Abstract
Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect, even in the context of healthy diets, and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Contrary to expectations, epidemiologic studies and clinical trials suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Safety concerns are limited to the infrequent occurrence of nut allergy in children. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets.
Highlights
Extensive research has been carried out on nuts and health outcomes during the last two decades since publication of a report from the pioneering Adventist Health Study showing an association of nut consumption with a lower risk of coronary heart disease (CHD) in 1992 [1], shortly followed by the seminal clinical trial of Sabaté et al [2] demonstrating that a diet enriched with walnuts reduced serum cholesterol levels compared to a standard healthy diet
In the 11 years of follow up, the postmenopausal women who ate nuts often had no reduced risk of diabetes compared to those who ate nuts occasionally after adjusting for multiple confounders. These negative findings might have been due to over adjustment for nutrients that mediate in part the protective effect of nuts, such as fiber and unsaturated fatty acids, because when adjusting for age only a significant 18% reduction in relative risk was observed between the highest and lowest categories of peanut butter consumption
A Mediterranean diet supplemented with 30 g of mixed nuts per day showed beneficial effects on the lipid profile compared with advice on a low-fat diet in diabetic and non diabetic participants in the PREDIMED study, a randomized trial of dietary intervention for the primary prevention of cardiovascular disease [80]
Summary
Extensive research has been carried out on nuts and health outcomes during the last two decades since publication of a report from the pioneering Adventist Health Study showing an association of nut consumption with a lower risk of coronary heart disease (CHD) in 1992 [1], shortly followed by the seminal clinical trial of Sabaté et al [2] demonstrating that a diet enriched with walnuts reduced serum cholesterol levels compared to a standard healthy diet. The scientific evidence behind the proposal of nuts as cardio-protective foods stem from both epidemiological observations suggesting a consistent inverse association between the frequency of nut intake and development of CHD [reviewed in 13,15,16] and numerous short-term clinical trials showing beneficial effects of nut intake on the lipid profile [reviewed in 13,17-20] and other intermediate markers of CHD [reviewed in 13,20-22]. The mechanism for these salutary effects probably lies in the synergistic interaction of the many bioactive constituents of nuts, which may all. First an outline of the unique nutrient content of nuts is necessary in order to better understand their health effects
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