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46 to 0. 77 (CI, 0. In all probability the phytosterol content of nuts contributes to their cholesterol-lowering effect (see below). 97) comparing those who ate nuts five times or more times a week with those who never or almost never ate nuts. 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. The consumer definition also includes peanuts ( Arachis hypogea ), which botanically are groundnuts or legumes but are widely identified as part of the nuts food group. These facts, rarely taken into consideration in prior studies with nuts, should not be overlooked when giving advice on nut intake in healthy diets. Keywords: tree nuts, peanuts, fatty acids, antioxidants, cholesterol, cardiovascular disease, diabetes, inflammation 1. The third study was carried out in 772 older subjects at high risk for CHD living in Spain for the purpose of assessing adherence to the Mediterranean dietary pattern and its food components in relation to levels of soluble inflammatory markers. 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. Walnuts are an exception because they are almost always consumed as a raw, unpeeled product. Obviously, the advantage of the low sodium content of nuts is lost if they are consumed as a salted product. Two separate studies by the same authors, each on different populations, examined the relationship between frequency of nut intake and gallstone disease risk. Nutrient Content of Nuts Nuts are clearly nutrient dense foods. The most popular edible tree nuts are almonds ( Prunus amigdalis ), hazelnuts ( Corylus avellana ), walnuts ( Juglans regia ), and pistachios ( Pistachia vera ). Since inflammation is a key process in atherogenesis, one mechanism by which nut consumption may decrease CHD risk is by improving inflammatory status, which can be ascertained from levels of circulating inflammatory markers. Most clinical studies with nuts have been short-term and have compared diets supplemented with nuts with control diets for outcomes on blood lipid changes in healthy subjects or patients with moderate hypercholesterolemia. Consumption of peanut products was also associated with a decreased relative risk of CHD. Clearly, more research is necessary on the important topic of nuts and cancer. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( ). The mechanism of action of phytosterols has been linked to their hydrophobicity, which is higher than cholesterol because of a bulkier hydrocarbon molecule and entails a higher affinity for micelles than has cholesterol. This study showed an adjusted 20% risk reduction between the lowest quintile (0. However, the protective effect was not observed in men. 30) in this relatively young sample of well educated adults at little baseline risk for hypertension, thus a larger sample and longer duration of follow-up might have provided a better level of evidence. Table 1 Average nutrient composition of nuts (per 100 g). 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. Thus, nuts are one of the natural plant foods richest in fat after vegetable oils. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. These results must be taken with caution, however, because salt intake and changes in weight, two major factors that influence the risk of hypertension, were not accounted for in this study. First an outline of the unique nutrient content of nuts is necessary in order to better understand their health effects. The NCBI web site requires JavaScript to function. Nuts are also rich sources of other bioactive macronutrients that have the potential to beneficially affect metabolic and cardiovascular outcomes. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. During 457,305 person-years of follow-up, men who consumed 5 or more servings of nuts per week showed a risk of developing clinical gallstone disease that was 30% lower compared to those who rarely or never ate nuts. The fact that nuts are often eaten with salt from snack packs is an added source of confusion in the relationship between nut consumption and hypertension. However, there were a limited number of hemorrhagic strokes in the highest categories of nut consumption, thus further studies are clearly warranted to confirm or discard this improbable adverse effect of nuts. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets. Among premenopausal women the multivariate relative risk was 0. 46 to 1. In summary, limited epidemiologic data provide only circumstantial evidence for a protective effect of nut consumption on development of hypertension. In summary, regular consumption of nuts is clearly beneficial for CHD risk, but confirmation of any protective role on diabetes risk must await further studies.
In a secondary analysis stratified by BMI, there was an inverse relationship between nut intake and hypertension in lean subjects but not in those who were overweight or obese at baseline. Source: US Department of Agriculture Nutrient Data Base at: (Accessed on 26 April 2010). No associations were seen between nut consumption and diverticular bleeding or uncomplicated diverticulosis. The hazard ratio for the highest versus lowest nut consumption category was 0. Compared to other common foods, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium, and potassium. Figure 2 Results of prospective studies of nut consumption and risk of diabetes. In this study 20,224 male participants were followed for an average of 19 years. Again because of the richness of nuts in bioactive components, particularly unsaturated fatty acids, fiber, and minerals, a protective effect of nut intake on gallstone disease is biologically plausible. 1 g) and upper quintile (3. 80 (CI, 0. The present review summarizes current knowledge on the expanding topic of nuts and health outcomes. 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. 01). 2. Although chestnuts ( Castanea sativa ) are tree nuts as well, they are different from all other common nuts because of being starchier and having a different nutrient profile. 1 g) of daily peanut consumption. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. However, nut consumption has increased in recent times in Western countries following both the inclusion of this food group in many guidelines for healthy eating and wide media coverage of recent evidence connecting nut consumption to a wide range of health benefits. The results showed an inverse association between nut consumption and the risk of diverticulitis, with a multivariate hazard ratio for men with the highest intake compared with those with the lowest intake of 0. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Phytosterols interfere with cholesterol absorption and thus help lower blood cholesterol when present in sufficient amounts in the intestinal lumen. The consistency of findings in all studies points to a causal association between nut consumption and reduced CHD, indicating that nuts possibly are one of the most cardioprotective foods in the habitual diet. 67 (CI, 0. There have been fewer studies with nuts in patients with obesity, the metabolic syndrome, or type-2 diabetes investigating insulin sensitivity or glycemic control besides the lipid profile. This article has been cited by other articles in PMC. 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. The results of the two studies suggest that frequent nut consumption is equally protective of gallstone disease in men and women. In Western countries nuts are consumed as snacks, desserts or part of a meal, and are eaten whole (fresh or roasted), in spreads (peanut butter, almond paste), as oils or hidden in commercial products, mixed dishes, sauces, pastries, ice creams and baked goods. Among the constituents of nuts there are significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. The mechanism for these salutary effects probably lies in the synergistic interaction of the many bioactive constituents of nuts, which may all favorably influence human physiology. By definition, tree nuts are dry fruits with one seed in which the ovary wall becomes hard at maturity. Figure 2 illustrates the findings of the main prospective studies relating nut consumption to the risk of developing type-2 diabetes. This study showed that women consuming peanuts had a remarkable risk reduction of 58% compared to non-consumers. As discussed below, the particular lipid profile of nuts in general and walnuts in particular is likely to be an important contributor to the beneficial health effects of frequent nut consumption. 63 to 1. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Other common edible nuts are pine nuts ( Pinus pinea ), cashews ( Anacardium occidentale ), pecans ( Carya illinoiensis ), macadamias ( Macadamia integrifolia ), and Brazil nuts ( Bertholletia excelsa ). Safety concerns are limited to the infrequent occurrence of nut allergy in children. In summary, the macronutrient, micronutrient and non-nutrient components of nuts shown in Table 1 and Table 2 have all been documented to contribute to a reduced risk of CHD and related metabolic disturbances.
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