Walnuts & Artery Function

Walnuts & Artery Function
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Not eating walnuts may double our risk of dying from heart disease (compared to at least one serving a week)—perhaps because nuts appear to improve endothelial function, allowing our arteries to better relax normally.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Not eating walnuts may double our risk of dying from heart disease, compared to at least one serving a week. But, walnut consumption may only drop our cholesterol levels about 5%. How could we get a 50% drop in cardiac mortality from just a 5% drop in cholesterol? Walnuts must have some other heart-protecting benefits, besides just lowering cholesterol—such as improving arterial function.

This review found five clinical trials analyzing the effect of nut consumption on the ability of our arteries to relax and open normally—considered “an excellent ‘barometer’ of underlying vascular health.” Even after controlling for other risk factors, 80% of those with better-than-average arterial function survived cardiac event-free over the years, whereas 80% of those with below-average dilation didn’t.

And so, what effect do nuts have? All three studies on walnuts showed an improvement in endothelial function, arterial function—this so-called flow-mediated dilation measured in the arm. The one study on pistachios also found a positive effect, but the one study on hazelnuts was a wash. A subsequent study on hazelnuts, though, did find a significant improvement in arterial function, so the data on hazelnuts is mixed—whereas two subsequent walnut studies, however, confirmed walnuts’ benefits.

So, eight studies to date on nuts and brachial artery function, and seven out of eight showed a significant improvement in arterial function; one showed a negligible effect; and none found nuts made things worse. Half the studies, though, used the added walnuts to replace foods in the diet known to have a negative effect on endothelial function.

For example, in this study, walnuts replaced meat and dairy, which have been shown to be detrimental, so, no wonder arterial function got better. When you do a study like that, you can’t tell if the benefits you’re seeing is because you’re adding good stuff, or getting rid of the bad.

And, in three of the other studies, nuts replaced olive oil, which tends to lead to a worsening of endothelial function—thereby exaggerating the beneficial effects of the walnuts, from here to here.

But, the other four studies, like this one, that just added nuts “as a snack or with a meal,” without replacing any specific foods, found nuts “significantly improved [arterial] functioning.” And, given their association with longevity, I encourage everyone to eat an ounce of nuts a day—unless, of course, you’re allergic. Only about 1% of people report nut allergies, but still, that’s a significant “downside of [nut] consumption” for millions of Americans.

Please consider volunteering to help out on the site.

Images thanks to Alex Ex and J.Dncsn via Wikimedia, and angels aguirre via flickr

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Not eating walnuts may double our risk of dying from heart disease, compared to at least one serving a week. But, walnut consumption may only drop our cholesterol levels about 5%. How could we get a 50% drop in cardiac mortality from just a 5% drop in cholesterol? Walnuts must have some other heart-protecting benefits, besides just lowering cholesterol—such as improving arterial function.

This review found five clinical trials analyzing the effect of nut consumption on the ability of our arteries to relax and open normally—considered “an excellent ‘barometer’ of underlying vascular health.” Even after controlling for other risk factors, 80% of those with better-than-average arterial function survived cardiac event-free over the years, whereas 80% of those with below-average dilation didn’t.

And so, what effect do nuts have? All three studies on walnuts showed an improvement in endothelial function, arterial function—this so-called flow-mediated dilation measured in the arm. The one study on pistachios also found a positive effect, but the one study on hazelnuts was a wash. A subsequent study on hazelnuts, though, did find a significant improvement in arterial function, so the data on hazelnuts is mixed—whereas two subsequent walnut studies, however, confirmed walnuts’ benefits.

So, eight studies to date on nuts and brachial artery function, and seven out of eight showed a significant improvement in arterial function; one showed a negligible effect; and none found nuts made things worse. Half the studies, though, used the added walnuts to replace foods in the diet known to have a negative effect on endothelial function.

For example, in this study, walnuts replaced meat and dairy, which have been shown to be detrimental, so, no wonder arterial function got better. When you do a study like that, you can’t tell if the benefits you’re seeing is because you’re adding good stuff, or getting rid of the bad.

And, in three of the other studies, nuts replaced olive oil, which tends to lead to a worsening of endothelial function—thereby exaggerating the beneficial effects of the walnuts, from here to here.

But, the other four studies, like this one, that just added nuts “as a snack or with a meal,” without replacing any specific foods, found nuts “significantly improved [arterial] functioning.” And, given their association with longevity, I encourage everyone to eat an ounce of nuts a day—unless, of course, you’re allergic. Only about 1% of people report nut allergies, but still, that’s a significant “downside of [nut] consumption” for millions of Americans.

Please consider volunteering to help out on the site.

Images thanks to Alex Ex and J.Dncsn via Wikimedia, and angels aguirre via flickr

Doctor's Note

This helps explain why Nuts May Help Prevent Death.

What else can nuts do? See, for example:

Don’t nuts make us fat, though? You may be surprised—see Nuts & Obesity: The Weight of Evidence.

Which type of walnut is better? See Black vs. English Walnuts.

What about the phytates in nuts–do we need to soak or toast them? See:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

119 responses to “Walnuts & Artery Function

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  1. I wish there was more data available on this subject. What is it in nuts that has this artery-enhancing effect? Arginine? What about seeds? are they just as good for you? Perhaps I don’t need nuts because I take a tablespoon of flax seeds each day. Since I’m on a healthy plant-based, whole foods diet, low in fat, and as a result, my blood pressure is around 100/60, will nuts and anything to my health? Perhaps they’ll add excess calories and fat that I don’t want.




    5
    1. In addition to the ALA PUFA, walnuts contain Beta Sitosterol (a phytosterol that has been shown to lower cholesterol) and pedunculagin (a polyphenol also found in pomegranates) and tocopherols (forms of Vitamin E). The improved endothelial function most likely is a result of a combination of these nutrients.




