4 Nuts That Cut Your Heart Disease Risk
       
       
       
       
Recently, I set up an experiment in a grocery store. I placed four 
nut mixes on a shelf. Each was labeled differently. One promoted men’s 
health. Another was labeled as a heart-healthy mix, while a third was 
just a wholesome nut mix. Finally, the fourth one made no claims at all 
regarding health; it was just labeled as a deluxe combination of nuts.
I consider myself an amateur when it comes to nuts, I asked passing 
customers which one was best and why. The responses were as variable as 
the people.
One man said, “You are a man and one is for men’s health, so you 
should choose that one.” I asked why it might help me as a man, and he 
said because it was a great source of fiber. (Looking back, I’m not sure
 it’s ever a good idea to rely on a guy in a grocery store to recommend 
that you take more fiber.)
Another shopper recommended the 
heart-healthy mix. When I asked why, she said because it has more walnuts and pistachios and they are good for the heart.
My experiment seemed to fizzle when an authoritative elderly man 
joined the discussion. He said we were all wrong and that only raw nuts 
were healthy. He was not amused when I asked if he thought it was okay 
if I met my daily nut needs by eating a candy bar.
A Heart-Healthy Passion for Nuts
I learned a few things about nuts and people. First, some people are 
very passionate about their nuts. Also, people seem to feel peanuts are 
the least healthy nuts and perceive them as degrading a mixed-nut 
selection. What I thought was good news is that most people recognized 
that the nuts were often salted and felt 
healthy mixes should have less salt or no salt.
The bottom line, based on the research evidence, is that all nuts are
 a very healthy choice. Many new clinical studies highlight 
heart-related benefits of nuts. For example, adding 30 grams (gm)  per 
day of nuts a little over an ounce) to a 
Mediterranean diet lowers risk of 
heart disease by 30 percent
Based on the research, here’s a breakdown of the links betweeen nuts 
and heart disease, and what makes nuts heart healthy. I hope this will 
help you make tough choices, such as which nut mix to purchase.
Almonds Help Lower Cholesterol and Body Fat
Adding almonds to your diet lowers your LDL cholesterol, or bad 
cholesterol, which is involved in creating plaques in your coronary 
arteries that can cause heart attacks. Almonds lower LDL in a 
dose-dependent manner. This means that by increasing the amount of 
almonds you eat, you 
can further lower your LDL. Clinical diet studies show almonds can also 
reduce your risk of insulin resistance and diabetes. Even if you have diabetes, adding almonds to your diet can improve your sensitivity to insulin.
Almonds can also increase your likelihood of losing weight. In one 
study, adding 84 gm, or about 3 ounces (oz) of almonds  a day to a 
planned diet improved weight loss and resulted in a 14 percent 
decrease in waist circumference. A 
study published in 2015
 looked at cholesterol and body fat in people who ate 1.5 oz of almonds a
 day versus a healthy muffin with similar calories. In only six weeks, 
people who consumed almonds had lower LDL cholesterol by an average of 5
 mg/dL. They also had less belly fat and leg fat.
There are also several studies showing eating almonds lowers body inflammation.
If you are looking to shrink your waist and improve your cholesterol, start by adding some almonds to your diet.
Pistachios Help Lower Blood Pressure Under Stress
Adding pistachios to your diet also has potential heart benefits. Previously, I discussed how our body and 
heart responds adversely to stress
 and how we respond to it with increased blood pressure. A study of 
people who ate approximately 1.5 0z of pistachios a day and were then 
exposed to mental stress found they had lower blood pressure rises than 
those who did not 
eat pistachios.
 In people with diabetes, eating pistachios lowers total and LDL 
cholesterol and can reduce the risk of diabetes-related disease in the 
arteries. In a four-week trial 
published in 2014 of patients
 who had diabetes, a diet rich in pistachios (about 6 to 10 gm/day) 
improved heart rate response to stress, 24-hour blood pressure 
measurements, and heart function and output. Total cholesterol also 
decreased for those who ate pistachios.
If you are looking to lower your blood pressure, improve your 
response to stress, and lower your cholesterol, consider adding 
pistachios to your diet.
