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Background: Tree nuts are nutrient dense, and their consumption has been associated with improvements in health outcomes., Objective: To estimate the usual tree nut intake and examine the association between tree nut consumption and cardiometabolic (CM) health outcomes in a nationally representative sample of US adults., Methods: Cross-sectional data were analyzed from a sample of 18,150 adults aged ≥ 20y who provided at least one reliable 24-h dietary recall and had complete data for the variables of interest in the NHANES 2011-2018. Tree nut consumers were defined as those consuming ≥ ¼ ounce/d (7.09 g). The National Cancer Institute Method was used to estimate the usual tree nut intake among consumers. Measurement error calibrated regression models were used to assess the association between tree nut consumption and each health outcome of interest., Results: Approximately 8% of all participants ( n = 1238) consumed tree nuts and had a mean ± SE usual intake of 39.5 ± 1.8 g/d. Tree nut consumers were less likely to have obesity (31% vs. 40%, P < 0.001) and low high-density lipoprotein cholesterol (22% vs. 30%, P < 0.001 ) compared with nonconsumers. Moreover, tree nut consumers had a lower mean waist circumference (WC) (97.1 ± 0.7 vs. 100.5 ± 0.3 cm, P < 0.001) and apolipoprotein B (87.5 ± 1.2 vs. 91.8 ± 0.5 mg/dL, P = 0.004) than nonconsumers. After adjusting models for demographics and lifestyle covariates, the difference in WC between average intake (33.7 g/d) and low threshold intake (7.09/g) of tree nuts was -1.42 ± 0.58 cm ( P = 0.005)., Conclusions: Most US adults do not consume tree nuts, yet modest consumption was associated with decreased prevalence of cardiovascular disease and CM risk factors and improvement for some health outcome measures., (© 2023 The Authors.)

This study estimated the prevalence of cardiovascular disease (CVD) risk factors, cardiometabolic (CM) risk factors, and cardiovascular health metrics (CVHMs) among US adults and across race/ethnicity groups. The study comprised 8370 US adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, free of coronary heart disease/heart failure, angina/angina pectoris, heart attack, and stroke, who provided complete data for the outcome variables of interest. Age-adjusted prevalence of CVD and CM risk factors, and CVHMs were computed for all adults and across race/ethnicity groups. All analyses accounted for the complex, multi-stage survey sampling design of the NHANES. Hypertension (45.0%), obesity (40.0%), fasting plasma glucose ≥ 100 mg/dL or hypoglycemic medication (51.0%), ideal physical activity (59.2%) and ideal smoking status (56.9%) were most prevalent for the whole sample. Mexican Americans and non-Hispanic Blacks had elevated risk for some, but not all, CVD and CM risk factors compared to non-Hispanic Whites and non-Hispanic Asians. Reducing further health disparities and persisting differences among racial and ethnic groups is vital to achieving the American Heart Association vision of all people having ideal cardiovascular health, living healthier and longer., (© 2022. The Author(s).)