      1
    2. will nuts [add] anything to my health?

      At the very least, pleasure and variety to your WFPB diet. Variety is a good thing nutritionally speaking. “Blue Zone” Adventists who eat nuts live 2 years longer than those who don’t. (Blue Zones, Buettner, page 165)




      1
    1. Kathy, I can relate! A lot of vegan/vegetarian recipes call for such unusual items that you can feel nickel-dimed to death! Add to your pantry slowly, trying one new thing at a time – really explore that new item to get the best use out of it and learn about its versatility (EX: flax). Some simple ideas here:

      http://www.wikihow.com/Be-Vegetarian-on-a-Budget




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    2. Dried beans and lentils are very economical.

      Minimizing spoilage helps. Cruciferous veggies keep well in the fridge, allowing me to apportion them without spoiling. Ripen fruit at room temp, then refrigerate. Etc.




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      1. Heck you can buy 1 pound of dried black beans in the dollar stores for …guess what…$1!!! Lentils can be found at most Wal-Mart stores too for around $1…! great stuff! vv




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        1. It varies from place to place in price, of course. As an aside, the Mormons have a religious prerogative to keep a supply of food in long-term storage, and, conveniently enough, dry legumes are appropriate for long-term storage. If you are willing to commit in volume in order to capture lower prices, you may want to see if the LDS have a food storage center near you, what their policy is, and whether they carry 25 pound sacks for sale. I got my recent supply of beans from them and though the beans are smaller than usual (not necessarily a bad thing) and do need to be sorted before soaking (some store bought types basically don’t), it’s very hard to beat the price.




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    3. Hi Kathy, Dr. Neal Barnard has a book, “Dr. Barnard’s Program for Reversing Diabetes” which has plant-based recipes. I prefer the easy to prepare recipes in Dr. John McDougall’s books. Many of the recipes are available for free on his website, drmcdougall.com. They are tasty and don’t require fancy ingredients. Good luck!




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    4. Hi Kathy, in addition to the great resources already mentioned, you might also want to check out Jeff Novick. His cooking style is very cheap, very fast and easy, and always low fat, whole foods plant-based (i.e. diabetic-friendly!). The link below is for a facebook album of his of cheap, simple recipes. He describes them as taking less than 5 minutes, having 5 ingredients or less, and being less than $5 (and you can decrease this cost quite a bit by choosing dried beans or even generic canned beans over the “premium” Eden brand canned beans he uses).

      https://www.facebook.com/media/set/?set=a.204432390124.260255.177550385124&type=3




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  2. my mom use to have high cholesterol and was diabetic, I helped her change her diet to vegan and we added a daily snack of walnuts. This helps to confirm her normal cholesterol and blood sugar numbers, walnuts help improve both.




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  3. Looks like I’m breaking a weight loss plateau with a couple of diet tweaks. Instead of 1/2 of a honking big avocado, I tapered back to 2 oz/day and stopped binging on frozen mango. But walnuts? They’re staying put!!




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  4. Walnuts seem to inflame my gums and cause severe toothache! What other nuts work well, I wonder? I am mainly vegan, nondairy and have a good low blood pressure.




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    1. Hi Doda,
      Dr. Robert Vogel did the research study showing that olive oil, which is 14% saturated fat, inflamed the endothelial lining of the arteries:
      http://www.webmd.com/food-recipes/features/say-no-to-olive-oil

      Dr. Dean Ornish, heart reversal diet expert, also chimed in:
      http://www.rd.com/health/the-great-olive-oil-misconception-dr-ornish-responds/

      And Dr. Caldwell Esselstyn, equally renowned clinician who has documented heart disease reversal in his book:
      https://www.youtube.com/watch?v=b_o4YBQPKtQ




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        1. Agreed Val. I add walnuts to my steel-cut oats, along with either blackberries or cranberries, and some unsweetened soy milk. I always have to have a cooked breakfast to start my day.




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    2. Oil isn’t healthy, olive oil shown only a minute improvement over other oil and boy did the marketing grab hold of it! Our human bodies were never designed to ingest such a highly concentrated item as oil. There is no such thing as concentrated oil as a food found in nature, ever see an oil plant or an oil tree? Our livers go into overdrive within 5 minutes of eating oil just trying to detoxify it it takes the liver up to 2 hrs just to handle it. All oils cause inflammation and increase arterial pressures including coronary artery (in the heart) spasm especially in women and can bring on chest pain or worse. Next time you have a high fat meal check your pulse prior to the meal, you will find it has increased afterwards…




      1
      1. “All oils cause inflammation” .

        Flaxseed oil has anti inflammatory effect and have antiarrhythmic properties. Improve flow-mediated dilation (FMD), lower C-reactive protein (CRP). As a suppliment (1-2 teaspoons/day) flaxseed oil is good fo your arteries and heart. The bioavailability of ALA is dependent on the type
        of flax ingested (ALA has greater bioavailability in oil than in milled
        seed, and has greater bioavailability in milled seed than in whole seed).
        Is there any data showing that flaxseed oil is bad ?? I see only good things about it.

        1. “http://www.ncbi.nlm.nih.gov/pubmed/21677123”
        2. “http://www.ncbi.nlm.nih.gov/pubmed/15893192”
        3. “http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989356/”

        I think flaxseed oil will be rehabilitated in the future.




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    3. Olive oil is fine as long as you keep your total calories from fat under 5-10% each day. That’s hard to do with olive oil, eat the walnuts instead for quality fat.




