Cited by 422Nuts composition and effectsNutritional Studies and DietLipoproteins and Cardiovascular Health

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Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials

Sabaté, Joan·2010·Archives of Internal Medicine

DOI 10.1001/archinternmed.2010.79

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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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Background
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“Nut consumption has been found to improve blood lipid levels [7] and reduce the risk of coronary heart disease [8,9].”
Background
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Background
Health benefits of pistachios consumption
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“The effects of nut consumption were dose-related, and different types of nuts had similar effects on blood lipid levels (Sabaté et al. 2010).”
Background
Quantitative determination of free and esterified phytosterol profile in nuts and seeds commonly consumed in China by SPE/GC–MS
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Disentangling the Effects of Monounsaturated Fatty Acids from Other Components of a Mediterranean Diet on Serum Metabolite Profiles: A Randomized Fully Controlled Dietary Intervention in Healthy Subjects at Risk of the Metabolic Syndrome
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Meta-analysis of the association between nut consumption and the risks of cancer incidence and cancer-specific mortality
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“A randomizedcontrolled trial [40] suggested that different types of nuts exert different effects on cardiovascular risk and that”
Background
Effect of almond consumption on the serum fatty acid profile: a dose–response study
Nishi, S. K., Kendall, C. W. C., Gascoyne, A.-M., Bazinet, R. P., Bashyam, B., Lapsley, K. G., Augustin, L. S. A., Sievenpiper, J. L., & Jenkins, D. J. A. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114514001640 · Cited by 44
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The effect of dietary walnuts compared to fatty fish on eicosanoids, cytokines, soluble endothelial adhesion molecules and lymphocyte subsets: a randomized, controlled crossover trial
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Background
Effects of hazelnuts consumption on fasting blood sugar and lipoproteins in patients with type 2 diabetes.
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“types of nuts have also been shown to reduce LDLcholesterol (LDL-c) [7], improve endothelial function [7, 8] and reduce postprandial blood glucose levels when consumed”
BackgroundResult
Relationships between Nut Size, Kernel Quality, Nutritional Composition and Levels of Outcrossing in Three Macadamia Cultivars
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“The differences in total‐SFA and total‐UFA relative abundance were less than 1% but they could confer a slight health advantage on small “Daddow” kernels because of the beneficial effects of dietary UFAs in regulating lipid levels, maintaining healthy body weight and preventing inflammation [12,13,18,70].”
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Mixed Nut Consumption May Improve Cardiovascular Disease Risk Factors in Overweight and Obese Adults
Abbaspour, N., Roberts, T., Hooshmand, S., Kern, M., & Hong, M. Y. (2019) · Nutrients · doi:10.3390/nu11071488 · Cited by 43
“Most of the cholesterol-lowering effects have been shown in studies with hypercholesterolemic subjects [28,49].”
Background
The Effect of Walnut Oil Consumption on Blood Sugar in Patients With Diabetes Mellitus Type 2
Zibaeenezhad, M. J., Aghasadeghi, K., Hakimi, H., Yarmohammadi, H., & Nikaein, F. (2016) · Intern J Endocrinol Metab · doi:10.5812/ijem.34889 · Cited by 42
“It was noted that an increase in intake of plant sources of fats and proteins in the diet would reduce the risk of CAD and DM type 2 (8).”
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Beneficial effects of ω-3 PUFA in children on cardiovascular risk factors during childhood and adolescence
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Effects of Walnut Consumption on Mood in Young Adults—A Randomized Controlled Trial
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Effects of Nut Consumption on Blood Lipids and Lipoproteins: A Comprehensive Literature Update
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“Three focused on interventions of both nuts and peanuts together [11,12,21], three were on tree nuts [16,18,22], five on almonds [13,15,19,25,29], four on walnuts [17,23,24,26], two on cashews [20,28], one on pistachios [27] and one on peanuts including peanut butter [14].”
Influential
Nut consumption is associated with lower incidence of type 2 diabetes: The Tehran Lipid and Glucose Study
Asghari, G., Ghorbani, Z., Mirmiran, P., & Azizi, F. (2016) · Diabetes & Metabolism · doi:10.1016/j.diabet.2016.09.008 · Cited by 38
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“2% only in people with hypertriglyceridemia but no overall triglyceride-lowering effect of nuts was seen [29].”
Background
Nut Consumption and Cardiovascular Risk Factors: A Cross-Sectional Study in a Mediterranean Population
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“Habitual nut intake, as a preventive measure, could offer protection against cardiovascular disease complications and death, especially in people with lower adherence to the Mediterranean diet [14,41] and diabetes [43].”
Background
Nuts and Non-Alcoholic Fatty Liver Disease: Are Nuts Safe for Patients with Fatty Liver Disease?
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“A pooled analysis of 25 clinical trials including different types of nuts showed a significant dose-related reduction in total cholesterol and LDL-C, but no effect on HDL-C or triglycerides (except in participants with hypertriglyceridemia) after nut consumption [5].”
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“Interestingly, walnut consumption has been shown to reduce various cardiometabolic risk factors and has been associated with a significantly lower risk of various diseases such as cancers and type 2 diabetes (Sabate et al., 2010; Pan et al., 2013).”
Background
Nut consumption is associated with better nutrient intakes: results from the 2008/09 New Zealand Adult Nutrition Survey
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“1) conducted in seven countries among 583 men and women with normolipidemia and hypercholesterolemia [45] revealed that a mean daily consumption of”
Background
Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals
Wirth, J., Song, M., Fung, T. T., Joshi, A. D., Tabung, F. K., Chan, A. T., Weikert, C., Leitzmann, M. F., Willett, W. C., Giovannucci, E. L., et al. (2018) · International Journal of Epidemiology · doi:10.1093/ije/dyy210 · Cited by 32
Does Nut Consumption Reduce Mortality and/or Risk of Cardiometabolic Disease? An Updated Review Based on Meta-Analyses
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Tree Nut and Peanut Consumption and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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“Nuts: Consumption of 50–100g nuts five times or more per week can lower LDL-C (∼7%) and triglyceride levels (∼10%), particularly in individuals with elevated LDL-C and blood triglyceride levels [42].”
Background
Influence of body mass index and serum lipids on the cholesterol-lowering effects of almonds in free-living individuals
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“” There was a tendency in our study for those with normal BMI to improve the ratios TC:HDL and LDL:HDL; however, our non-significant results on the interaction between BMI and diet do not corroborate the findings of a pooled analysis [34], which found BMI as a significant effect modifier of the cholesterol-lowering pr…”
Result
High-performance liquid chromatography-diode array detector determination and availability of phenolic compounds in 10 genotypes of walnuts
Figueroa, F., Marhuenda, J., Zafrilla, P., Villaño, D., Martínez‐Cachá, A., Tejada, L. C., Cerdá, B., & Mulero, J. (2016) · International Journal of Food Properties · doi:10.1080/10942912.2016.1199036 · Cited by 31
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“These perceptions are at odds with data from both epidemiological studies((4,5)) and clinical trials((8)), which show reductions in CVD risk and lower total and LDL cholesterol”
BackgroundResult
Groundnut (Peanut) (Arachis hypogaea)
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Effects of Walnut Consumption for 2 Years on Lipoprotein Subclasses Among Healthy Elders
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Perspective: Is it Time to Expand Research on “Nuts” to Include “Seeds”? Justifications and Key Considerations
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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)
DOI: 10.1001/archinternmed.2010.79
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 › Cardiology and Cardiovascular Medicine › 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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Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials

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