Nuts Added to the Mediterranean Diet Improve Heart Disease Risk

Mediterranean diet and heart disease risk

The Mediterranean diet has been proven to benefit people at risk for heart disease and strokes. Now a study published in the Archives of Internal Medicine, shows that people who were at high risk for heart disease who followed the Mediterranean diet and ate 2 tablespoons of mixed nuts a day significantly improved their risk factors.

Here is what happened:

The PREDIMED trial enrolled 1224 participants. The volunteers were older men and women who had numerous risk factors for heart disease and many were at even higher risk with the metabolic syndrome. Throughout the year long trial they all followed a standard Mediterranean diet which included fresh fruits and vegetables, whole grains, legumes, seafood, yogurt, olive oil and small amounts of wine. The researchers randomized the volunteers into three groups.

* A control group that followed a low fat diet.
* A group that was counseled on the Mediterranean diet and used virgin olive oil to replace refined oil.
* A group that was counseled but who were also given 2 tablespoons of mixed nuts a day.


After one year, the patients who had risk factors of the metabolic syndrome were 70% more likely to have a reversal if they were in the nut group compared to the control group. The nut group also improved more than the olive oil group. None of the groups lost weight or increased their physical activity, but the group that ate the extra nuts experienced more of a drop in waist size, triglycerides and blood pressure than those on the low-fat diet.

The metabolic syndrome is defined as having three or more of the following conditions: abdominal obesity, high triglycerides, low levels of good cholesterol (HDL), high blood sugar and high blood pressure. These are significant risk factor for heart attack, strokes and vascular disease. Twenty five percent of the population in developing countries has the metabolic syndrome and it increases with obesity and age.

Over sixty percent of the participants in the PREDIMED study met criteria for metabolic syndrome at the beginning of the study. After one year, the prevalence of metabolic syndrome decreased by 13.7 percent in the mixed nut group, by 6.7 percent in the olive oil group, and by 2 percent in the control group.

Although nuts are high in fats and can be “fattening”, when eaten in small amounts (three walnuts, seven or eight almonds and hazelnuts), they can add an additional benefit to the Mediterranean diet. They are naturally high in Omega 3 Fatty Acids and are anti-inflammatory. Nuts contain unsaturated fats, a more healthy type of fat, and also contain fiber that helps with a sense of fullness.

The Mediterranean diet is one of the easiest and best diets for prevention of heart disease. Add a handful of nuts and there is additional benefit.