      0
  5. This is definitely such a great thing to know. A couple questions on topic
    – are flax seeds are just as much beneficial (given even better W-3/6 profile and anti-cancer properties). I remember seeing in other video where studies showed even a bit of peanuts was good for cardiac health.
    – what if I am on low-fat WFPB diet Ornish-McDoug-Ess style (since I have no discomfort I’m doing a strict version while hoping to clean some of my arteries from before China Study years:)), can I afford an ounce of walnuts per day/few days? Should I exclude my daily 1-2 tbsp of flax (some mix)?
    – another two products with some studies on endothelial function improvement were cocoa and garlic, would be very nice to know an up-to-date expert’s take of Dr.Greger’s and NF team on these too…




    0
    1. Because of the high content of omega 3, high content of lignans, and countless studies showing great benefit of flax, I would not exclude it from your diet. Walnuts are definitely more fatty, but a 1/4 cup a day would not cause heart disease. I think the essylsten approach works best when you actually have heart disease.

      http://nutritionfacts.org/topics/flax-seeds/




      1
      1. Many thanks for your reply Toxins! I guess flax is indeed too good to be let go of :)

        Regarding stricts version of LF WFPB diet I’m acting on assumption anyone who “enjoyed” western diet for a number of years has some degree of heart disease (again remembering China Study fragment about young soldiers and also Dr.Greger speaking about initial stages of CVD found in younger populations). I also keep in mind Dr.Ornish’s words that the more adherence the better results (with mediocre adherence leading basically to no improvement even if not worsening). So I’d guess anyone would benefit from some period of strict following (no nuts for a while??), especially if it is surprisingly pretty simple and easy.. :)
        ps personally I am on this version since Jan 1 and now I don’t feel discomfort in my heart area I felt after strenuous 1+ hr workouts before, which feels so good




        0
        1. I agree, those following a western style diet probably have developed early stages of heart disease. But still, an ounce of nuts, especially walnuts in your oatmeal, or something of that nature, will not hurt your diet. I think the problem arises when nuts make up a greater bulk of our caloric intake, as an ounce of walnuts is about 200 calories, and this is only a 1/4 cup. Because nuts in general are so high in omega 6 and throws off the omega6:3 ratio, this may also hurt the quality of the diet when including nuts and seeds. Flax and walnuts are the rare exceptions with great omega 3 ratios. If we are talking about including or excluding a 1/4 cup of walnuts, I don’t think it will cause harm in the big picture, especially since they are so anti inflammatory, as this video demonstrates.




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          1. Had these studies focused on, say, pumpkin seeds instead of walnuts, I am confident the same positive results would have been found. I see no reason to add walnuts if my seed intake is sufficient.




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            1. That may well be true – but walnuts do appear to have some antioxidant compounds not found in other nuts and seeds that may make a difference. The omega 3/6 ratio is important, but probably not so much for people who are avoiding vegetable oils or other rich omega 6 sources.




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            2. Seeds, other then flax, generally have extremely poor ratios of omega 6:3. This can lead to a poor conversion rate of your ALA omega 3 to DHA and EPA. A great ratio is 4:1, of omega 6:3 respectively which walnuts satisfy and flax excels.

              Seeds are healthy though, and I agree, an ounce of walnuts swapped for an ounce of seeds would probably be beneficial as well.




              1
              1. In addition to the omega 6:3 issue which Toxins and Dr. Greger have given a good review of the current science. Nuts and seeds also are a good source of minerals and most likely contain other ingredients that we don’t yet understand can contribute to health. Dr. Esselstyn advises his patients with clinically significant heart disease to avoid nuts and he has had outstanding results. His most recent paper has been accepted for publication and should come out in the near future. Bottom line for me at this time is an ounce of nuts or seeds per day as a general population recommendation is fine unless of course you have an allergy or specific condition for not consuming them.




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              2. But if you eat a lowfat WFPB diet, and consume one tablespoon of flax per day, per Dr. Gregor’s recommendation, it wouldn’t matter what the other one ounce of nuts or seeds comes from, whether its walnuts or pumpkin seeds, your omega 6/3 ratio will be in the optimal range.




                0
                  1. One thing I have noticed is, one tablespoon of flax seeds equals about two tablespoons of ground up flax. I always just put one tablespoon of whole seed in my coffee grinder and eat that. Should I do two tablespoons of whole flax seed? I think that would be too much.




                    0
                    1. Ben: Wow. I never thought of that. I always grind up an amount where the ground flax fills a peanut butter jar and keep it in the fridge. So, I never gave it much thought about pre vs post measuring.

                      Your comment really caught my eye because this is one of the issues that gives me angst when it comes to cooking. “Oh no. The recipe calls for 1 cup chopped __” So, is that one cup before or after chopping???? ;-0

                      For what it’s worth, it’s my understanding that the recommendation is for 2 tablespoon flaxseed, measured post grounding. I’m sure I’ll be corrected if I got that wrong.




                      0
      2. I infer you mean zero oil is indicated if one has had a CVE, but it appears that if one has not had a CVE Esselstyn would have the same advice. How much difference is there in the preventive power of no oil between those who have had a CVE and those who have not? Need to know.




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      1. the sample may not reflect general population as it is from those already with diabetes. On the other hand , this experiment shows that nuts is good but olive oil is 2 times more effective than nuts for this sample population.




        0
  6. That was the fastest I’ve ever heard you speak!! Too much coffee :) ! haha, actually, I like your normal voice, I lost track totally in what you were saying, didn’t have time to think of what you were saying :(. I like your regular pace…




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    1. Esselstyn, McDougall, Novick, Barnard, Fuhrman, and Greger all agree that 1 ounce nuts per day is fine (excluding patients with advanced CVD).

