Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials
Abstract
BACKGROUND: Epidemiological studies have consistently associated nut consumption with reduced risk for coronary heart disease. Subsequently, many dietary intervention trials investigated the effects of nut consumption on blood lipid levels. The objectives of this study were to estimate the effects of nut consumption on blood lipid levels and to examine whether different factors modify the effects. METHODS: We pooled individual primary data from 25 nut consumption trials conducted in 7 countries among 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications. In a pooled analysis, we used mixed linear models to assess the effects of nut consumption and the potential interactions. RESULTS: With a mean daily consumption of 67 g of nuts, the following estimated mean reductions were achieved: total cholesterol concentration (10.9 mg/dL [5.1% change]), low-density lipoprotein cholesterol concentration (LDL-C) (10.2 mg/dL [7.4% change]), ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C) (0.22 [8.3% change]), and ratio of total cholesterol concentration to HDL-C (0.24 [5.6% change]) (P < .001 for all) (to convert all cholesterol concentrations to millimoles per liter, multiply by 0.0259). Triglyceride levels were reduced by 20.6 mg/dL (10.2%) in subjects with blood triglyceride levels of at least 150 mg/dL (P < .05) but not in those with lower levels (to convert triglyceride level to millimoles per liter, multiply by 0.0113). The effects of nut consumption were dose related, and different types of nuts had similar effects on blood lipid levels. The effects of nut consumption were significantly modified by LDL-C, body mass index, and diet type: the lipid-lowering effects of nut consumption were greatest among subjects with high baseline LDL-C and with low body mass index and among those consuming Western diets. CONCLUSION: Nut consumption improves blood lipid levels in a dose-related manner, particularly among subjects with higher LDL-C or with lower BMI.
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Adults with elevated cholesterol exhibit larger cholesterol reductions in response to targeted dietary intervention.
“Evidence supports that adults with elevated cholesterol exhibit larger cholesterol reductions in response to targeted dietary intervention [51,52].”
Systematic reviews and meta-analyses of randomized controlled trials have shown reductions in LDL-C of 7% for nuts at a median dose of 67 g/d.
“Systematic reviews and meta-analyses of randomized controlled trials have shown reductions in LDL-C of 7% for nuts at a median dose of 67 g/d, 33”
From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [33]
Systematic reviews and meta-analyses of randomized controlled trials have shown beneficial effects of nuts on non-HDL-C, apoB, TC, and TG.
“Systematic reviews and meta-analyses of randomized controlled trials have shown beneficial effects of plant sterols, 38,39 viscous fibres, 37,40,41 plant proteins, 34 and nuts 33,42,43 on the established alternate lipid targets, non-HDL-C and apoB, and other blood lipids including TC and TG.”
From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [33]
In clinical trials, nuts improve serum lipids.
“In clinical trials nuts improve serum lipids (209) (210,211).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [210]
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- Authors
- Sabaté, J.
- Affiliations
- Loma Linda University (US)
- Corresponding author
- Sabaté, Joan
- ORCID
- Sabaté, Joan
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2010-05-10
- Volume
- 170
- Issue
- 9
- Pages
- 821
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2134454487
- Cited by
- 422
- References
- 52
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 11 · 2023: 17 · 2022: 29 · 2021: 25 · 2020: 25 · 2019: 32 · 2018: 28 · 2017: 28 · 2016: 22 · 2015: 35 · 2014: 43 · 2013: 34 · 2012: 35
- FWCI
- 30.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nuts composition and effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- nut consumption, serum lipids, LDL cholesterol, HDL cholesterol, triglycerides, total cholesterol, hypercholesterolemia, coronary artery disease, dose-response relationship, body mass index, Western diet, dietary intervention, hypolipidemic effect
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cholesterol, Feeding Behavior, Female, Humans, Hyperlipidemias, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Nuts, Triglycerides, Linear Models
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