CoChat
Sign Up
Cited by 335Nuts composition and effectsNutritional Studies and DietFatty Acid Research and Health

Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials

Open access
Del Gobbo, Liana C, Falk, Michael C, Feldman, Robin, Lewis, Kara, Mozaffarian, Dariush·2015·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.115.110965PMC PMC4658458
Open this paper in CoChat — free accountOpen PDF

Abstract

Background The effects of nuts on major cardiovascular disease (CVD) risk factors, including dose-responses and potential heterogeneity by nut type or phytosterol content, are not well established. Objectives We examined the effects of tree nuts (walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts) on blood lipids [total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein, and triglycerides], lipoproteins [apolipoprotein A1, apolipoprotein B (ApoB), and apolipoprotein B100], blood pressure, and inflammation (C-reactive protein) in adults aged ≥18 y without prevalent CVD. Design We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two investigators screened 1301 potentially eligible PubMed articles in duplicate. We calculated mean differences between nut intervention and control arms, dose-standardized to one 1-oz (28.4 g) serving/d, by using inverse-variance fixed-effects meta-analysis. Dose-response for nut intake was examined by using linear regression and fractional polynomial modeling. Heterogeneity by age, sex, background diet, baseline risk factors, nut type, disease condition, duration, and quality score was assessed with meta-regression. Publication bias was evaluated by using funnel plots and Egger's and Begg's tests. Results Sixty-one trials met eligibility criteria (n = 2582). Interventions ranged from 3 to 26 wk. Nut intake (per serving/d) lowered total cholesterol (-4.7 mg/dL; 95% CI: -5.3, -4.0 mg/dL), LDL cholesterol (-4.8 mg/dL; 95% CI: -5.5, -4.2 mg/dL), ApoB (-3.7 mg/dL; 95% CI: -5.2, -2.3 mg/dL), and triglycerides (-2.2 mg/dL; 95% CI: -3.8, -0.5 mg/dL) with no statistically significant effects on other outcomes. The dose-response between nut intake and total cholesterol and LDL cholesterol was nonlinear (P-nonlinearity < 0.001 each); stronger effects were observed for ≥60 g nuts/d. Significant heterogeneity was not observed by nut type or other factors. For ApoB, stronger effects were observed in populations with type 2 diabetes (-11.5 mg/dL; 95% CI: -16.2, -6.8 mg/dL) than in healthy populations (-2.5 mg/dL; 95% CI: -4.7, -0.3 mg/dL) (P-heterogeneity = 0.015). Little evidence of publication bias was found. Conclusions Tree nut intake lowers total cholesterol, LDL cholesterol, ApoB, and triglycerides. The major determinant of cholesterol lowering appears to be nut dose rather than nut type. Our findings also highlight the need for investigation of possible stronger effects at high nut doses and among diabetic populations.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3945/ajcn.115.110965

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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 [42]

    The Main outcomes and Discussion sections (page not provided) report that tree nuts lowered total cholesterol and ApoB, but do not report non-HDL-C as an outcome. The Discussion says the triglyceride reduction was small and statistically significant only in nonrandomized trials, so the claim overstates what this source shows from randomized trials. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Individual randomized controlled trials of nuts have demonstrated significant reductions in blood pressure.

    “Individual randomized controlled trials of nuts have also demonstrated significant reductions in blood pressure 42,53”

    From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [42]

    The Study characteristics section reports randomized nut trials, and the References section lists an included pistachio study whose title reports reduced systolic blood pressure. But the paper does not establish in these passages that individual randomized trials found statistically significant reductions. Its Main outcomes section instead reports no significant pooled effect on systolic or diastolic blood pressure, including when randomized trials were evaluated separately (page numbers unavailable). (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

No citation lists for this paper

No citation lists for this paper yet — checked again daily.