      “For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable.” -Esselstyn




      1
  7. Nature is a genius. It has all the perfect systems to protect itself against predators and the threat of eradication. Starting with its source: the seeds, nature’s reproductive system. They need to survive storms, rain, high temperatures, animals, man. Their natural defence systems include enzyme inhibitors and toxic substances that will be removed naturally once the ideal circumstances are gathered to germinate those seeds for a new plant or tree. When you are not sure about what to do, look at nature and do the same. A seed uses rain to remove the toxins and to bring the enzymes to life. We have to mimic those natural actions to optimise these foods before consuming them safely. By soaking your nuts and seeds you will minimize or eliminate the toxic substances inside of nuts and seeds. These are:
    Enzyme inhibitors (who make it difficult to digest them properly)
    Phytates (phytic acid)
    Polyphenols (tannins)
    Goitrogens
    (…)

    Almonds- 8 to 12 hours at room temperature
    Walnuts- 4 hours at room temperature
    Sesame seeds- 8 hours at room temperature
    Sunflower seeds- 2 hours at room temperature
    All other nuts- 6-24 hours at room temperature
    (http://ravishingraw.com/nuts-seeds)




    0
      1. Good point. I think the anti-nutrients are taken a bit too seriously. Phytic acid has some very positive effects in the body, and the actual effect on mineral levels seems to be pretty minimal.




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  8. Did you see the article “The Questionable Link Between Saturated Fat and Heart Disease” published in the May 6, 2014 issue of the Wall Street Journal? How does stuff like this make it past the Journal’s medical editors?




    0
    1. Bear in mind that this is the same outfit that published Taubes’ article and launched his career. A relatively straightforward explanation for the article is that this is a Saturday Essay, and is probably meant to be relatively fluffy and more edgy than uncontroversially true. For instance, “Why Asian Mothers are Superior” was another article in this category. Editorial review is probably minimal, and may be even less these days as the mainline media face more competition from small and often subjectivist outfits in the blogosphere. Who is this Nina Teicholz character, anyway? If she had an MD or PhD it seems like they would have pushed that to the front of her bio.

      The Times may also realize that it has lost substantial credibility with people like the people that frequent this site when they published Taubes’ article and that people who identify with nutritional vegetarianism are a minority compared with those who want to hear that they can eat the foods that they like without significant worries, and are interested in the issue because they are struggling with weight and health. Just a hypothesis, though. I don’t really know what makes their audience tick and how the publication thinks about that information.




      0
      1. Q: “Who is this Nina Teicholz character, anyway?”

        A: Someone with a new book coming out!

        From the bottom of the WSJ article:
        “Ms. Teicholz has been researching dietary fat and disease for nearly a decade. Her book, “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet,” will be published by Simon & Schuster on May 13.”

        According to her linkedin, she’s an “Independent Writing and Editing Professional”. Not a scientist, not a statistician, not a medical professional. The comparison to Taubes is appropriate, indeed.




        0
    1. Nut antioxidants are better absorbed roasts, but AGE’s may be of concern. According to JEff Novick, Advanced Glycation End-products are considered toxic molecules formed by heating foods and are thought to increase the risk and severity of many diseases including the metabolic syndrome, atherosclerosis, arthritis, Alzheimer’s Disease, and cancer. AGE’s are also thought to contribute to diabetic neuropathy, diabetic retinopathy, diabetic nephropathy and aging.

      AGE Amounts In Food (per serving)

      Starchy vegetables

      Corn, 20

      Sweet potato, roasted, 72

      White potato, boiled, 17

      White potato, french fries, homemade, 694

      White potato, french fries, fast food, 1,522

      White potato, roasted, 45 min, prepared with 5 mL oil, 218

      Grains/legumes/Cereals

      Bean, red kidney, raw, 116

      Bean, red kidney, canned, 191

      Bean, red kidney, cooked, 1 h, 298

      Pasta, cooked 8 min, 112

      Bran Flakes, 10

      Corn Flakes, 70

      Frosted Flakes, 128

      Oatmeal, dry, instant, 4

      Oatmeal, cooked, instant 25

      Bread

      Whole wheat, center, 16

      Whole wheat, center toasted, 25

      Whole wheat, crust, 22

      Whole wheat, crust, toasted, 36

      Pita pocket, 16

      Fruits

      Apple 13

      Apple, baked, 45

      Banana, 9

      Cantaloupe, 20

      Raisins, 36

      High Fat Plant Foods

      Almonds, roasted, 1,995

      Avocado, 473

      Cashews, roasted 2,942

      Olive, ripe 501

      Peanut butter, smooth 2,255

      Walnuts, roasted 2,366

      High Fat Animal Products

      Cream cheese, 3,265

      Mayonnaise, 9,470

      Butter, 1,324

      Beef

      Frankfurter, boiled 7 min, 6,736

      Frankfurter, broiled 5 min, 10,143

      Hamburger, fried 6 min, 2,375

      Hamburger, fast food, 4,876

      Meatball, boiled in sauce, 2,567

      Shoulder cut, broiled, 5,367

      Bacon, microwave, 1,173

      Deli ham, smoked, 2,114

      Pork chop, pan fried, 4,277

      Chicken breast, skinless cubes

      Steamed 10 min and broiled 12 min, 5,071

      Pan fried 10 min and boiled 12 min, 5,706

      Chicken breast, skinless cutlet

      Raw, 692

      Boiled 1 h, 1,011

      Broiled 15 min, 5,245

      Fried 8 min, 6,651

      Roasted, barbecue sauce, 4,291

      Roasted, breaded, 4,102

      Roasted, breaded, microwave, 1 min, 5,157

      Fish

      Salmon, raw, 502

      Salmon, smoked, 515

      Trout, raw, 705

      Trout, roasted 25 min, 1,924

      Cheese

      American, processed, 2,603

      American, processed, low fat, 1,425

      Brie, 1,679

      Cottage cheese, 1,744

      Feta 2,527

      Mozzarella, part skim, 503

      Parmesan, grated, 2,535

      http://cjasn.asnjournals.org/content/1/6/1293.full




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  9. Nuts and seeds (and whole grains, soy and legumes) contain high levels of phytates – ‘anti-nutrients’ that block the absorption of these minerals and vitamins (particularly zinc, calcium, iron and magnesium). High intakes of phytate-rich foods in the diet (particularly in vegetarian diets) can actually cause mineral deficiencies as the phytates inhibit the absorption of minerals not only in these foods, but in other foods eaten in combination with them (e.g. the calcium in dairy if consumed in a meal with nuts).

