Cardiovascular benefits of nuts

f m h d c ust before Christmas 1944, Adolph Hitler ordered his generals to launch a sudden massive mechaized infantry attack on allied forces. Subsequently eferred to as the “Battle of the Bulge,” the Nazis uickly surrounded the outnumbered and outgunned mericans of the 101st Airborne Division at the small own of Bastogne and demanded their unconditional urrender. A defiant Brigadier General Anthony cAuliffe befuddled the Germans with his terse reponse: “nuts.” Sixty years later we live in a country that faces an pidemic of obesity and diabetes mellitus.1 An unforunate consequence of our increasingly automated and ast-paced society has been decreased physical activty and increased consumption of nutritionally chalenged foods.2 The value of “low-fat” diets (with a igh concentration of simple sugars) or “low-carb” iets (with a high concentration of animal fats) has ecently been debated.3 Yet it may be possible to ncrease consumption of some foods relatively high in at without accelerating the development of atheroclerotic cardiovascular disease. A plethora of data urrently suggests that substituting nuts for simple ugars as a snack or for meats/dairy as a source of fats nd protein may have significant health benefits (a utty alternative). Much has been written about the cardiovascular enefits of the so-called Mediterranean diet. Residents f Greece and southern Italy have low rates of coroary artery disease despite consuming more fat than in typical American diet.4,5 The Mediterranean diet is haracterized by significant quantities of olive oil, anola oil, and nuts. Nuts derive nearly 80% of their nergy from fat and, although low in saturated fatty cids (FAs), nuts are high in unsaturated FAs, most of hich are monounsaturated FAs.6 In patients who ave myocardial infarction, the Mediterranean diet as been shown to decrease recurrent cardiac events nd cardiac death.7 The Physicians Health Study docmented an inverse relation between nut consumption nd total deaths due to coronary heart disease primarly due to a decrease in sudden cardiac death.8 One plausible explanation for the favorable cardioascular actions of a diet rich in nuts is their effects on erum lipids. The macadamia nut is a tree nut native to ustralia that has become a major export crop from awaii.9 It is 75% fat by weight, 80% of which is onosaturated, and contains the highest levels of mononsaturated FAs among known foods.10 Macadamia nuts