References 90 · Cited by 335

Research works printed but not linked: 83

  1. Bao Y, Han J, Hu FB, Giovannucci EL, Stampfer MJ, Willett WC, Fuchs CS. Association of nut consumption with total and cause-specific mortality. N Engl J Med 2013;369:2001-11.
  2. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M; PREDIMED Study In- vestigators. Primary prevention of cardiovascular disease with a Med- iterranean diet. N Engl J Med 2013;368:1279-90.
  3. Kris-Etherton PM, Hu FB, Ros E, Sabaté J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple po- tential mechanisms. J Nutr 2008;138:1746S-51S.
  4. Ros E. Health benefits of nut consumption. Nutrients 2010;2:652-82.
  5. Sabate J, Wien M. Consumption of nuts in the prevention of cardio- vascular disease. Curr Nutr Rep 2013;2:258-66.
  6. Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. Continuous dose-response relation- ship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr 2009;139:271-84.
  7. Phung OJ, Makanji SS, White CM, Coleman C. Almonds have a neu- tral effect on serum lipid profiles: a meta-analysis of randomized trials. J Am Diet Assoc 2009;109:865-73.
  8. Banel DK, Hu FB. Effects of walnut consumption on blood lipids and other cardiovascular risk factors: a meta-analysis and systematic re- view. Am J Clin Nutr 2009;90:56-63.
  9. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Pre- ferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. BMJ 2009;339:b2535.
  10. Flores-Mateo G, Rojas-Rueda D, Basora J, Ros E, Salas-Salvado J. Nut intake and adiposity: meta-analysis of clinical trials. Am J Clin Nutr 2013;97:1346-55.
  11. Kris-Etherton PM, Dietschy J. Design criteria for studies examining individual fatty acid effects on cardiovascular disease risk factors: human and animal studies. Am J Clin Nutr 1997;65:1590S-6S.
  12. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring in- consistency in meta-analyses. BMJ 2003;327:557-60.
  13. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta- analysis detected by a simple, graphical test. BMJ 1997;315:629-34.
  14. Abbey M, Noakes M, Belling GB, Nestel PJ. Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr 1994;59:995-9.
  15. Aldemir M, Okulu E, Nes xelioglu S, Erel O, Kayigil O. Pistachio diet improves erectile function parameters and serum lipid profiles in pa- tients with erectile dysfunction. Int J Impot Res 2011;23:32-8.
  16. Almario RU, Vonghavaravat V, Wong R, Kasim-Karakas SE. Effects of walnut consumption on plasma fatty acids and lipoproteins in com- bined hyperlipidemia. Am J Clin Nutr 2001;74:72-9.
  17. Aronis KN, Vamvini MT, Chamberland JP, Sweeney LL, Brennan AM, Magkos F, Mantzoros CS. Short-term walnut consumption increases circulating total adiponectin and apolipoprotein A concentrations, but does not affect markers of inflammation or vascular injury in obese humans with the metabolic syndrome: data from a double-blinded, randomized, placebo-controlled study. Metabolism 2012;61:577-82.
  18. Canales A, Benedí J, Nus M, Librelotto J, Sánchez-Montero JM, Sánchez-Muniz FJ. Effect of walnut-enriched restructured meat in the antioxidant status of overweight/obese senior subjects with at least one extra CHD-risk factor. J Am Coll Nutr 2007;26:225-32.
  19. Canales A, Sánchez-Muniz FJ, Bastida S, Librelotto J, Nus M, Corella D, Guillen M, Benedí J. Effect of walnut-enriched meat on the relationship between VCAM, ICAM, and LTB4 levels and PON-1 activity in ApoA4 360 and PON-1 allele carriers at increased cardiovascular risk. Eur J Clin Nutr 2011;65:703-10.
