Current Atherosclerosis Reports

, Volume 1, Issue 3, pp 204–209 | Cite as

Nut consumption and risk of coronary heart disease: A review of epidemiologic evidence

  • Frank B. Hu
  • Meir J. Stampfer


Traditionally nuts have been perceived as an unhealthy food because of their high fat content. However, recent accumulative evidence suggests that frequent consumption of nuts may be protective against coronary heart disease (CHD). So far, five large prospective cohort studies (the Adventist Health Study, the Iowa Women Health Study, the Nurses’ Health Study, the Physicians’ Health Study, and the CARE Study) have examined the relation between nut consumption and the risk of CHD and all have found an inverse association. In addition, several clinical studies have observed beneficial effects of diets high in nuts (including walnuts, peanuts, almonds, and other nuts) on blood lipids. The beneficial effects of nut consumption observed in clinical and epidemiologic studies underscore the importance of distinguishing different types of fat. Most fats in nuts are mono- and polyunsaturated fats that lower low-density lipoprotein cholesterol level. Based on the data from the Nurses’ Health Study, we estimated that substitution of the fat from 1 ounce of nuts for equivalent energy from carbohydrate in an average diet was associated with a 30% reduction in CHD risk and the substitution of nut fat for saturated fat was associated with 45% reduction in risk. Given the strong scientific evidence for the beneficial effects of nuts, it seems justifiable to move nuts to a more prominent place in the United States Department of Agriculture Food Guide Pyramid. Regular nut consumption can be recommended in the context of a healthy and balanced diet.


Coronary Heart Disease Cardiovascular Heart Disease Risk Cardiovascular Heart Disease Risk Factor Large Prospective Cohort Study Fatal Cardiovascular Heart Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    American Heart Association: Invest in heart and stroke research—ensure the future of our nation, our Families and Our children. Washington, DC: American Heart Association, 1996:7.Google Scholar
  2. 2.
    Rosamond WD, Chambless LE, Folsom AR, et al.: Trends in the incidence of myocardial infarction and in mortality due to cornary heart disease, 1987–1994. N Engl J Med 1998, 339:861–867.PubMedCrossRefGoogle Scholar
  3. 3.
    Willett WC: Nutritional Epidemiology, 2nd edn. New York, NY: Oxford University Press, 1998.Google Scholar
  4. 4.
    Dreher ML, Maher CV: The traditional and emerging role of nuts in healthful diets. Nutr Rev 1996, 54:241–245.PubMedCrossRefGoogle Scholar
  5. 5.
    Willett WC: Diet and health: What should we eat? Science 1994, 264:532–537.PubMedCrossRefGoogle Scholar
  6. 6.
    Fraser GE, Sabate J, Beeson WL, et al.: A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med 1992, 152:1416–1424.PubMedCrossRefGoogle Scholar
  7. 7.
    Fraser GE, Sumbureru D, Pribis P, et al.: Association among health habits, risk factors, and all-cause mortality in a blac California population. Epidemiology 1997, 8:168–174.PubMedCrossRefGoogle Scholar
  8. 8.
    Prineas RJ, Kushi LH, Folsom AR, et al.: Walnuts and serum lipids [Letter]. E Engl J Med 1993, 329:359.Google Scholar
  9. 9.
    Kushi LH, Folsom AR, Prineas RJ, et al.: Dietary antioxidant vitamins and death from coronary heart disease in post-menopausal women. N Engl J Med 1996 334:1156–1162.PubMedCrossRefGoogle Scholar
  10. 10.
    Hu FB, Stampfer MJ, Manson JE, et al.: Frequent nut consumption and risk of coronary heart disease: prospectiv cohort study. BMJ 1998, 317:1341–1345.PubMedGoogle Scholar
  11. 11.
    Salvini S, Hunter DJ, Sampson L, et al.: Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 1989, 18:858–867.PubMedCrossRefGoogle Scholar
  12. 12.
    Grundy SM, Denke MA: Dietary influences on serum lipids and lipoproteins. J Lipid Res 1990, 31:1149–1172.PubMedGoogle Scholar
  13. 13.
    Sabate J, Fraser GE, Burke K, et al.: Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med 1993, 328:603–607.PubMedCrossRefGoogle Scholar
  14. 14.
    Spiller GA, Jenkins D, Gragen LN, et al.: Effect of a diet high in monounsaturated fat from almonds on plasma cholesterol and lipoproteins. J Am Coll Nutr 1992, 11:126–130.PubMedGoogle Scholar
  15. 15.
    Abbey M, Noakes M, Belling GB, et al.: Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr 1994, 59:995–999.PubMedGoogle Scholar
  16. 16.
    O’Byrne DJ, Knauft DA, Shireman RB: Low fat-monounsaturated rich diets containing high-oleic peanuts improve serum lipoprotein profiles. Lipids 1997, 32:687–695.PubMedCrossRefGoogle Scholar
  17. 17.
    Sabate J: Does nut consumption protest against ischemic heart disease. Eur J Clin Nutr 1993, 47:S71-S75.PubMedGoogle Scholar
  18. 18.
    Fraser GE: Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol. Am J Clin Nutr 1994, 59(Suppl):117–1123Google Scholar
  19. 19.
    Cooke JP, Tsao P, Singer A, et al.: Anti-atherogenic effect of nuts: is the answer NO [Letter]? Arch Intern Med 1993, 153:898–899.CrossRefGoogle Scholar
  20. 20.
    Hu FB, Stampfer MJ, Manson JE, et al.: Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart diseas among women. Am J Clin Nutr 1999, 69:890–897.PubMedGoogle Scholar
  21. 21.
    Dolecek TA: Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proc Soc Exp Biol Med 1992, 200:177–182.PubMedGoogle Scholar
  22. 22.
    Ascherio A, Rimm EB, Giovannucci EL, et al.: Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. Br Med J 1996, 313:84–90.Google Scholar
  23. 23.
    Pietinen P, Ascherio A, Korhonen P, et al.: Intake of fatt acids and risk of coronary heart disease in a cohort of Finnish men: the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol 1997, 145:876–887.PubMedGoogle Scholar
  24. 24.
    Hu FB, Stampfer MJ, Manson JE, et al.: Dietary fat intake and the risk of coronary heart disease in women. N Eng J Med 1997, 337:1491–1499.CrossRefGoogle Scholar
  25. 25.
    Appel L, Moore TJ, Obrazanek E, et al.: A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997, 336:1117–1124.PubMedCrossRefGoogle Scholar
  26. 26.
    Singh RB, Rastogi SS, Verman R, et al.: Randomised controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: results of one year follow up. Br Med J 1992, 304:1015–1019.CrossRefGoogle Scholar
  27. 27.
    U. S. Department of Agriculture U. S. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. Homes and Garden Bulletin No. 232 Washington, DC, U.S. Printing Office 1995.Google Scholar
  28. 28.
    Oldways Preservation and Exchange Trust. Food Guide Pyramid. 1998.Google Scholar

Copyright information

© Current Science Inc. 1999

Authors and Affiliations

  • Frank B. Hu
    • 1
  • Meir J. Stampfer
    • 1
  1. 1.Department of NutritionHarvard School of Public HealthBoston

Personalised recommendations