    – See more at: http://www.nutritionbynature.com.au/1/post/2012/11/nuts-seeds-are-for-birds-and-squirrels-not-humans.html#sthash.nxk45D2v.dpuf

    http://www.nutritionbynature.com.au/1/post/2012/11/nuts-seeds-are-for-birds-and-squirrels-not-humans.html




    1
      1. And what about the other issues from the article: Phytates in nuts and seeds also interfere with the enzymes we need to digest our food, including amylase (required for the breakdown of starch), pepsin (needed to breakdown proteins in the stomach) and trypsin (needed for effective protein digestion in the small intestine). Nuts and seeds may contain some protein, but this protein is not well assimilated and absorbed in the human digestive tract, if at all.

        Nuts and seeds are rich in polyunsaturated oils – wrongly touted as ‘healthy’ oils but far, far from it. These fats suppress metabolism, contributing to weight gain, tissue destruction, free radical damage, insulin resistance and a whole host of other health problems. See this post for more. These fats are highly unstable – prone to oxidation and rancidity – you’d be hard-pressed to find ‘fresh’ nuts around that aren’t actually already rancid.

        The polyunsaturated fats in nuts and seeds suppress energy metabolism and thyroid hormone, and actually contribute to weight gain – See more at: http://www.nutritionbynature.com.au/1/post/2012/11/nuts-seeds-are-for-birds-and-squirrels-not-humans.html#sthash.pHxgepnj.dpuf




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        1. It is difficult to come to neutral conclusions on nutrition when the studies are being interpreted by another author. It is best to draw conclusions based on the primary resources.

          Cooking eliminates trypsin inhibitors, phytic acid and most other antinutrients. Even without cooking though, these antinutrients do not cause disease conditions, nor do they cause nutrient deficiencies. The evidence shows benefit to phytic acid consumption. The statements in the article you shared are over hyped.
          http://nutritionfacts.org/topics/antinutrients/

          Polyunsaturated fats are the only fats required by the body. The problem may arise from over consuming omega 6, but omega 3 is also a polyunsaturated fat. The statements of polyunsaturated fats being harmful come from the idea of overcooking polyunsaturated oils, which no one is recommending. The fats in nuts and seeds are actually quite stable, and even some cooking will not cause oxidation, as evidenced with flaxseeds.

          “ALA in whole and milled flaxseed also appears to be stable to heat equal or greater than the temperatures involved in baking batters and doughs such as muffins and yeast bread. Thermal stability was shown in 1992 by the absence of significant changes in peroxide values and fatty acid composition when both forms of flaxseed were heated for 60 minutes at either 100°C (212°F) or 350°C (662°F)”

          “Storage effects:
          Flaxseed, either whole or coarsely ground, appears
          stable to long-term storage at room temperature. Even after 308 days at 22°C (72°F) there was essentially no change in peroxide value as a measure of oxidation by-products or in the percentage of ALA in fat extracted from the stored flaxseed samples5. This demonstration of oxidative stability in common storage was later confirmed by direct measurement of oxygen consumption. One gram samples of whole flaxseed, milled flaxseed and extracted flax oil were held in individual sealed glass tubes for 280 days at room temperature with 12h alternating dark/light cycles. All three preparations showed little change in headspace oxygen during this time although the flax oil sample was more variable.”
          http://www.flaxcouncil.ca/english/pdf/stor.pdf

          You can tell in the article you cited, the nutritionist is more on the “fad” style of diets with her recommendation of coconut oil.
          http://nutritionfacts.org/index.php?s=coconut+oil

          Antinutrients are not something to worry about for the general population.




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    1. 1.4% if i recall correctly. That is a lot of folks, but it’s not 98%. Dr. Weil wrote a good bit about allergies, and the reprogramming and such, since by definition an allergy is an abnormal inflammatory response to a non-harmful substance (for most). If I recall correctly a woman was deprogrammed via hypnosis to no longer be allergic to peas or carrots-something usually beneficial to humans. I’d be more interested and better read on the subject if indeed I had any allergies. Dropping dairy cleared up all my “allergic” sort of response. You might be interested in reading more on the subject. Best.




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  10. I consume everyday: 1 tablespoon of ground flaxseed, 2 tablespoons of hemp seeds, 1 tablespoon of pumpkin seeds, 4 tablespoons of pistachios and 2 tablespoons of pecans (and I do it in a delicious manner =D ). I will get some blood tests soon so I shall be able to say if there is an improvement in my health markers compared to the times I did not consume all these fatty nuts/seeds. I mean, the question whether we can consume too much nuts/seeds needs to be addressed. Nonetheless, one thing is clear so far: while consuming the above-mentioned foods, I managed to lose weight. I did exercise more and consumed less of other foods, but I still managed to lose fat. Now, I’m very close to the leanest I’ve been in my life.




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  11. How many walnuts does one need to eat to get the right amount of Omega 3’s daily? I know flax has the most concentrated form of ground flax, but if you can’t and can eat walnuts, what is the equivalent in walnuts?




