Scientific Study

Background and aims: few studies have examined long-term associations of walnut, other nut, and no nut consumption with cardiovascular disease (CVD) risk factors. Results from prospective studies with long-term follow-up can provide further evidence for dietary guideline messaging to consume nuts. Therefore, we examined the associations of walnut, other nut, and no nut consumption with diet quality and CVD risk factors over 30 years of follow-up. Methods and results: data were analyzed from 3092 young adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake, including walnuts and other nuts, was assessed 3 times over 20 years. CVD risk factors were measured at multiple exams. General linear regression evaluated the associations of walnut, other nut, and no nut consumption with CVD risk factors over 30 years (Y30) of follow-up. The 20-year cumulative mean intake of walnuts (0.74 oz/d), other nuts (1.6 oz/d), or no nut consumption was differentially associated with HEI-2015 and CVD risk factors by Y30. Generally, walnut consumers had significantly higher HEI-2015, lower body mass index, waist circumference, blood pressure, and triglyceride concentration, and gained less weight since baseline than other nut consumers (p ≤ 0.05 for all). Further, walnut consumers had lower fasting blood glucose than no nut consumers (p ≤ 0.05). Conclusion: study findings that walnut and other nut consumption was associated with better CVD risk factors and diet quality aligns with the 2020–2025 US. Dietary Guidelines for Americans recommendation to consume nuts, such as walnuts, within the context of a healthy diet.  https://doi.org/10.1016/j.numecd.2022.07.013