Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Leah M. Ferrucci


Background: While nuts and their related nutrients have been inversely associated with some cancers, the association between nut consumption and prostate cancer has been inconsistent.

Methods: We conducted an analysis of the association between nut and peanut butter consumption and risk of incident prostate cancer among 173,243 men in the prospective NIH-AARP Diet and Health Study. There was a total of 18,619 incident prostate cancer cases during the 16 years of follow-up. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for intake of nuts, peanut butter, and total nuts (nuts plus peanut butter), as well as frequency of nut consumption. We evaluated associations with overall prostate cancer and the following subtypes: adenocarcinoma, localized, advanced, fatal, low-grade (Gleason 2-7), and high-grade (Gleason ≥8).

Results: There was no association between nuts (highest versus lowest category HR=1.00, 95% CI: 0.95, 1.07), peanut butter consumption (HR=1.02, 95% CI: 0.98, 1.07), or total nuts (HR=1.00, 95% CI: 0.93, 1.09) and prostate cancer. Similarly, there were no associations with nuts, peanut butter, and total nuts localized, advanced, or fatal prostate cancer in this population. There was some evidence of an inverse association for frequency of nut consumption and prostate cancer (highest versus lowest category HR=0.93, 95% CI: 0.88, 0.98), but the p-trend was not statistically significant (0.07).

Conclusions: In this large prospective cohort study, there was no clear evidence for an association between nut or peanut butter consumption and prostate cancer. Additional research in prospective studies with detailed information on nut consumption is warranted given the lack of data on this association.

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