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  12. I assume that you are familiar with the raw till 4 vegan lifestyle? I was thinking about trying this out. I wanted to know your thoughts on how health beneficial this diet would be if I were to include B12 supplements, 5 cups of legumes per week, adequate grain intake (after 4), 1 ounce of nuts daily, and adequate omega 3 intake from seeds by your recommendation from a combination of your videos? Thank you!




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  13. Dr. Caldwell Esselstyn in his book, “Prevent and Reverse Heart Disease,” recommends that folks like me who’ve had bypass surgery not eat nuts. Your recommendation on walnuts is more current and seems to dispute Esselstyn. What would you recommend for folks with a history of heart disease who’ve gone “all in” with heart-healthy diets?




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    1. Hard to say. Dr. Esselstyn has made striking findings in the world of cardiology. He has treated many patients. I feel like patients of his should listen to his advice, as he can help save lives! Dr. Esselstyn published research showing how a plant-based diet can be A way to reverse CAD. . Another researcher, Dr. David Jenkins who helped invent the glycemic index, developed a portfolio diet for lowering cholesterol, which includes nuts. Here are 38 citations about diet and disease, with this one showing tree nuts help improve glycemic control. Nuts and seeds appear helpful for those with diabetes, so perhaps nuts are also helpful for those with heart disease? I cannot say for certain, but as you mentioned the research Dr. Greger provides suggests that nuts are healthful and may help prevent sudden cardiac death.




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      1. Im still confused if heart disease starts at age 11. Then we all have it (unless we were brought up vegan) so if low fat diets that are plant based reverse heart disease, your saying high fat plant based diets that consist of nuts also reverse heart disease? Is adding 1 cup of nuts too much because that’s what im having to do to maintain a low end of healthy BMI.




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        1. No problem! I think the diet can still be lower in fat and contain nuts and seeds. Please read the portfolio diet link I attached. 1 cup may be too much. An ounce is about the right amount per day for most folks. Are you saying you are barely meeting the BMI range? For those trying to gain a few pounds I have some ideas let me know if that is something you’d like?




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          1. Yes, I can’t seem to gain weight even adding up to 1 cup for over a week I have only gained a little over 1 lb up from 114 to 116. I am 5′ 5 ” and have weighed 114 for 3 years at times even dropping to 109. I walk about 9 miles a week since I have no car.

            Go to Thursday July 9th and back to see my latest eating habits.
            http://Www.myfitnesspal.com/food/diary/genuinesynthetic462 . I have talked to nutritionists and my primary care dr and my primary care dr has scared me telling me im at risk for heart disease since my bmi is so low. If you could help me I would greatly appreciate it. Please take s look at my food diary and give me an honest opinion…what am I doing wrong. My pcp won’t even look at it she just told me to take ssris.




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            1. I cannot seem to view your food diary. Sorry to hear your pcp will not look at your food intake that seems odd? I am very glad you are seeing a nutritionist or dietitian. I think eating more calories and more often is the key. Higher calorie smoothies, more whole grains, and a few more nuts and seeds would be fine. Please re-send a link or write out your food choices and I can give some brief suggested advice.




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              1. http://www.myfitnesspal.com/food/diary/genuinesynthetic462?date=2015-07-09 if you go from that day backwards about a week you should get an over all picture of how I’ve been eating.

                Note I have very low income less than 9000 per year and spend about 300$ a month on food. I was born with a low body weight @ 2.18lbs and dropped to 1lb 1/2 during the 3 months spent in intensive care.

                I used to smoke when I was a teenager until about age 24 (about 9 years up to 1 ppd) I have not smoked cigarettes for 3 years I also smoked marijuana for about 2 years but stopped in 2012 and switched to a vaporizer.

                Recently I had a pulmonary test done that shows small airways are @66% pre brociodilator down from 75% in 2012 which has me very anxious lately awaiting a final diagnosis. So my appetite appetite may be effected by stress. I use klonopin as needed and medical marijuana @0.3-0.5 grams per day via digital temp controlled convection vaporizer.

                I also walk daily and have recently started eating more apples and taking quercertin supplements as well as tiptropium inhalation powder until I get a final diagnosis I’m going to be a wreck.

                I hate to think ill be dead by 40 seeing as I’m a proponant of transhuman ideals and want to see the rise of consumer based nano tech end heart disease, stop aging, and end biological death. Did I mention I also have ocd and dysthmia? I currently take: rose root 500mg, milk thistle, taurine(to prevent age formation due to vegan diet), alage oil derived epa/dha and inositol(to try and help the OCD)

                Hope that’s enough info about me. Sorry for the tanget, in just really worried about this lung test a 10% drop in small airway function makes me think incurable emphysema. (Although I can walk 4 mph 30 mins a treadmill no problem. As well as walking 9 miles a week.

                P.S. I’m no longer seeing a nutritionist due to the 165$ she wanted to do s video teleconference. She is the one who told me to eat more fat telling me that I don’t need to worry about fat consumption. She said nuts and avocados. I tried to tell her about ornish and esselstyn and she didn’t seem to agree with them. She told me to aim for 30% calories from fat.

                And she told me to see a therapist which I’m doing and have been doing cbt for over a year now. I feel like nothing is working sometimes and the professionals I see don’t seem to have the time or the care to listen to me.




