About one third of annual worldwide mortality for both man and women is attributed to cardiovascular disease (CVD), making it the main cause of global death, especially in developed countries. Elevated serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and hypertension, diabetes, cigarette smoking, overweight or obesity, physical inactivity and atherogenic diet are the most important risk factors associated with the development and progression of CVD. Numerous epidemiological studies have shown that a diet rich in fruits and vegetables and poor in saturated fat reduce risk of CVD. Recently, it has been shown that some dietary components, as stanols/sterols, viscous fibers, mono- and polyunsaturated fatty acids, are able to reduce the serum levels of total cholesterol and LDL cholesterol. Nuts (as almonds, walnuts, pistachios, pecan nuts, peanuts) contain all these compounds in addition to other microcomponents, and several epidemiologic studies have shown that nut consumption for 4 or more serving a week is responsible to reduce by 37% the mean coronary heart disease (CHD) risk, respect to rare or no consumption, with a mean reduction of 8.3% for each incremental serving per week. In addition, numerous randomized, controlled human intervention trials have shown that nut consumption reduced blood levels of total cholesterol and LDL cholesterol. These results have been considered a sufficient basis by the US Food and Drugs Administration, which in 2003 issued a qualified health claim stating that eating 43 g/die of nuts as part of a diet low in saturated fats and cholesterol may reduce the risk of heart disease.
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