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Current nut recommendation practices differ between health professionals in New Zealand

  • Rachel C Brown (a1), Andrew R Gray (a2), Lee Ching Yong (a1), Alex Chisholm (a1), Sook Ling Leong (a3) and Siew Ling Tey (a1)...
Abstract
Objective

Despite evidence linking regular nut consumption with reduced chronic disease risk, population-level intakes remain low. Research suggests nut-promoting advice from doctors facilitates regular nut consumption. However, there is no information on current nut recommendation practices of health professionals. The aim of the present study was to examine the advice provided by health professionals regarding nut consumption.

Design

In this cross-sectional study, participants were invited to complete a survey including questions about their nut recommendation practices.

Setting

New Zealand (NZ).

Subjects

The NZ Electoral Roll was used to identify dietitians, general practitioners and practice nurses.

Results

In total 318 dietitians, 292 general practitioners and 149 practice nurses responded. Dietitians were more likely (82·7 %) to recommend patients increase consumption of nuts than general practitioners (55·5 %) and practice nurses (63·1 %; both P<0·001). The most popular nuts recommended were almonds, Brazil nuts and walnuts, with most health professionals recommending raw nuts. The most common recommendation for frequency of consumption by dietitians and practice nurses was to eat nuts every day, while general practitioners most frequently recommended 2–4 times weekly, although not statistically significantly different between professions. Dietitians recommended a significantly greater amount of nuts (median 30 g/d) than both general practitioners and practice nurses (20 g/d; both P<0·001).

Conclusions

Dietitians were most likely to recommend consumption of nuts in accordance with current guidelines, but there are opportunities to improve the adoption of nut consumption recommendations for all professions. This may be a viable strategy for increasing population-level nut intakes to reduce chronic disease.