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                1. Thanks for sharing. Sounds like there is a lot going on in your life! Diet is only one factor. Medications and substances can alter appetite. Of course I cannot give medical advice so please listen to your doctor. From the looks of one diet recall it seems you are consuming some healthful foods! I would say if you are looking to boost calories than more whole fruit and whole grains could be added, but also a few nuts and seeds atop your breakfast. I would agree that based on your history a few more servings of avocado or olives would be appropriate. Bone bearing exercise may also really help. It seems you use no oil, so that is another reason I’d say more whole plant foods that are higher in fat are okay. I think therapy is a good idea (not just for you but for anyone) and I hope you do find the right team to help you. Surely you can speak your mind here, as I am always happy to listen :-) We have a strong community of users who want to better their health and learn about the science on nutrition. I am also learning as I go from everyone’s comments and inquiries, and of course Dr. Greger who has been a strong mentor. I think it’s important to surround ourselves with helpful advice and kind people. Thanks again for taking the time to write.

                  Warm wishes,
                  Joseph




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                  1. I try not to add oil as you noticed but I must confess I do snack a few times a week on things that have safflower, canola, cottonseed or olive oil; things such as beanitos black bean chips or flax and millet chips.

                    Maybe once a month I will get a pizza hut pizza with hand tossed dough(that has no milk) with no cheese and all veggies. Other than that I try to eat whole foods primarily. Thank you for taking time to reply, and for your advice I appreciate it.

                    Take care.




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            2. Fire your PCP immediately. She is a hazard to your L-T health. Do not argue w/her, just let her go and ask around for recommendations for an integrative physician, an ND, an orthomolecular MD or a Functional Medicine MD.




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          2. YES, I am needing to GAIN 15 lbs., from a current underweight of 125 lbs, height 5’8 ½”. Don’t try too hard looking for that information on the web without a lot of patience…it’s fat busters all day everywhere.
            What do you have?? Thanks in advance!




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  14. But I thought Ornish and Esselstyn recommended low fat to reverse heart disease, which in on of your videos you say that heart disease starts in childhood so we should all try to reverse heat disease that we already have, does that not mean we should all follow a low fat diet. I tried for years and have problems gaining weight ( i weigh 113 5′ 6″.) So now I have decided to add 1 cup of walnuts per day to my diet. Will this help? Or hurt? I am so confused with what to eat now.




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    1. Hi Jordan. Please see my comment right below to Craig. That should help clear things up a bit. Let me know if you need more information and I’ll try to help.




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  15. Among nuts, walnuts have one of the best omega3 to omega6 ratios– 1:4.2. The only potential problem is walnuts also contain a huge amount of omega6, even if “balanced” proportionally by the omega3.

    So, the question– is there a point in consuming walnuts at which the cumulative omega6 becomes a health hazard? Omega6 is a promoter of inflammation through arachidonic acid, so the concern is walnut omega6 at some point becomes an effective promoter of inflammation, despite the limiting factor of omega3.




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  16. Among nuts, walnuts have one of the best omega3 to omega6 ratios–
    1:4.2. The only potential problem is walnuts also contain a huge amount
    of omega6, even if “balanced” proportionally by the omega3.

    So,
    the question– is there a point in consuming walnuts at which the
    cumulative omega6 becomes a health hazard? Omega6 is a promoter of
    inflammation through arachidonic acid, so the concern is walnut omega6
    at some point becomes an effective promoter of inflammation, despite the
    limiting factor of omega3.




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  17. Among nuts, walnuts have one of the best omega3 to omega6 ratios– 1:4.2. The only potential problem is walnuts also contain a huge amount of omega6, even if “balanced” proportionally by the omega3.

    So, the question– is there a point in consuming walnuts at which the cumulative omega6 becomes a health hazard? Omega6 is a promoter of inflammation through arachidonic acid, so the concern is walnut omega6 at some point becomes an effective promoter of inflammation, despite the limiting factor of omega3.




    0
  18. Among nuts, walnuts have one of the best omega3 to omega6 ratios– 1:4. The only potential problem is walnuts also contain a huge amount of omega6, even if “balanced” proportionally by the omega3.

    So, the question– is there a danger in consuming walnuts to the point at which the cumulative omega6 becomes a health hazard? Omega6 is a promoter of inflammation through arachidonic acid, so the obvious concern is walnut omega6 at some point becomes an effective promoter of inflammation, despite the limiting factor of omega3.




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  19. Great info.Thank you very much Dr.Greger…

    I do not think that the most beneficial effect of walnuts is their content of Omega 3 or the ratio of Omega 3 to Omega 6, which also is very important. I think it lies in its wholeness. The overall content of anti-oxidants, minerals, vitamins, proteins, carbs, and fats. Only altogether they may be so powerful to serve human health.




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  20. I have atherosclerosis and am attempting to remove​ the artery plaque via the plant based diet prescribed by Caldwell Esselstyn (and Dean Ornish), which is vegan with strictly no sugars, oils, or fats apart from ground flaxseeds. Esselstyn says NO avocados or walnuts at all. However I have been led to believe that there are clinical studies which say avocados and walnuts aid artery function. But will they nevertheless inhibit plaque removal? What is your opinion? Does anyone have clinical references to confirm if walnuts fats (and avocado fats) will adversely impact the plaque removal process? I’d be grateful if any of you knowledgeable in this could advise me. Thanks




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  21. Hi, Wendy. You might be interested in this study https://www.ncbi.nlm.nih.gov/pubmed/23756586 cited in the video above. It discusses benefits of walnut for artery function. Check out this video: https://nutritionfacts.org/video/effects-of-avocados-and-red-wine-on-meal-induced-inflammation/
    Although free full text is not available, you may be interested in this abstract also: https://www.ncbi.nlm.nih.gov/pubmed/25319210. I hope that helps!




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    1. Hi Christine

      Thanks for that information.

      Do you know if there are any studies done on people that are not overweight (or have BMI of under 20)?

      Most of the studies seem to be on overweight people – so are likely to give different results for those of us who are slim and healthy weights and are already on a very healthy plant based diet.




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  22. Thanks for your question Udit.

    Dr Greger has an article on the influence of food on testosterone levels.

