Tree nut consumption is associated with a lower risk of hyperestrogenism in men

Hyperestrogenism may affect 2% to 8% of men globally. Previous studies indicate that tree nut consumption is associated with sex hormones in women. Whether this is the case in men remains unknown. This study hypothesized that consumption of tree nuts was inversely associated with circulating estradiol and prevalence of hyperestrogenism in men. This cross-sectional study included 3340 men aged ≥20 years from the US National Health and Nutrition Examination Survey from 2013 to 2016. Associations of tree nut consumption with circulating estradiol and prevalence of hyperestrogenism were assessed using weighted linear regression and binary logistic regression, respectively. Among the 3340 men, 207 consumed tree nuts. The mean usual intake of tree nuts among tree nut consumers was 34.2 g/d. Amounts of usual intake of tree nuts were inversely associated with bioavailable estradiol (β = -0.032, P = .037) after adjustment for all confounders. Usual intake of tree nuts of ≥ 30 g/d (vs <30 g/d) or ≥42.52 g/d (vs <42.52 g/d) was associated with a 24% or 7% lower multivariate-adjusted risk of hyperestrogenism, respectively. Further analyses showed that usual intake of tree nuts was positively associated with circulating folate, and the latter was inversely associated with circulating estradiol. In conclusion, higher tree nut consumption was independently associated with lower circulating levels of bioavailable estradiol and a lower risk of hyperestrogenism in men. Further research is needed to verify the effectiveness of using tree nuts to treat hyperestrogenism in men.