***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background Atrial Fibrillation is highly prevalent in clinical practice affecting approximately 2.3 million people in USA and 4.5 million people in European Union . The aim of the study was to examine the association between  nut consumption and incident atrial fibrillation . Methods Prospect i ve cohort of 21,054 male participants of Physicians ' Health Study I.  Nut consumption was estimated using food frequency question naire and incident atrial fibrillation was ascertained through yearly follow-up question naires . Cox regression was used to estimate relative risks of atrial fibrillation . Results The average age was 54.6 ± 9.5 years ( 40.7 - 87.1 ) . During a mean follow up of 20 years ( median 24 years ) , 3,317 cases of atrial fibrillation occurred . The crude incidence rate was 7.6 , 7.4 , 8.2 , 7.9 , and 6.8 cases/1000 person-years for people reporting nut consumption of rarely/never , 1 - 3/month , 1/per week , 2 - 6/week , and ≥ 7/week , respectively . Multivariable adjusted hazard ratios ( 95 % CI ) for incident atrial fibrillation were 1.00 ( ref ) , 1.00 ( 0.90 - 1.11 ) , 1.09 ( 0.97 - 1.21 ) , 1.07 ( 0.95 - 1.21 ) , and 0.91 ( 0.70 - 1.17 ) for nut consumption from the lowest to the highest category of nut consumption ( p for trend 0.26 ) . No statistically significant association between nut consumption and atrial fibrillation was found when stratified by body mass index ( BMI < 25 vs ≥ 25 kg/m2 ) or age ( < 65 vs. ≥ 65 years ) . Conclusions Our data did not show an association between nut consumption and incident atrial fibrillation among US male physicians BACKGROUND Heart failure is highly prevalent among older adults and is associated with high cost and societal burden . Although previous studies have reported beneficial effects of dietary factors on heart failure predictors , no previous study has examined whether frequent consumption of nuts is associated with a lower risk of heart failure in a large prospect i ve cohort . OBJECTIVE We examined the association between nut consumption and incident heart failure to determine whether such a relation is modified by overweight or obesity . DESIGN This was a prospect i ve cohort study of 20,976 participants from the Physicians ' Health Study I.  Nut consumption was assessed with a simple abbreviated food question naire , and self-reported heart failure was ascertained by follow-up question naires . We used Cox regression to estimate relative risks of heart failure . RESULTS After an average follow-up of 19.6 y , 1,093 new cases of heart failure occurred . Nut consumption was not associated with the risk of developing heart failure in this cohort : multivariable adjusted hazard ratios were 1.0 ( reference ) , 0.98 ( 95 % CI : 0.83 , 1.15 ) , 1.06 ( 95 % CI : 0.89 , 1.27 ) , and 1.01 ( 95 % CI : 0.84 , 1.22 ) for nut consumption of < 1 , 1 , and > or = 2 servings/wk , respectively ( P for linear trend : 0.64 ) . The lack of a meaningful relation between nut intake and incident heart failure was seen in both lean and overweight or obese participants ( P for interaction : 0.96 ) . CONCLUSION Our data do not provide evidence for an association between nut consumption and incident heart failure in US male physicians . However , our data can not rule out possible benefits of nut consumption on subtypes of heart failure not prevalent in this cohort Background A number of prospect i ve studies have observed inverse associations between nut consumption and chronic diseases . However , these studies have predominantly been conducted in Western countries , where nut consumption tends to be more common among individuals with healthier lifestyles . It is important to examine the association in other parts of the world , and particularly among population s with different patterns of disease , socioeconomic status , lifestyles and disease risk factors . Our objective was to examine the association between nut consumption and mortality in a population whose nut consumption does not track with a healthy lifestyle . Methods We examined the association between nut consumption and all-cause and cause-specific mortality in the 50 045 participants of the Golestan Cohort Study . Participants were aged 40 and older at baseline in 2004 , and have been actively followed since that time . Dietary data were collected using a vali date d semi-quantitative food frequency question naire that was administered at baseline . Results During 349 677 person-years of follow-up , 3981 cohort participants died , including 1732 women and 2249 men . Nut consumption was associated inversely with all-cause mortality . The pooled multivariate adjusted hazard ratios for death among participants who ate nuts , as compared with those who did not , were 0.89 [ 95 % confidence interval ( CI ) , 0.82 - 0.95 ] for the consumption of less than one serving of nuts per week , 0.75 ( 95 % CI , 0.67 - 0.85 ) for one to less than three servings per week and 0.71 ( 95 % CI , 0.58 - 0.86 ) for three or more servings per week ( P < 0.001 for trend ) . Among specific causes , significant inverse associations were observed between nut consumption and deaths due to cardiovascular disease , all cancers and gastrointestinal cancers . Conclusions This study provides evidence for an inverse association between nut consumption and mortality in a developing country , where nut consumption does not track with a healthy lifestyle . Further work is needed to establish the underlying mechanisms responsible for this association Background Nut consumption has been found to be inversely associated with cardiovascular disease mortality , but the association between nut consumption and incidence of specific cardiovascular diseases is unclear . We examined the association between nut consumption and incidence of seven cardiovascular diseases . Methods This prospect i ve study included 61 364 Swedish adults who had completed a Food Frequency Question naire and were followed up for 17 years through linkage with the Swedish National Patient and Death Registers . Results Nut consumption was inversely associated with risk of myocardial infa rct ion , heart failure , atrial fibrillation and abdominal aortic aneurysm in the age-adjusted and sex-adjusted analysis . However , adjustment for multiple risk factors attenuated these associations and only a linear , dose – response , association with atrial fibrillation ( ptrend=0.004 ) and