Background In a recent six-year follow-up study, we found thatfrequent consumption of nuts was associated with a reduced riskof ischemic heart disease. To explore possible explanationsfor this finding, we studied the effects of nut consumptionon serum lipids and blood pressure.
Methods We randomly placed 18 healthy men on two mixed naturaldiets, each diet to be followed for four weeks. Both diets conformedto the National Cholesterol Education Program Step 1 diet andcontained identical foods and macronutrients, except that 20percent of the calories of one diet (the walnut diet) were derivedfrom walnuts (offset by lesser amounts of fatty foods, meat,and visible fat [oils, margarine, and butter]).
Results With the reference diet, the mean (±SD) serumvalues for total, low-density lipoprotein (LDL), and high-densitylipoprotein (HDL) cholesterol were, respectively, 182 ±23,112 ±16, and 47 ±11 mg per deciliter (4.71 ±0.59,2.90 ±0.41, and 1.22 ±0.28 mmol per liter). Withthe walnut diet, the mean total cholesterol level was 22.4 mgper deciliter (0.58 mmol per liter) lower than the mean levelwith the reference diet (95 percent confidence interval, 28to 17 mg per deciliter [0.72 to 0.44 mmol per liter]); the LDLand HDL cholesterol levels were, respectively, 18.2 mg per deciliter(0.47 mmol per liter) (P<0.001) and 2.3 mg per deciliter(0.06 mmol per liter) (P = 0.01) lower. These lower values representedreductions of 12.4, 16.3, and 4.9 percent in the levels of total,LDL, and HDL cholesterol, respectively. The ratio of LDL cholesterolto HDL cholesterol was also lowered (P<0.001) by the walnutdiet. Mean blood-pressure values did not change during eitherdietary period.
Conclusions Incorporating moderate quantities of walnuts intothe recommended cholesterol-lowering diet while maintainingthe intake of total dietary fat and calories decreases serumlevels of total cholesterol and favorably modifies the lipoproteinprofile in normal men. The long-term effects of walnut consumptionand the extension of this finding to other population groupsdeserve further study.
Source Information
From the Center for Health Research (J.S., G.E.F., H.B., K.D.L.), the Department of Epidemiology and Biostatistics (J.S., S.F.K., K.D.L.), and the Department of Nutrition (J.S., K.B.), School of Public Health; and the Department of Nutrition and Dietetics, School of Allied Health Professionals (K.B.), Loma Linda University, Loma Linda, Calif.
Address reprint requests to Dr. Sabate at Loma Linda University, Nichol Hall, Rm. 2016, Loma Linda, CA 92350.
Walnuts and Serum Lipids
Mann G. V., Mirkin G., Mogadam M., Prineas R. J., Kushi L. H., Folsom A. R., Bostick R. M., Sabate J., Fraser G. E.
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N Engl J Med 1993;
329:358-360, Jul 29, 1993.
Correspondence
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Mann, G. V., Mirkin, G., Mogadam, M., Prineas, R. J., Kushi, L. H., Folsom, A. R., Bostick, R. M., Sabate, J., Fraser, G. E.
(1993). Walnuts and Serum Lipids. NEJM
329: 358-360
[Full Text]