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Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials
Open accessAbstract
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 (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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Metadata
- 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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