  20. Casas-Agustench P, López-Uriarte P, Bullo M, Ros E, Cabre-Vila JJ, Salas-Salvadó J. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis 2011;21:126-35.
  21. Chisholm A, Mann J, Skeaff M, Frampton C, Sutherland W, Duncan A, Tiszavari S. A diet rich in walnuts favourably influences plasma fatty acid profile in moderately hyperlipidaemic subjects. Eur J Clin Nutr 1998;52:12-6.
  22. Chisholm A, Mc Auley K, Mann J, Williams S, Skeaff M. Cholesterol lowering effects of nuts compared with a Canola oil enriched cereal of similar fat composition. Nutr Metab Cardiovasc Dis 2005;15:284- 92.
  23. Colquhoun DM, Humphries JA, Moores D, Somerset SM. Effects of macadamia nut enriched diet on serum lipids and lipoproteins com- pared to a low fat diet. Food Aust 1996;48:216-22.
  24. Cominetti C, de Bortoli MC, Garrido AB Jr., Cozzolino SM. Brazilian nut consumption improves selenium status and glutathione peroxidase activity and reduces atherogenic risk in obese women. Nutr Res 2012; 32:403-7.
  25. Damasceno NR, Pérez-Heras A, Serra M, Cofán M, Sala-Vila A, Salas-Salvadó J, Ros E. Crossover study of diets enriched with virgin olive oil, walnuts or almonds: effects on lipids and other cardiovascular risk markers. Nutr Metab Cardiovasc Dis 2011;21:S14-20.
  26. Din JN, Aftab SM, Jubb AW, Carnegy FH, Lyall K, Sarma J, Newby DE, Flapan AD. Effect of moderate walnut consumption on lipid profile, arterial stiffness and platelet activation in humans. Eur J Clin Nutr 2011;65:234-9.
  27. Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr 1999;18:229-32.
  28. Foster GD, Shantz KL, Vander Veur SS, Oliver TL, Lent MR, Virus A, Szapary PO, Rader DJ, Zemel BS, Gilden-Tsai A. A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity. Am J Clin Nutr 2012;96:249-54.
  29. Garg ML, Blake RJ, Wills RB. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. J Nutr 2003;133:1060-3.
  30. Gebauer SK, West SG, Kay CD, Alaupovic P, Bagshaw D, Kris- Etherton PM. Effects of pistachios on cardiovascular disease risk fac- tors and potential mechanisms of action: a dose-response study. Am J Clin Nutr 2008;88:651-9.
  31. Griel AE, Cao Y, Bagshaw DD, Cifelli AM, Holub B, Kris-Etherton PM. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. J Nutr 2008;138:761-7.
  32. Hiraoka-Yamamoto J, Ikeda K, Negishi H, Mori M, Hirose A, Sawada S, Onobayashi Y, Kitamori K, Kitano S, Tashiro M, et al. Serum lipid effects of a monounsaturated (palmitoleic) fatty acid-rich diet based on macadamia nuts in healthy, young Japanese women. Clin Exp Phar- macol Physiol 2004;31:S37-8.
  33. Hyson DA, Schneeman BO, Davis PA. Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women. J Nutr 2002;132:703-7.
  34. Iwamoto M, Imaizumi K, Sato M, Hirooka Y, Sakai K, Takeshita A, Kono M. Serum lipid profiles in Japanese women and men during consumption of walnuts. Eur J Clin Nutr 2002;56:629-37.
  35. Jaceldo-Siegl K, Sabaté J, Batech M, Fraser GE. Influence of body mass index and serum lipids on the cholesterol-lowering effects of almonds in free-living individuals. Nutr Metab Cardiovasc Dis 2011;21:S7-13.
  36. Jalali-Khanabadi BA, Mozaffari-Khosravi H, Parsaeyan N. Effects of almond dietary supplementation on coronary heart disease lipid risk factors and serum lipid oxidation parameters in men with mild hy- perlipidemia. J Altern Complement Med 2010;16:1279-83.
