Nut consumption, lipids, and risk of a coronary event

In the past many have avoided nuts because of their high fat content. The D ietary Approaches to Stop Hypertension diet, however, recommends regular co nsumption of this food along with seeds and dried beans (4-5 servings per w eek) as part of a diet to control hypertension. Nuts are nutrient-dense and most of their fat is unsaturated. They are also perhaps the best natural s ource of vitamin E and are relatively concentrated repositories of dietary fibre, magnesium, potassium and arginine, which is the dietary precursor of nitric oxide. Human feeding studies have demonstrated reductions of 8-12% in low-density lipoprotein (LDL) cholesterol when almonds and walnuts are s ubstituted for more traditional fats. Other studies show that macadamias an d hazelnuts appear at least as beneficial as fats in commonly recommended d irts. Whether the daily consumption of modest quantities of nuts may promot e obesity is not known with certainty, but preliminary data suggest that th is is unlikely. Four of the best and largest cohort studies in nutritional epidemiology have now reported that eating nuts frequently is associated wi th a decreased risk of coronary heart disease in the order of 30-50%. The f indings are very consistent in subgroup analyses and unlikely to be due to confounding. Possible mechanisms include reduction in LDL cholesterol, the antioxidant actions of vitamin El and the effects on the endothelium and pl atelet function of higher levels of nitric oxide. Although nuts may account for a relatively small percentage of dietary kilojules, the potential inte racting effects of these factors on disease risk may be considerable.