg/m2 (considered a healthy weight range) had the lowest mortality risk during the time they were followed. The risk of mortality increased significantly throughout the overweight range: a BMI of 25-<27.5 kg/m2 was associated with a 7% higher risk of mortality; a BMI of 27.5-<30 kg/m2 was associated with a 20% higher risk; a BMI of 30.0-<35.0 kg/m2 was associated with a 45% higher risk; a BMI of 35.0-<40.0 kg/m2 was associated with a 94% higher risk; and a BMI of 40.0-<60.0 kg/m2 was associated with a nearly three-fold risk. Every 5 units higher BMI above 25 kg/m2 was associated with about 31% higher risk of premature death. Participants who were underweight also had a higher mortality risk.

Looking at specific causes of death, the study found that, for each 5-unit increase in BMI above 25 kg/m2, the corresponding increases in risk were 49% for cardiovascular mortality, 38% for respiratory disease mortality, and 19% for cancer mortality. Researchers also found that the hazards of excess body weight were greater in younger than in older people and in men than in women.