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Previous Volume 328:603-607 March 4, 1993 Number 9 Next

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ABSTRACT

Background In a recent six-year follow-up study, we found that frequent consumption of nuts was associated with a reduced risk of ischemic heart disease. To explore possible explanations for this finding, we studied the effects of nut consumption on serum lipids and blood pressure.

Methods We randomly placed 18 healthy men on two mixed natural diets, each diet to be followed for four weeks. Both diets conformed to the National Cholesterol Education Program Step 1 diet and contained identical foods and macronutrients, except that 20 percent of the calories of one diet (the walnut diet) were derived from walnuts (offset by lesser amounts of fatty foods, meat, and visible fat [oils, margarine, and butter]).

Results With the reference diet, the mean (±SD) serum values for total, low-density lipoprotein (LDL), and high-density lipoprotein (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). With the walnut diet, the mean total cholesterol level was 22.4 mg per deciliter (0.58 mmol per liter) lower than the mean level with the reference diet (95 percent confidence interval, 28 to 17 mg per deciliter [0.72 to 0.44 mmol per liter]); the LDL and 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 represented reductions of 12.4, 16.3, and 4.9 percent in the levels of total, LDL, and HDL cholesterol, respectively. The ratio of LDL cholesterol to HDL cholesterol was also lowered (P<0.001) by the walnut diet. Mean blood-pressure values did not change during either dietary period.

Conclusions Incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet while maintaining the intake of total dietary fat and calories decreases serum levels of total cholesterol and favorably modifies the lipoprotein profile in normal men. The long-term effects of walnut consumption and the extension of this finding to other population groups deserve 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.

Full Text of this Article

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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.
Extract | Full Text  
N Engl J Med 1993; 329:358-360, Jul 29, 1993. Correspondence

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