Peanuts Equivalent to Tree Nuts in Biggest Mediterranean Diet Health Study

Written by Dr. Andrew Craig, APC Health Consultant

PREDIMED stands for Prevención con Dieta Mediterránea, the largest and most robust study ever mounted of the health impact of the Mediterranean Diet. Based in Spanish academic centres, PREDIMED researchers reported recently that consuming a diet rich in either extra-virgin olive oil or nuts cuts by 30 per cent the chances of those at risk of experiencing heart attacks or strokes, or dying of a heart condition¹. This finding itself isn’t new, but the size and power (7,000+ participants aged 55-88, almost 60 per cent female, followed up for nearly 5 years) of the PREDIMED study is and that’s what makes the outcomes important in public health terms.

So what does this mean for peanuts? The simple answer is “quite a lot”. Even though the study focused on common European tree nuts (walnuts, almonds and hazelnuts) PREDIMED’s dietary recommendations to participants made the point that peanuts are nutritionally equivalent to tree nuts. Peanuts, of course, have also recently gained the American Heart Association’s “health check” certification.

There is media and consumer confusion about what constitutes a Mediterranean diet and what its equivalents are for people in non-Mediterranean countries. It is certainly not about drizzling olive oil over what we are eating already. Traditionally it is associated with what people in rural Southern Europe ate about a century ago – lots of cooked and fresh vegetables including legumes, grains, fruit, fish, small amounts of meat and dairy products, nuts, wine with meals and of course olive oil as the predominant fat for cooking and dressing vegetables.

This eating pattern was part of a traditional lifestyle which was characterized for most people by regular hard physical work. Modern day equivalent eating patterns are equally good, but our problem is urban, largely sedentary lifestyles. And even in the Mediterranean world, obesity is now a growing problem. In considering the PREDIMED results, therefore, we have to remember that this diet is not a magic bullet, but a powerful part of a healthful eating and activity pattern.

Participants in the Mediterranean diet group were split into two groups: one consumed four tablespoons of extra virgin olive oil a day and the other version of the diet ate about an ounce a day of walnuts, almonds and hazelnuts. A control group followed a low-fat diet avoiding olive oil and nuts.

After adjustments, the bottom line finding was that compared to those on a standard low-fat diet, those assigned to a Mediterranean diet with extra virgin olive oil had a 30 per cent reduced risk of suffering a heart attack, stroke or dying from a cardiovascular event. Those consuming a Mediterranean diet with nuts had a 28 per cent reduced risk of suffering a heart attack, stroke or dying from a cardiovascular event. The authors concluded: “an energy unrestricted Mediterranean diet supplemented with extra virgin olive oil or nuts resulted in a substantial reduction in the risk of major cardiovascular events among high risk persons. The results support the benefits of the Mediterranean diet for the primary prevention of cardiovascular disease.”

This study is part of our growing understanding of what “eating the right kinds of fat” means. And it shows that peanuts and other nuts are central to what “the right kinds of fat” should be as part of an eating pattern, which can be used on its own, or which can be adapted to suit non-Mediterranean cultures while being delicious, easy to consume and hugely beneficial for everyone.

¹ Estruch R et al. “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet” New England Journal of Medicine February 2013. Free to download from