Walnut consumption and cardiac phenotypes: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Lyn M. Steffen, So Yun Yi, Daniel Duprez, Xia Zhou, James M. Shikany, David R. Jacobs

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background and aims: Observational studies and clinical trials have shown cardiovascular benefits of nut consumption, including walnuts. However, the relations of walnut consumption with systolic and diastolic function, risk factors for heart failure, are unknown. We examined the associations of walnut consumption with cardiac structure and function parameters in black and white adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods and results: After exclusions, the study population included 3341 participants. Dietary intake was assessed using the CARDIA Diet History questionnaire at baseline, year 7 and year 20 exams. Cardiac structure and function were measured by echocardiography at year 25. Multivariable linear regression evaluated the associations of walnut consumption with blood pressure (BP), heart rate, and cardiac phenotypes, adjusting for age, sex, race, lifestyle habits, and clinical characteristics. We found the majority of walnut consumers compared to non-consumers were females, whites, and more highly educated, and had lower waist circumference, diastolic BP, and heart rate, and higher diet quality score. Even though cardiac structure and function measures were generally within normal ranges among participants, walnut consumers had significantly better values for diastolic function parameters A wave, E/A ratio, septal and lateral e’ than non-consumers. Further adjustment for body mass index and diabetes status did not materially change the significance between walnut consumer groups. Systolic function parameters did not differ by walnut group. Conclusion: Compared to non-consumers, walnut consumption is associated with better diastolic dysfunction in young to middle-aged adults.

Original languageEnglish (US)
Pages (from-to)95-101
Number of pages7
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number1
StatePublished - Sep 5 2020

Bibliographical note

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham [ HHSN268201800005I & HHSN268201800007I ], Northwestern University [ HHSN268201800003I ], University of Minnesota [ HHSN268201800006I ], and Kaiser Foundation Research Institute [ HHSN268201800004I ]. The study was also funded by a grant provided by the California Walnut Commission (Dr. Steffen).

Funding Information:
Dr. Steffen received a grant from the California Walnut Commission to support this research study. The California Walnut Commission had no role in writing or reviewing this paper. The coauthors had no conflicts to declare.

Publisher Copyright:
© 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University


  • Diastolic function
  • Diet
  • Epidemiology
  • Prospective study
  • Systolic function
  • Walnuts


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