  37. Jambazian PR, Haddad E, Rajaram S, Tanzman J, Sabaté J. Almonds in the diet simultaneously improve plasma a-tocopherol concentrations and reduce plasma lipids. J Am Diet Assoc 2005;105:449-54.
  38. Jia X, Li N, Zhang W, Zhang X, Lapsley K, Huang G, Blumberg J, Ma G, Chen J. A pilot study on the effects of almond consumption on DNA damage and oxidative stress in smokers. Nutr Cancer 2006;54:179-83.
  39. Kocyigit A, Koylu AA, Keles H. Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutr Metab Cardiovasc Dis 2006;16:202-9.
  40. Kurlandsky SB, Stote KS. Cardioprotective effects of chocolate and almond consumption in healthy women. Nutr Res 2006;26:509-16.
  41. Li SC, Liu YH, Liu JF, Chang WH, Chen CM, Chen CY. Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism 2011;60:474-9.
  42. Li Z, Song R, Nguyen C, Zerlin A, Karp H, Naowamondhol K, Thames G, Gao K, Li L, Tseng CH, et al. Pistachio nuts reduce triglycerides and body weight by comparison to refined carbohydrate snack in obese subjects on a 12-week weight loss program. J Am Coll Nutr 2010;29:198-203.
  43. Lovejoy JC, Most MM, Lefevre M, Greenway FL, Rood JC. Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. Am J Clin Nutr 2002; 76:1000-6.
  44. McKay DL, Chen CY, Yeum KJ, Matthan NR, Lichtenstein AH, Blumberg JB. Chronic and acute effects of walnuts on antioxidant capacity and nutritional status in humans: a randomized, cross-over pilot study. Nutr J 2010;9:21.
  45. Mercanligil SM, Arslan P, Alasalvar C, Okut E, Akgul E, Pinar A, Geyik PO, Tokgozoglu L, Shahidi F. Effects of hazelnut-enriched diet on plasma cholesterol and lipoprotein profiles in hypercholesterolemic adult men. Eur J Clin Nutr 2007;61:212-20.
  46. Morgan WA, Clayshulte BJ. Pecans lower low-density lipoprotein cholesterol in people with normal lipid levels. J Am Diet Assoc 2000; 100:312-8.
  47. Mukuddem-Petersen J, Stonehouse OW, Jerling JC, Hanekom SM, White Z. Effects of a high walnut and high cashew nut diet on selected markers of the metabolic syndrome: a controlled feeding trial. Br J Nutr 2007;97:1144-53.
  48. Muñoz S, Merlos M, Zambón D, Rodriguez C, Sabaté J, Ros E, La- guna JC. Walnut-enriched diet increases the association of LDL from hypercholesterolemic men with human HepG2 cells. J Lipid Res 2001; 42:2069-76.
  49. Olmedilla-Alonso B, Granado-Lorencio F, Herrero-Barbudo C, Blanco- Navarro I, Blázquez-García S, Pérez-Sacristán B. Consumption of restructured meat products with added walnuts has a cholesterol- lowering effect in subjects at high cardiovascular risk: a randomised, crossover, placebo-controlled study. J Am Coll Nutr 2008;27:342-8.
  50. Orem A, Yucesan FB, Orem C, Akcan B, Kural BV, Alasalvar C, Shahidi F. Hazelnut-enriched diet improves cardiovascular risk bio- markers beyond a lipid-lowering effect in hypercholesterolemic sub- jects. J Clin Lipidol 2013;7:123-31.
  51. Rajaram S, Burke K, Connell B, Myint T, Sabaté J. A mono- unsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. J Nutr 2001;131:2275-9.
  52. Rajaram S, Connell KM, Sabaté J. Effect of almond-enriched high- monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. Br J Nutr 2010;103:907- 12.
  53. Rajaram S, Haddad EH, Mejia A, Sabaté J. Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hy- perlipidemic individuals: a randomized controlled study. Am J Clin Nutr 2009;89:1657S-63S.
  54. Ros E, Nu ´ñez I, Pérez-Heras A, Serra M, Gilabert R, Casals E, Deulofeu R. A walnut diet improves endothelial function in hyper- cholesterolemic subjects: a randomized crossover trial. Circulation 2004;109:1609-14.
