Research Paper Volume 12, Issue 11 pp 10772—10794

Meta-analysis of the association between nut consumption and the risks of cancer incidence and cancer-specific mortality

Dai Zhang1,2, *, , Cong Dai3, *, , Linghui Zhou1,2, , Yiche Li4, , Kang Liu5, , Yu-Jiao Deng1,2, , Na Li1,2, , Yi Zheng1,2, , Qian Hao2, , Si Yang1,2, , Dingli Song2, , Ying Wu1,2, , Zhen Zhai2, , Shiyi Cao6, , Zhijun Dai1,2, ,

  • 1 Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • 2 Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • 3 Department of Thyroid and Breast Surgery, Xi 'an International Medical Center Hospital, Xi'an, China
  • 4 Breast Center Department, The Fourth Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, China
  • 5 Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  • 6 School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
* Equal contribution

Received: December 19, 2019       Accepted: April 27, 2020       Published: June 2, 2020
How to Cite

Copyright © 2020 Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Previous studies have indicated a correlation between nut intake and cancer risk in humans. This meta-analysis aimed to determine the relationship between nut consumption and the risks of cancer incidence and mortality. The PubMed, Embase, and Web of Science databases were searched up to August 2019. Relative risks and 95% confidence intervals were calculated using random-effects and fixed-effects models. We included 38 studies on nut consumption and cancer risk and 9 studies on cancer-specific mortality. Compared with no nut intake, nut intake was associated with a lower cancer risk (Relative Risk=0.90; 95% confidence interval, 0.86–0.94). Inverse associations were observed with colorectal cancer, gastric cancer, pancreatic cancer, and lung cancer in subgroup analyses. Tree nut consumption was found to reduce cancer risk (Relative Risk=0.88; 95% confidence interval, 0.79–0.99). Dose-response curves suggested that protective benefits against cancer increased with increased nut intake (P=0.005, P-nonlinearity=0.0414). An inverse correlation with cancer-specific mortality (Odd Ratio=0.90; 95% confidence interval, 0.88–0.92) was observed. In conclusion, nut consumption is inversely associated with the risks of cancer incidence and mortality; a higher intake is significantly associated with a lower cancer risk.


RR: Relative risks; OR: Odds ratio; HR: Hazard ratio; CI: Confidence intervals; PRISMA: Preferred Reporting items for System Review and Meta-analysis; NOS: Newcastle–Ottawa Scale; EPIC: European Prospective Investigation into Cancer and Nutrition; LDL: Low density lipoprotein; BMES: Blue Mountains Eye Study; GLST: Generalized least squares for trend; the PREDIMED study: The ‘PREvención con DIeta MEDiterránea’ study; the NHS: The Nurses’ Health Study; the HPFS: The Health Professionals Follow-up Study.