Greater frequency of nut consumption is associated with lower prevalence of peripheral arterial disease

•In a sample of > 4% all US adults, nearly half consumed nuts less than once weekly.•We observe an inverse association of dietary nut consumption with PAD.•These findings persisted with correction for multiple confounders.

Nut consumption has been associated with lower risk of coronary heart disease and all-cause mortality. The association between nut intake and peripheral arterial disease (PAD) is uncertain.ObjectiveWe sought to investigate the association between nut consumption and presence of prevalent PAD in a large cross-sectional sample.MethodsSelf-referred participants at > 20,000 US sites who completed a medical and lifestyle questionnaire were evaluated by screening ankle brachial indices for PAD. Multivariable logistic regression analysis was used to estimate odds of PAD in different nut consumption categories.ResultsAmong 3,312,403 individuals, mean age was 63.6 ± 10.6 years and 62.8% were female. There were 219,527 cases of PAD. After multivariable adjustment there was an inverse association of nut intake with PAD. Compared to subjects with consumption of nuts < once/month, daily nut consumption was associated with a 21% (95% CI 20%–23%) lower odds of having PAD.ConclusionThese observations suggest the need for more rigorous testing evaluating the role of nuts in PAD prevention.