  55. Sabaté J, Fraser GE, Burke K, Knutsen SF, Bennett H, Lindsted KD. Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med 1993;328:603-7.
  56. Sabaté J, Haddad E, Tanzman JS, Jambazian P, Rajaram S. Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feeding trial. Am J Clin Nutr 2003;77:1379-84.
  57. Sari I, Baltaci Y, Bagci C, Davutoglu V, Erel O, Celik H, Ozer O, Aksoy N, Aksoy M. Effect of pistachio diet on lipid parameters, en- dothelial function, inflammation, and oxidative status: a prospective study. Nutrition 2010;26:399-404.
  58. Schutte AE, Van Rooyen JM, Huisman HW, Mukuddem-Petersen J, Oosthuizen W, Hanekom SM, Jerling JC. Modulation of baroreflex sensitivity by walnuts versus cashew nuts in subjects with metabolic syndrome. Am J Hypertens 2006;19:629-36.
  59. Sheridan MJ, Cooper JN, Erario M, Cheifetz CE. Pistachio nut con- sumption and serum lipid levels. J Am Coll Nutr 2007;26:141-8.
  60. Sola `R, Valls RM, Goda `s G, Perez-Busquets G, Ribalta J, Girona J, Heras M, Cabré A, Castro A, Domenech G, et al. Cocoa, hazelnuts, sterols and soluble fiber cream reduces lipids and inflammation bio- markers in hypertensive patients: a randomized controlled trial. PLoS One 2012;7:e31103.
  61. Spaccarotella KJ, Kris-Etherton PM, Stone WL, Bagshaw DM, Fishell VK, West SG, Lawrence FR, Hartman TJ. The effect of walnut intake on factors related to prostate and vascular health in older men. Nutr J 2008;7:13.
  62. Spiller GA, Jenkins DJ, Cragen LN, Gates JE, Bosello O, Berra K, Rudd C, Stevenson M, Superko R. Effect of a diet high in mono- unsaturated fat from almonds on plasma cholesterol and lipoproteins. J Am Coll Nutr 1992;11:126-30.
  63. Spiller GA, Miller A, Olivera K, Reynolds J, Miller B, Morse SJ, Dewell A, Farquhar JW. Effects of plant-based diets high in raw or roasted almonds, or roasted almond butter on serum lipoproteins in humans. J Am Coll Nutr 2003;22:195-200.
  64. Tapsell LC, Gillen LJ, Patch CS, Batterham M, Owen A, Bare M, Kennedy M. Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 di- abetes. Diabetes Care 2004;27:2777-83.
  65. Tey SL, Brown RC, Chisholm AW, Delahunty CM, Gray AR, Williams SM. Effects of different forms of hazelnuts on blood lipids and a-to- copherol concentrations in mildly hypercholesterolemic individuals. Eur J Clin Nutr 2011;65:117-24.
  66. Tey SL, Brown R, Gray A, Chisholm A, Delahunty C. Nuts improve diet quality compared to other energy-dense snacks while maintaining body weight. J Nutr Metab 2011;2011:357350.
  67. Torabian S, Haddad E, Cordero-MacIntyre Z, Tanzman J, Fernandez ML, Sabaté J. Long-term walnut supplementation without dietary advice induces favorable serum lipid changes in free-living in- dividuals. Eur J Clin Nutr 2010;64:274-9.
  68. Wang X, Li Z, Liu Y, Lv X, Yang W. Effects of pistachios on body weight in Chinese subjects with metabolic syndrome. Nutr J 2012;11: 20.
  69. West SG, Gebauer SK, Kay CD, Bagshaw DM, Savastano DM, Die- fenbach C, Kris-Etherton PM. Diets containing pistachios reduce sys- tolic blood pressure and peripheral vascular responses to stress in adults with dyslipidemia. Hypertension 2012;60:58-63.
  70. Wien MA, Sabaté JM, Iklé DN, Cole SE, Kandeel FR. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord 2003;27:1365-72.
  71. Wien M, Bleich D, Raghuwanshi M, Gould-Forgerite S, Gomes J, Monahan-Couch L, Oda K. Almond consumption and cardiovascular risk factors in adults with prediabetes. J Am Coll Nutr 2010;29:189-97.
