Effects of walnut consumption on blood lipids and other cardiovascular risk factors: An updated meta-analysis and systematic review of controlled trials
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Background Intervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain.Objective We conducted a systematic review and meta-analysis of controlled trials evaluating the effects of walnut consumption on blood lipids and other cardiovascular risk factors.Design We conducted a comprehensive search of PubMed and EMBASE databases (from database inception to January 2018) of clinical trials comparing walnut-enriched diets with control diets. We performed random-effects meta-analyses comparing walnut-enriched and control diets for changes in pre-post intervention in blood lipids (mmol/L), apolipoproteins (mg/dL), body weight (kg), and blood pressure (mm Hg).Results Twenty-six clinical trials with a total of 1059 participants were included. The following weighted mean differences (WMDs) in reductions were obtained for walnut-enriched diets compared with control groups: -6.99 mg/dL (95% CI: -9.39, -4.58 mg/dL; P < 0.001) (3.25% greater reduction) for total blood cholesterol (TC) and -5.51 mg/dL (95% CI: -7.72, -3.29 mg/dL; P < 0.001) (3.73% greater reduction) for low-density lipoprotein (LDL) cholesterol. Triglyceride concentrations were also reduced in walnut-enriched diets compared with control [WMD = -4.69 (95% CI: -8.93, -0.45); P = 0.03; 5.52% greater reduction]. More pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for TC = -12.30 (95% CI: -23.17, -1.43) and for LDL = -8.28 (95% CI: -13.04, -3.51); P < 0.001]. Apolipoprotein B (mg/dL) was also reduced significantly more on walnut-enriched diets compared with control groups [WMD = -3.74 (95% CI: -6.51, -0.97); P = 0.008] and a trend towards a reduction was observed for apolipoprotein A [WMD = -2.91 (95% CI: -5.98, 0.08); P = 0.057]. Walnut-enriched diets did not lead to significant differences in weight change (kg) compared with control diets [WMD = -0.12 (95% CI: -2.12, 1.88); P = 0.90], systolic blood pressure (mm Hg) [WMD = -0.72 (95% CI: -2.75, 1.30); P = 0.48], or diastolic blood pressure (mm Hg) [WMD = -0.10 (95% CI: -1.49, 1.30); P = 0.88].Conclusions Incorporating walnuts into the diet improved blood lipid profile without adversely affecting body weight or blood pressure.
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Monounsaturated fatty acids and polyunsaturated fatty acids, in forms of olive oil, nuts and seeds in plant-based dietary regimens, may function as the driving force for amelioration of glucose metabolism, insulin sensitivity, blood lipids, and cardiovascular disease risk in diabetic individuals or the general population.
“Monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs), in forms of olive oil, nuts and seeds in plant-based dietary regimens, may function as the driving force for the amelioration of glucose metabolism, insulin sensitivity, blood lipids and CVD risk, observed either in diabetic individuals [17,40,41] or in the general population [42].”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [40]
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- Authors
- Guasch-Ferré, M., Li, J., Hu, F. B., Salas-Salvadó, J., & Tobias, D. K.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 108
- Issue
- 1
- Pages
- 174-187
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC6862936
- OpenAlex
- W2809402472
- Cited by
- 147
- References
- 57
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 18 · 2023: 26 · 2022: 21 · 2021: 25 · 2020: 20 · 2019: 15 · 2018: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association (9-17-CMF-011)
- Pfizer
- National Institutes of Health (DK46200)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200)
- 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 › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- walnut consumption, serum lipids, cardiovascular risk factors, total cholesterol, LDL cholesterol, triglycerides, apolipoprotein B, apolipoprotein(a), body weight, blood pressure, dietary intervention, weight gain, Western diet, American diet, Mediterranean diet
- MeSH terms
- Cardiovascular Diseases, Humans, Lipids, Nuts, Risk Factors, Juglans
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