a non-linear association ( pnon-linearity=0.003 ) with heart failure remained . Compared with no consumption of nuts , the multivariable HRs ( 95 % CI ) of atrial fibrillation across categories of nut consumption were 0.97 ( 0.93 to 1.02 ) for 1–3 times/month , 0.88 ( 0.79 to 0.99 ) for 1–2 times/week and 0.82 ( 0.68 to 0.99 ) for ≥3 times/week . For heart failure , the corresponding HRs ( 95 % CI ) were 0.87 ( 0.80 to 0.94 ) , 0.80 ( 0.67 to 0.97 ) and 0.98 ( 0.76 to 1.27 ) . Nut consumption was not associated with risk of aortic valve stenosis , ischaemic stroke or intracerebral haemorrhage . Conclusions These findings suggest that nut consumption or factors associated with this nutritional behaviour may play a role in reducing the risk of atrial fibrillation and possibly heart failure . Trial registration number NCT01127711 and NCT01127698 ; Results BACKGROUND Prospect i ve studies evaluating associations between food intake and risk of heart failure ( HF )  in diverse population s are needed . OBJECTIVES Relationships between incident HF ( death or hospitalization ) and intake of seven food categories ( whole grains , fruits/vegetables , fish , nuts , high-fat dairy , eggs , red meat ) were investigated in an observational cohort of 14,153 African-American and white adults , age 45 to 64 years , sample d from four US communities . METHODS Between baseline ( 1987 - 1989 ) and Exam 3 ( 1993 - 1995 ) ,  dietary intake was based on responses to a 66-item food frequency question naire administered at baseline ; thereafter , intake was based on averaged baseline and Exam 3 responses . Hazard ratios ( HR [ 95 % CI ] ) for HF were calculated per 1-daily serving difference in food group intake . RESULTS During a mean of 13 years , 1,140 HF hospitalizations were identified . After multivariable adjustment ( energy intake , demographics , lifestyle factors , prevalent cardiovascular disease , diabetes , hypertension ) , HF risk was lower with greater whole-grain intake ( 0.93 [ 0.87 , 0.99 ] ) , but HF risk was higher with greater intake of eggs ( 1.23 [ 1.08 , 1.41 ] ) and high-fat dairy ( 1.08 [ 1.01 , 1.16 ] ) . These associations remained significant independent of intakes of the five other food categories , which were not associated with HF . CONCLUSIONS In this large , population -based sample of African-American and white adults , whole-grain intake was associated with lower HF risk , whereas intake of eggs and high-fat dairy were associated with greater HF risk after adjustment for several confounders Background / Objectives : There is still a need for scientific evidence about which foods characterize a healthy diet in terms of primary prevention of major chronic diseases . Therefore , we aim ed to give a comprehensive overview on health-related foods , based on 8 years of follow-up of the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-Potsdam study .Subjects/ Methods : We used data from 23 531 participants of the EPIC-Potsdam study to analyse the associations between 45 single food groups and risk of major chronic diseases , namely , cardiovascular diseases ( CVD ) , type 2 diabetes and cancer using multivariable-adjusted Cox regression . Habitual dietary intake was assessed at baseline using food-frequency question naires .  Incident chronic diseases were determined by self-administered follow-up question naires and medically verified , based on inquiry to treating physicians , cancer registries or through death certificates . Results : During follow-up , 363 incident CVD , 837 type 2 diabetes and 844 cancer cases were identified . Higher intakes of whole-grain bread , raw vegetables , coffee and cakes and cookies were found to be significantly associated with a lower risk of chronic diseases . Conversely , higher intakes of low-fat dairy , butter , red meat and sauce were associated with higher risks of chronic diseases . Conclusion : Overall , a healthy diet was characterized by a high consumption of whole-grain bread , raw vegetables and a low consumption of red meat and possibly butter , which is generally in line with previous findings . The paradoxical findings concerning the potential health benefit of coffee as well as cakes and cookies are interesting and should be investigated further Background Prospect i ve data examining the relationship between dietary protein intake and incident coronary heart disease ( CHD )  are inconclusive . Most evidence is derived from homogenous population s such as health professionals . Large community-based analyses in more diverse sample s are lacking . Methods We studied the association of protein type and major dietary protein sources and risk for incident CHD in 12,066 middle-aged adults ( aged 45–64 at baseline , 1987–1989 ) from four U.S. communities enrolled in the Atherosclerosis Risk in Communities ( ARIC ) Study who were free of diabetes mellitus and cardiovascular disease at baseline .  Dietary protein intake was assessed at baseline and after 6 years of follow-up by food frequency question naire . Our primary outcome was adjudicated coronary heart disease events or deaths with following up through December 31 , 2010 . Cox proportional hazard models with multivariable adjustment were used for statistical analyses . Results During a median follow-up of 22 years , there were 1,147 CHD events . In multivariable analyses total , animal and vegetable protein were not associated with an increased risk for CHD before or after adjustment . In food group analyses of major dietary protein sources , protein intake from red and processed meat , dairy products , fish , nuts , eggs , and legumes were not significantly associated with CHD risk . The hazard ratios [ with 95 % confidence intervals ] for risk of CHD across quintiles of protein from poultry were 1.00 [ ref ] , 0.83 [ 0.70–0.99 ] , 0.93 [ 0.75–1.15 ] , 0.88 [ 0.73–1.06 ] , 0.79 [ 0.64–0.98 ] , P for trend = 0.16 ) . Replacement analyses evaluating the association of substituting one source of dietary protein for another or of decreasing protein intake at the expense of carbohydrates or total fats did not show any statistically significant association with CHD risk . Conclusion Based on a large community cohort 
    Output:
    
No association was observed with stroke incidence and heart failure .
This systematic review and meta- analysis revealed a beneficial role of nut consumption in reducing the incidence of , and mortality from , different CVD outcomes