  72. Wu H, Pan A, Yu Z, Qi Q, Lu L, Zhang G, Yu D, Zong G, Zhou Y, Chen X, et al. Lifestyle counseling and supplementation with flaxseed or walnuts influence the management of metabolic syndrome. J Nutr 2010;140:1937-42.
  73. Yu ¨cesan FB, Orem A, Kural BV, Orem C, Turan I. Hazelnut con- sumption decreases the susceptibility of LDL to oxidation, plasma oxidized LDL level and increases the ratio of large/small LDL in normolipidemic healthy subjects. Anadolu Kardiyol Derg 2010;10:28- 35.
  74. Zambón D, Sabaté J, Muñoz S, Campero B, Casals E, Merlos M, Laguna JC, Ros E. Substituting walnuts for monounsaturated fat im- proves the serum lipid profile of hypercholesterolemic men and women: a randomized crossover trial. Ann Intern Med 2000;132:538- 46.
  75. Zibaeenezhad MJ, Shamsnia SJ, Khorasani M. Walnut consumption in hyperlipidemic patients. Angiology 2005;56:581-3.
  76. Cholesterol Treatment Trialists' Collaborators, Mihaylova B, Ember- son J, Blackwell L, Keech A, Simes J, Barnes EH, Voysey M, Gray A, Collins R, Baigent C. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380:581-90.
  77. Martin SS, Qasim AN, Mehta NN, Wolfe M, Terembula K, Schwartz S, Iqbal N, Schutta M, Bagheri R, Reilly MP. Apolipoprotein B but not LDL cholesterol is associated with coronary artery calcification in type 2 diabetic whites. Diabetes 2009;58:1887-92.
  78. Di Angelantonio E; Emerging Risk Factors Collaboration. Major lipids, apolipoprotiens, and risk of vascular disease. JAMA 2009;302: 1993-2000.
  79. Luo C, Zhang Y, Ding Y, Shan Z, Chen S, Yu M, Hu FB, Liu L. Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis. Am J Clin Nutr 2014;100:256-69.
  80. Pan A, Chen M, Chowdhury R, Wu JH, Sun Q, Campos H, Mozaffarian D, Hu FB. a-Linolenic acid and risk of cardiovascular disease: a sys- tematic review and meta-analysis. Am J Clin Nutr 2012;96:1262-73.
  81. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010;7:e1000252.
  82. Zhao G, Etherton TD, Martin KR, Gillies PJ, West SG, Kris-Etherton PM. Dietary alpha-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholester- olemic subjects. Am J Clin Nutr 2007;85:385-91.
  83. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-404.

Authors
Del Gobbo, L. C., Falk, M. C., Feldman, R., Lewis, K., & Mozaffarian, D.
Affiliations
Tufts University (US)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2015-12
Volume
102
Issue
6
Pages
1347-1356
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.115.110965
PMC
PMC4658458
OpenAlex
W2180829221
Cited by
335
References
90
Citations by year
2026: 11 · 2025: 19 · 2024: 22 · 2023: 49 · 2022: 44 · 2021: 41 · 2020: 32 · 2019: 42 · 2018: 33 · 2017: 30 · 2016: 12
FWCI
3.15
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (R01-HL085710-07)
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
tree nuts, serum lipids, LDL cholesterol, total cholesterol, apolipoprotein B, apolipoprotein A-I, triglycerides, blood pressure, C-reactive protein, inflammation, cardiovascular risk factors, dose-response relationship, phytosterols, dietary intervention, nut consumption, publication bias, meta-regression
MeSH terms
Apolipoproteins B, Cholesterol, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Humans, Hyperlipidemias, Hypertension, Cholesterol, LDL, Nuts, Trees, Down-Regulation, Controlled Clinical Trials as Topic, Evidence-Based Medicine

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review