Nut consumption and coronary heart disease (CHD) risk and mortality

The purpose of this chapter is to review the evidence about the role of nuts in cardiovascular disease (CVD) risk reduction. CVD risk reduction has been the target of dietary intervention for decades as a result of the disease burden. Approximately 25% of all deaths in the United States are from heart disease (CHD) each year, ranking CVD the number one cause of death, both in the United States and worldwide. Epidemiological and clinical studies have been conducted that demonstrate the benefits of nuts on CVD morbidity and mortality. In addition, there is impressive evidence demonstrating beneficial effects of nuts on CVD risk factors. Several landmark epidemiological studies, including the Adventist Study and The Nurse’s Health Study, have reported beneficial associations between nut consumption and CVD risk, incidence, and mortality with different populations. One seminal randomized, controlled trial (RCT), PREDIMED, has also shown benefits of nut consumption on CVD risk, events, and mortality. This study, along with many others, has reported favorable changes in blood lipids, inflammation, and other markers of CVD with nut consumption. The studies discussed in this chapter have added to the evidence base that informs Dietary Guidelines. The 2015-2020 Dietary Guidelines recommend a healthful dietary pattern that includes nuts, for health promotion, as well as the prevention of chronic diseases, including CVD.