Physicians' Academy for Cardiovascular Education

Long-term consumption of walnuts lowers LDL-c in healthy elderly

Effects of Walnut Consumption for 2 Years on Lipoprotein Subclasses Among Healthy Elders – Findings from the WAHA Randomized Controlled trial

Literature - Rajaram S, Cofán M, Sala-Vila A, et al., - Circulation 2021;144:00–00. DOI:10.1161/CIRCULATIONAHA.121.054051

Introduction and methods

More frequent consumption of nuts has been associated with lower CVD and findings of small randomized controlled trials suggested cholesterol-lowering effects of nuts [1,2]. However, these studies were limited; there was no focus on elderly individuals, no recruitment from diverse geographical areas, had no duration >2 years, and no information on effects on lipoprotein subclasses.

Therefore, the WAHA study (Walnuts and Healthy Aging) [3] was conducted; a 2-center (Spain and California, USA), 2-year, parallel-group randomized controlled trial in which the effects of walnut-supplemented diet were examined in healthy elderly individuals. Changes in lipoproteins were prespecified secondary outcomes. Cognitive healthy elders (63-79 years) without major comorbidities were included. Participants (n=628) were randomized to a walnut-free or walnut-supplemented diet (approximately 15% of energy, 30-60 g/d). Compliance with the diet was good with a stable body weight in both groups.

Main results


In the WAHA study, incorporation of walnuts to a diet in elderly individuals resulted in modest reductions of LDL-c, total cholesterol and IDL-c compared to a walnut-free diet.

The authors write: ‘Our data reinforce the notion that regular walnut consumption may be a useful part of a multicomponent dietary intervention or dietary pattern to lower atherogenic lipids and improve CVD risk’.


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