Abstract
The author and four independent experts evaluated the intent and quality of scientific evidence for a potential beneficial health relationship between the intake of walnuts and the reduction and prevention of coronary heart disease. The report also addresses the supporting evidence for the health benefit of other tree nuts and selected legumes. Compared to most other nuts, which contain monounsaturated fatty acids, walnuts are unique because they are rich in n-6 (linoleate) and n-3 (linolenate) polyunsaturated fatty acids. Walnuts contain multiple health-beneficial components, such as having a low lysine:arginine ratio and high levels of arginine, folate, fiber, tannins, and polyphenols. Though walnuts are energy rich, clinical dietary intervention studies show that walnut consumption does not cause a net gain in body weight when eaten as a replacement food. Five controlled, peer-reviewed, human clinical walnut intervention trials, involving approximately 200 subjects representative of the 51% of the adult population in the United States at risk of coronary heart disease were reviewed. The intervention trials consistently demonstrated walnuts as part of a heart-healthy diet, lower blood cholesterol concentrations. None of these studies were of extended duration that would be essential for evaluation of the sustainability of the observed outcomes. These results were supported by several large prospective observational studies in humans, all demonstrating a dose response-related inverse association of the relative risk of coronary heart disease with the frequent daily consumption of small amounts of nuts, including walnuts.