Significant heterogeneity was not observed by nut type or other factors .
Tree nut intake  lowers total cholesterol , LDL cholesterol , ApoB , and triglycerides .
The major determinant of cholesterol lowering appears to be nut dose rather than nut type .
BACKGROUND The effects of nuts on major cardiovascular disease ( CVD ) risk factors , including dose-responses and potential heterogeneity by nut type or phytosterol content , are not well established .
OBJECTIVES We examined the effects of tree nuts ( walnuts , pistachios , macadamia nuts , pecans , cashews , almonds , hazelnuts , and Brazil nuts ) on blood lipids [ total cholesterol , low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein , and triglycerides ] , lipoproteins [ apolipoprotein A1 , apolipoprotein B ( ApoB ) , and apolipoprotein B100 ] , blood pressure , and inflammation ( C-reactive protein ) in adults aged ≥18 y without prevalent CVD .
Major lipids, apolipoproteins, and risk of vascular disease.
CONTEXT Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified . OBJECTIVE To assess major lipids and apolipoproteins in vascular risk . DESIGN , SETTING , AND PARTICIPANTS Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospect i ve studies , mostly in Europe and North America . During 2.79 million person-years of follow-up , there were 8857 nonfatal myocardial infa rct ions , 3928 coronary heart disease [ CHD ] deaths , 2534 ischemic strokes , 513 hemorrhagic strokes , and 2536 unclassified strokes . MAIN OUTCOME MEASURES Hazard ratios ( HRs ) , adjusted for several conventional factors , were calculated for 1-SD higher values : 0.52 log(e ) triglyceride , 15 mg/dL high-density lipoprotein cholesterol ( HDL-C ) , 43 mg/dL non-HDL-C , 29 mg/dL apolipoprotein AI , 29 mg/dL apolipoprotein B , and 33 mg/dL directly measured low-density lipoprotein cholesterol ( LDL-C )  . Within- study regression analyses were adjusted for within-person variation and combined using meta- analysis . RESULTS The rates of CHD per 1000 person-years in the bottom and top thirds of baseline lipid distributions , respectively , were 2.6 and 6.2 with triglyceride , 6.4 and 2.4 with HDL-C , and 2.3 and 6.7 with non-HDL-C. Adjusted HRs for CHD were 0.99 ( 95 % CI , 0.94 - 1.05 ) with triglyceride , 0.78 ( 95 % CI , 0.74 - 0.82 ) with HDL-C , and 1.50 ( 95 % CI , 1.39 - 1.61 ) with non-HDL-C. Hazard ratios were at least as strong in participants who did not fast as in those who did . The HR for CHD was 0.35 ( 95 % CI , 0.30 - 0.42 ) with a combination of 80 mg/dL lower non-HDL-C and 15 mg/dL higher HDL-C. For the subset with apolipoproteins or directly measured LDL-C , HRs were 1.50 ( 95 % CI , 1.38 - 1.62 ) with the ratio non-HDL-C/HDL-C , 1.49 ( 95 % CI , 1.39 - 1.60 ) with the ratio apo B/apo AI , 1.42 ( 95 % CI , 1.06 - 1.91 ) with non-HDL-C , and 1.38 ( 95 % CI , 1.09 - 1.73 ) with directly measured LDL-C. Hazard ratios for ischemic stroke were 1.02 ( 95 % CI , 0.94 - 1.11 ) with triglyceride , 0.93 ( 95 % CI , 0.84 - 1.02 ) with HDL-C , and 1.12 ( 95 % CI , 1.04 - 1.20 ) with non-HDL-C. CONCLUSION Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride
Significant heterogeneity was not observed by nut type or other factors .
Tree nut intake  lowers total cholesterol , LDL cholesterol , ApoB , and triglycerides .
The major determinant of cholesterol lowering appears to be nut dose rather than nut type .
BACKGROUND The effects of nuts on major cardiovascular disease ( CVD ) risk factors , including dose-responses and potential heterogeneity by nut type or phytosterol content , are not well established .
OBJECTIVES We examined the effects of tree nuts ( walnuts , pistachios , macadamia nuts , pecans , cashews , almonds , hazelnuts , and Brazil nuts ) on blood lipids [ total cholesterol , low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein , and triglycerides ] , lipoproteins [ apolipoprotein A1 , apolipoprotein B ( ApoB ) , and apolipoprotein B100 ] , blood pressure , and inflammation ( C-reactive protein ) in adults aged ≥18 y without prevalent CVD .