    One recent 2016 review suggests that:

    “There is paucity of well-designed studies on how nutrients modify T level; therefore, solid recommendations cannot be issued. As practical advice, we suggest fasting before the mea- surement of T levels, because most foods will lower its levels. A few studies have investigated the role of diet and meal composition on T level, suggesting some possible acute effects, but the specific role of single nutrients remains unclear and the subject for future, more robust studies.”

    Hope this answer helps.




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  23. Because people do not eat the shells of walnut or brasil nuts, the assumption would be studies on nutritional value of these nuts would be on the nut minus shell and thus shelled nut nutrient equals that of unshelled nut. One other thought– One could potentially end up with slowed eating of these nuts, if it includes cracking the shell, as opposed to just gobbling down the shelled nuts. In most cases that would improve one’s nutrition (less excess fat). This is much more true with pistachios and peanuts, when it’s so much easier to eat handfuls when shelled as opposed to much fewer when shells slow the hungry eater down.)




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  24. Hi there:-)

    I’d like to know if I do my body harm if I eat more than Dr. Greger’s recommended 1 ounce of nuts a day? I love eating almond butter on whole wheat bread or with fruit, and often can’t seem to stick to the recommended 1 ounce…
    Thanks in advance for taking the time to answer my question:-)

    Annie




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  25. Hello Anne, and thanks for your question.
    I am a family doctor with a private practice in lifestyle medicine, and also a volunteer moderator for this website. The quick answer to your question is that it depends on your particular situation, but probably eating more nuts would not be a problem for you.

    In How Not to Die, in the Chapter on Nuts and Seeds, pp 342-349, Dr. G’s recommendation for quantity of nuts & seeds is: 1/4 cup, or 2 tablespoons of nut or seed butter. He raises the issue than nuts and seeds are loaded with fat and calories — so there’s a concern they could cause weight gain. But he then goes on to show that those who eat nuts and seeds do NOT gain weight relative to those who don’t eat them. He explains that there are 3 reasons for this. The main reason is that eating nuts is very satiating — i.e. they suppress the appetite. Second reason is that nuts/seeds actually boost your metabolism. Third reason is that about 10% of the calories don’t get digested and pass through into the feces — because of the fiber content of nuts/seeds.

    I think the biggest problem of eating more than the recommended amount of nuts/seeds, even if they don’t cause weight gain, is that you would then most likely be eating less of other very healthy foods such as vegetables, fruit, and legumes. As I’m sure you’ve noticed, eating a big handful of nuts will quickly satisfy your appetite.

    Also, it depends a little on which specific nuts and seeds you’re talking about. Dr. G points out that walnuts are particularly healthy because they are higher than other nuts in antioxidants and in omega-3 fatty acids. Most nuts have omega-6 fatty acids but little or no omega-3s. Among seeds, the clear winners for omega-3 content are flax and chia seeds.

    I hope this helps.
    Dr. Jon
    PhysicianAssistedWellness.com
    Volunteer moderator for NutritionFacts.org.




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    1. Hello Dr. Jon,

      thank you so much for taking the time to answer my question, that was really helpful! Your detailed post really helped me understand things:-) I will try to stick to the recommended amount then in order to make room for even more veggies and fruit (I already eat Dr. Greger’s recommended daily dozen) :-) Have a great week! All the best from Germany!

      Annie:-)




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  26. You’re very welcome. I’m happy that my comments were helpful to you. It’s great to hear from Germany. Are you interested in swapping your leader for ours?




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    1. Ahaha, I can understand why you would like to swap:-) That one is quite the trouble maker, so nope thank you:-) But I’d swap doctors like you in a heart beat, since we don’t have a lot of guys like you or Dr Greger here in Germany who educate people about the benefits of a whole foods plant based diet.




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  27. These studies are all done on FAT, SICK Americans/British/etc. in the first place.

    Of course if you substitute a certain amount of better fats (plant based whole nuts) for worse fats (big macs, fries, milk shakes etc) then you are going to see an improvement in blood marker levels OF THESE PEOPLE.

    I’m disappointed in Greger on this topic as it keeps coming up repeatedly.

    Try this study on a 7 year, no fat vegan like myself.

    One big handful of walnuts every night for 6 weeks while surfing the internet.

    Cholesterol raised from 101 to 155
    LDL tripled from 35 to 105.

    After this “experiment”, my cholesterol levels went back to their original, healthy levels.

    NONE OF THESE STUDIES HAVE ANY VALIDITY UNLESS DONE ON NO FAT VEGANS OR RURAL, INDIGENOUS PEOPLES…. of which there are very few left in the world.

    Think about it.

    How many no fat, largely raw vegans even have a hint of:

    1- Coronary Disease
    2- Cancer Risk
    3- Premature Death
    4- Respiratory Disease
    5- DIABETES!

    WE DON’T UNLESS YOU INTRODUCE EXTRA, FATTY FOODS INTO THE DIET.

    .




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  28. Hi there! The amino acid tyramine, found in nuts, including walnuts, is known to trigger migraines associated with vertigo in large quantities.




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  29. I fund this systematic review by Cochrane on Pubmed about the effects of nut consumptions and CVD.
    The authors concluded: “Currently there is a lack of evidence for the effects of nut consumption on CVD clinical events in primary prevention and very limited evidence for the effects on CVD risk factors.”
    How is that so? Can someone help me highlight any week spot of this study?
    I believe there is sufficient evidence in general for nut consumption to be beneficial for CVD like for stroke for example.
    Am I wrong?
    Thanks

    NT




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  30. Someone has just informed me we should soak all nuts due to phytic acid levels, so as to aid digestion. I can’t see anything on this site recommending this. So should I be soaking all the nuts I eat? Thanks Paul.




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