People who consume more nuts, especially tree nuts such as almonds, walnuts, and cashews, have a significantly lower risk of death from cardiovascular disease compared with those who rarely or never eat them, according to a new study by Loma Linda University Health researchers.
Those with the highest intake of tree nuts had a 17-27% lower risk of death, researchers said.
Though similar studies have examined the association of nut consumption and health, less than half of them focused on tree nuts, researchers said. Many of those studies included peanut butter and peanuts, which are technically legumes. Researchers said they hoped their study would add to the evidence that diet continues to play a substantial role in health.
“We embarked on this research because heart disease continues to be one of the leading causes of death in the United States and globally,” said Montry Suprono, DDS, director of the Center for Dental Research at Loma Linda University School of Dentistry and the study’s lead author. “A lot of medications have been created; however, many health problems can be prevented, and one of the best ways to prevent them is through diet.”
Their study — Nut consumption and risk of cardiovascular disease and ischemic heart disease mortality: The Adventist Health Study 2 — was published earlier this month in the Journal of Nutrition.
The team explored data from a longitudinal survey of more than 80,000 people to conduct their research. That cohort, from the Adventist Health Study 2, involved an in-depth questionnaire of Seventh-day Adventists from the United States and Canada from 2002 to 2007. Suprono said that cohort was generally healthier than the general population, with few regularly using tobacco or alcohol.
“Those kinds of harmful substances and behaviors in other cohorts appeared more frequently and can cloud the association between diet and disease,” Suprono said. “The Adventist Health Study 2 better allows researchers to evaluate the association between just diet and disease.”
Although the latest findings are observational and cannot prove cause and effect, they are consistent with other studies of nuts being associated with a drop in cardiovascular risk, Suprono said.
Suprono said nuts in the 1980s and early 1990s were considered by many people to be unhealthy because of their fat content. These were largely influenced by early research linking dietary fat intake to heart disease. As a result, medical advice and dietary guidelines at the time often discouraged high-fat foods (including nuts), leading many people to avoid them despite of their potential health benefits. It wasn’t until 1992 that Gary Fraser, who is the primary investigator of the Adventist Health Study 2, came out with a landmark study showing the potential protective effects of nuts against heart disease. Fraser was also involved in this latest study.
“That study literally put nuts back on the map,” Suprono said. “It triggered a cascade of studies from other U.S. based cohorts such as the Nurses’ Health Studies, Health Professionals Follow-up Study, along with other studies in Europe and Asia.”
Nuts contain plant sterols, magnesium, fiber, and vitamins that may help reduce inflammation and, to some degree, blood pressure, Suprono said. Together, these macro and micronutrients work synergistically to support healthier blood vessels and reduce the risk of atherosclerosis and heart disease.
Eating a few small handfuls of nuts a few times a week would be a great starting point for those who have previously avoided or are wanting to eat them, Suprono said. Nuts are nutrient-dense foods, packed with lots of macro- and micro-nutrients. They can be eaten in moderation whole or added to items such as salads, oatmeal, shakes, or yoghurt. He also recommends nuts that are minimally processed — unsalted and raw instead of processed or roasted.
The team also performed a substitution analysis to explore the potential reduced risk of substituting nuts for certain foods, such as unprocessed red meat, processed meat, eggs, and poultry. Suprono said the results were substantially significant, with a 35-44% drop in risk of death from cardiovascular disease. Although these findings are exploratory, they highlight the potential public health benefit of encouraging small, practical shifts toward more plant-based dietary strategies to support heart health.
“The general trend in research for healthy living is to eat less meat and replace it with plant-based protein,” Suprono said.
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