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Nuts Lower Cholesterol

Nuts & CholesterolNuts have been consistently associated with reduced risk of coronary heart disease in epidemiological studies.1 Evidence of nuts’ cardioprotective effects were originally recognized in the early 1990s2, and since then, several human trials have documented improvements in lipid levels in response to including nuts in the diet.3 Beneficial cardiovascular effects beyond cholesterol lowering have also been identified, particularly for walnuts and almonds.4-6

A review published in Archives of Internal Medicine in 2010 pooled the data from 25 different clinical studies that ran for a minimum of three weeks, comparing a nut eating group to a control group. Most of the studies were done on walnuts or almonds, but studies on macadamias, pistachios, hazelnuts, pecans, and peanuts were also included in the analysis.7

This review confirmed that nut consumption has beneficial effects on lipid levels, and it also reached two interesting new conclusions:

1. Dose dependent effect
First, the different studies were on different quantities of nuts, and the review concluded that the cholesterol-lowering effects of nuts are dose-dependent — this means that more nuts consumed translated into greater decreases in LDL and total cholesterol:

Quantity of nuts consumed
Decrease in total cholesterol
Decrease in LDL

1 oz.



1.5 oz.



2.4 oz.



For healthy weight individuals, these results suggest that 2.4 ounces may be better than 1 ounce for cardiovascular health.

Dr. Fuhrman gives you specific guidelines on quantity and quality of nuts and seeds.

2. Effects were greater in individuals with lower BMI
The researchers found that body mass index (BMI) modified the association between nut consumption and cholesterol lowering. The effects of nuts were greater in individuals with lower BMI, meaning that those who were overweight or obese saw less cholesterol-lowering benefit than healthy weight individuals.7

Nuts and seeds are critical components of a disease-preventing diet, and I recommend eating them daily. The addition of nuts and seeds benefits cardiovascular health and may even enhance lifespan, according to large, long-term studies; for example, in the Adventist Health Study, those who had a high level of physical activity, followed a vegetarian diet, and ate nuts frequently lived on average 8 years longer than those who did not share those habits.8, 9 Similarly, in a trial evaluating diets supplemented with either nuts or olive oil, nut consumption (more than 3 servings per week) was associated with a 39% reduced risk of death from all causes.10 For those that are overweight, nuts are beneficial, but nut and seed intake must also be consistent with weight loss goals. The primary means of decreasing cardiovascular risk in overweight individuals should be eating lots of high micronutrient, low calorie foods. For people who are significantly overweight, nuts should still be included, but their caloric density suggests a limit such as 1 ounce per day for women and 1.5–2 ounces a day for men.


1. Sabate J, Ang Y: Nuts and health outcomes: new epidemiologic evidence. Am J Clin Nutr 2009, 89:1643S-1648S.
2. 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.
3. Griel AE, Kris-Etherton PM: Tree nuts and the lipid profile: a review of clinical studies. Br J Nutr 2006, 96 Suppl 2:S68-78.
4. Ma Y, Njike VY, Millet J, et al: Effects of walnut consumption on endothelial function in type 2 diabetic subjects: a randomized controlled crossover trial. Diabetes Care 2010, 33:227-232.
5. Jenkins DJ, Kendall CW, Marchie A, et al: Almonds reduce biomarkers of lipid peroxidation in older hyperlipidemic subjects. J Nutr 2008, 138:908-913.
6. Jenkins DJ, Kendall CW, Marchie A, et al: Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation 2002, 106:1327-1332.
7. Sabate J, Oda K, Ros E: Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med 2010, 170:821-827.
8. Baer HJ, Glynn RJ, Hu FB, et al: Risk factors for mortality in the nurses' health study: a competing risks analysis. Am J Epidemiol 2011, 173:319-329.
9. Fraser GE, Shavlik DJ: Ten years of life: Is it a matter of choice? Arch Intern Med 2001, 161:1645-1652.
10. Guasch-Ferre M, Bullo M, Martinez-Gonzalez MA, et al: Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial. BMC Med 2013, 11:164.


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