Copyright
Corresponding author
* Corresponding author: Email rachel.brown@otago.ac.nz
References
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1. Alasalvar, C & Bolling, BW (2015) Review of nut phytochemicals, fat-soluble bioactives, antioxidant components and health effects. Br J Nutr 113, Suppl. 2, S68S78.
2. Brufau, G, Boatella, J & Rafecas, M (2006) Nuts: source of energy and macronutrients. Br J Nutr 96, Suppl. 2, S24S28.
3. Ros, E (2010) Health benefits of nut consumption. Nutrients 2, 652682.
4. Ministry of Health (2015) Eating and Activity Guidelines for New Zealand Adults. Wellington: Ministry of Health.
5. National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: NHMRC.
6. Nordic Council of Ministers (2014) Nordic Nutrition Recommendations 2012. https://www.norden.org/en/theme/former-themes/themes-2016/nordic-nutrition-recommendation/nordic-nutrition-recommendations-2012 (accessed September 2017).
7. US Department of Health and Human Services & US Department of Agriculture (2015) 2015–2020 Dietary Guidelines for Americans, 8th ed. http://www.health.gov/dietaryguidelines/2015/guidelines/ (accessed November 2017).
8. Grosso, G, Yang, J, Marventano, S et al. (2015) Nut consumption and all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 101, 783793.
9. Hshieh, TT, Petrone, AB, Gaziano, JM et al. (2015) Nut consumption and risk of mortality in the Physicians’ Health Study. Am J Clin Nutr 101, 407412.
10. Kris-Etherton, PM, Yu-Poth, S, Sabate, J et al. (1999) Nuts and their bioactive constituents: effects on serum lipids and other factors that affect disease risk. Am J Clin Nutr 70, 3 Suppl., S504S511.
11. Nash, SD & Nash, DT (2008) Nuts as part of a healthy cardiovascular diet. Curr Atheroscler Rep 10, 529535.
12. Sabate, J, Oda, K & Ros, E (2010) Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med 170, 821827.
13. Tey, S, Brown, R & Chisholm, A (2012) Nuts and Heart Health. National Heart Foundation of New Zealand Evidence-Based Position Statement on the Relationship of Nuts to Heart Health. Auckland: National Heart Foundation of New Zealand.
14. US Food and Drug Administration (2003) Qualified Health Claims: Letter of Enforcement Discretion – Nuts and Coronary Heart Disease (Docket No 02P-0505). http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm072926.htm (accessed September 2013).
15. Willett, WC, Sacks, F, Trichopoulou, A et al. (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 61, 6 Suppl., 1402S1406S.
16. Pawlak, R, Colby, S & Herring, J (2009) Beliefs, benefits, barriers, attitude, intake and knowledge about peanuts and tree nuts among WIC participants in eastern North Carolina. Nutr Res Pract 3, 220225.
17. Pawlak, R, London, HA, Colby, SE et al. (2012) Perception of nut intake among individuals with or at risk for heart disease and/or diabetes. J Behav Health 1, 185188.
18. Brown, RC, Tey, SL, Gray, AR et al. (2014) Patterns and predictors of nut consumption: results from the 2008/09 New Zealand Adult Nutrition Survey. Br J Nutr 112, 20282040.
19. Jenab, M, Sabate, J, Slimani, N et al. (2006) Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries. Br J Nutr 96, Suppl. 2, S12S23.
20. O’Neil, CE, Keast, DR, Nicklas, TA et al. (2012) Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999–2004. Nutr Res 32, 185194.
21. O’Neil, CE, Nicklas, TA & Fulgoni, VL (2015) Tree nut consumption is associated with better nutrient adequacy and diet quality in adults: National Health and Nutrition Examination Survey 2005–2010. Nutrients 7, 595607.
22. Tey, SL, Brown, R, Chisholm, A et al. (2011) Current guidelines for nut consumption are achievable and sustainable: a hazelnut intervention. Br J Nutr 105, 15031511.
23. Tey, SL, Gray, AR, Chisholm, AW et al. (2013) The dose of hazelnuts influences acceptance and diet quality but not inflammatory markers and body composition in overweight and obese individuals. J Nutr 143, 12541262.
24. American Nurses Association (2015) Nurses Rank as Most Honest, Ethical Profession for 14th Straight Year (12/21/15). http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2015-NR/Nurses-Rank-as-Most-Honest-Ethical-Profession-for-14th-Straight-Year.html (accessed September 2016).
25. Roy Morgan Research (2016) Roy Morgan Image of Professions Survey 2016: Nurses still easily most highly regarded – followed by Doctors, Pharmacists & Engineers. http://www.roymorgan.com/findings/6797-image-of-professions-2016-201605110031 (accessed September 2016).
26. Brown, RC, Yong, LC, Gray, AR et al. (2017) Perceptions and knowledge of nuts amongst health professionals in New Zealand. Nutrients 9, 220220.
27. Dillman, D (2011) Mail and Internet Surveys: The Tailored Design Method – 2007 Update with New Internet, Visual, and Mixed-Mode Guide, 2nd ed. Hoboken, NJ: John Wiley & Sons, Inc.
28. Statistics New Zealand (2005) The Statistical Standard for Ethnicity 2005. Wellington: Statistics New Zealand.
29. Peduzzi, P, Concato, J, Kemper, E et al. (1996) A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 49, 13731379.
30. Cochran, WG (1954) Some methods for strengthening the common χ 2 tests. Biometrics 10, 417451.
31. Djousse, L, Arnett, DK, Carr, JJ et al. (2005) Dietary linolenic acid is inversely associated with calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study. Circulation 111, 29212926.
32. Venkatachalam, M & Sathe, SK (2006) Chemical composition of selected edible nut seeds. J Agric Food Chem 54, 47054714.
33. Thomson, CD (2004) Selenium and iodine intakes and status in New Zealand and Australia. Br J Nutr 91, 661672.
34. Alasalvar, C, Pelvan, E & Amarowicz, R (2010) Effects of roasting on taste-active compounds of Turkish hazelnut varieties (Corylus avellana L.). J Agric Food Chem 58, 86748679.
35. Amaral, JS, Casal, S, Seabra, RM et al. (2006) Effects of roasting on hazelnut lipids. J Agric Food Chem 54, 13151321.
36. Schlormann, W, Birringer, M, Bohm, V et al. (2015) Influence of roasting conditions on health-related compounds in different nuts. Food Chem 180, 7785.
37. He, FJ, Li, J & Macgregor, GA (2013) Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ 346, f1325.
38. Frecka, JM, Hollis, JH & Mattes, RD (2008) Effects of appetite, BMI, food form and flavor on mastication: almonds as a test food. Eur J Clin Nutr 62, 12311238.
39. McKiernan, F, Lokko, P, Kuevi, A et al. (2010) Effects of peanut processing on body weight and fasting plasma lipids. Br J Nutr 104, 418426.
40. Tey, SL, Robinson, T, Gray, AR et al. (2017) Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability? Eur J Nutr 56, 10251036.
41. Jiang, R, Manson, JE, Stampfer, MJ et al. (2002) Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 288, 25542560.
42. Li, TY, Brennan, AM, Wedick, NM et al. (2009) Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr 139, 13331338.
43. Luu, HN, Blot, WJ, Xiang, YB et al. (2015) Prospective evaluation of the association of nut/peanut consumption with total and cause-specific mortality. JAMA Intern Med 175, 755766.
44. van den Brandt, PA & Schouten, LJ (2015) Relationship of tree nut, peanut and peanut butter intake with total and cause-specific mortality: a cohort study and meta-analysis. Int J Epidemiol 44, 10381049.
45. Ministry of Health (2014) Annual Update of Key Results 2012/14: New Zealand Health Survey. Wellington: Ministry of Health.
46. Lee, C, Dobson, AJ, Brown, WJ et al. (2005) Cohort profile: the Australian longitudinal study on women’s health. Int J Epidemiol 34, 987991.
47. Timperio, A, Cameron-Smith, D, Burns, C et al. (2000) Physical activity beliefs and behaviours among adults attempting weight control. Int J Obes Relat Metab Disord 24, 8187.
48. Martikainen, P, Laaksonen, M, Piha, K et al. (2007) Does survey non-response bias the association between occupational social class and health? Scand J Public Health 35, 212215.
49. Mealing, NM, Banks, E, Jorm, LR et al. (2010) Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs. BMC Med Res Methodol 10, 26.
50. Van Loon, AJ, Tijhuis, M, Picavet, HS et al. (2003) Survey non-response in the Netherlands: effects on prevalence estimates and associations. Ann Epidemiol 13, 105110.
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