Walnuts Help Keep Arteries Clear
Most nuts contain a high concentration of healthy fat. Walnuts are 
composed of 47 percent polyunsaturated fatty acids, thought of as “good 
fats.” But while most 
nuts contain polyunsaturated fatty acids,
 walnuts are the only ones with a significant amount of a certain type 
called alpha-linoleic acid. Alpha-linoleic acid acts as an 
anti-inflammatory agent and has actually been shown to help reduce 
plaque buildup in coronary arteries. Eating walnuts has been shown to 
improve cholesterol levels and the function of the 
small arteries and vessels within our bodies. Recently, a study looking people who consumed 43 gm of walnuts every day found the nuts 
reduced total and LDL cholesterol levels.
 However this study showed something even more important, in my view. 
Consumption of walnuts reduced the level of apolipoprotein B, which is a
 strong genetic risk factor for coronary artery disease.
If you are at high risk for coronary artery disease (CAD) or already have it, consider adding walnuts to your diet.
The Truth About Peanuts
In my grocery store experiment, peanuts took a beating. However, many
 studies show eating peanuts, including peanut butter, can reduce heart 
risk. In the 
Nurse’s Health Study,
 those women who consumed peanuts and peanut butter lowered their risk 
of heart disease by 34 percent. The greatest benefit was in those who 
ate peanuts multiple times a week. In a study of 6,309 women with 
diabetes, eating one serving of peanuts (28 gm [1 oz] for nuts and 16 gm
 [1 tablespoon] for peanut butter) five times a week or more 
lowered risk of heart disease by 44 percent.
Eating peanuts and peanut butter has also been shown to 
lower risk of diabetes
 in both lean and overweight women. Finally, like many other nuts, 
peanuts as an alternative food source for your protein needs can 
lower your cholesterol, particularly when added to other healthy diet choices.
If you are like the people in my study, perhaps you are asking: Are peanuts better than the others I have mentioned?
A recent study looked at this question, specifically diets rich in 
peanuts versus tree nuts. This study shed some light on the potential 
greater benefit of tree nuts compared to peanuts. In 803 adults, 
abdominal obesity, blood pressure, and cholesterol where all better 
controlled in those who had a high intake of tree nuts. However, if you 
ate a lot of tree nuts, it didn’t seem to matter how many peanuts you 
ate. Like the other trials mentioned in this section, this one showed 
that eating peanuts was better than not eating nuts, peanuts or other 
nuts, in regard to 
better blood pressure and cholesterol levels.
 The most striking difference in the study was that high consumption of 
tree nuts did not increase risk of abdominal obesity, whereas high 
consumption of peanuts alone did.
Can You Eat too Many Nuts?
The answer is yes, absolutely. The best approach to eating nuts is moderation.
Nuts are very good sources of energy, and if you eat too much you can
 gain weight and offset the heart benefits. I like to recommend adding 
nuts to an already heart-healthy diet or as an alternative healthy 
snack. If you change your snacks alone to unsalted nuts you will be 
surprised how effective that choice is in helping with weight loss and 
cholesterol management.
One thing to keep in mind is that some people can experience 
dangerous allergic reactions to nuts. If you have a potential allergy or
 a family history of nut allergies, don’t consider using nuts until you 
talk with your doctor.
Finally, there are data regarding contamination of some nuts with 
mycotoxins.  Consider reading about these toxins as I don’t have enough 
room to cover them here. The one that has the most data behind it is 
cases of 
contamination of peanuts with aflatoxin.
An Apology to Pecan, Hazelnut, and Macadamia Fans
I want to apologize for the nuts left off this list. It was not 
intentional. Pecans, hazelnuts, and macadamia nuts have also shown some 
benefits in reducing heart disease factors, but they don’t have the data
 of the nuts listed above.
I hope this information will help you with your next nut purchase or your next spirited debate with a passionate nut person.
T. Jared Bunch, MD is a native of Logan Utah and directs heart rhythm research at the 
Intermountain Medical Center Heart Institute. You can 
follow @TJaredBunch on Twitter.