Nuts, Baby Aspirin, and Statins – Which is Best?


All three of these reduce cardiac events by around 35%. However the groups benefited and the side effects are vastly different.


 The nut industry is now prominently displaying a “Heart-Healthy” symbol on their products, and for good reason: Of the three ‘medicines’ mentioned above, nuts are the most effective at reducing heart attacks and have the least side effects. In fact, unless you are allergic to them, they have no side effects at all.

It is not known how, exactly, nuts work. It was initially attributed to the high content of monounsaturated oil. This cannot explain the benefit however. In fact, the long venerated monounsaturated oil is not turning out to be particularly heart healthy at all. See this post for details.

Baby aspirin has been a very popular preventive remedy for a couple of decades. The logic seems to be that there could be no harm in taking something you could give to a baby. Unfortunately the actual situation is unclear to say the least.

The research is all over the place. Baby aspirin is thought to work either by its anti-inflammation property, or its blood thinning property. It appears to reduce colon cancer, significantly increase heart attacks among adult onset diabetics, reduce heart attacks among people at high risk for heart attacks that are not diabetic, and is more or less neutral for the population taken as a whole. There is also a risk of hemorrhage which could be serious.

It’s probably best to treat baby aspirin as a potentially dangerous prescription drug and to take it only upon a doctor’s recommendation. Make sure the doctor has good reasons for his or her recommendation, and that he or she is well aware of the possible dangers.

The research on statins is far more consistent. Except for certain very narrowly defined groups, statins do not have survival benefits. They reduce heart attacks 35% for some groups, but increase death elsewhere, negating the benefit. This is covered in detail here.

A lot of research focuses on all three ‘medicines’ as anti-inflammatory, and indeed, inflammation is the new bad guy on the block, recently getting a lot of very negative press. This should be taken with a grain of salt. Inflammation is not the bad guy. The thing causing the inflammation is the problem. This could be a pathogen, as in an infection, or it could be oxidized cholesterol forming plaque behind an artery wall. Inflammation is the immune system reaction. The immune system is trying to remove the cause.

The key question then is: Why is the inflammation reduced? If the medicine is participating in the reduction or elimination of the cause, that is good. If it is simply suppressing the immune system, that is likely not good. Unfortunately we don’t know the answer for nuts, aspirin, or statins.

However, among the three, nuts would seem to be the hands down winner. Except for allergy, they have no known side effects. The right ‘dose’ seems to be a handful 2 or 3 times a week. Most nut research focuses on their effect on various heart disease risk markers. Here the confusion continues because the three most commonly considered: oxidative markers, inflammation markers and LDL cholesterol are all improved by nuts. Since this is the case, it is very likely that nuts are striking at the core of the problem, somehow aiding directly in the battle against accumulated arterial plaque.

We do not yet know the exact mechanism. We do not. Here are three possibilities:

  • Nuts could lower triglycerides, which would raise the size of LDL particles, which would definitely decrease risk.
  • Nuts could improve the integrity of the endothelium, a thin layer of skin like cells that line the inner wall of the arteries. This would make it tougher for atherosclerosis to get started or progress.
  • Nuts could reduce or retard the dangerous degradation of LDL plaque-forming particles that do get trapped.

It could be all-of-the-above, it could be none-of-the-above. However, nuts do work, and no doubt we shall some day find out exactly how. Until then, whenever someone talks about statins or aspirin, just say ‘nuts!’

  6 comments for “Nuts, Baby Aspirin, and Statins – Which is Best?

  1. Dollie
    January 19, 2015 at 7:36 pm

    For people that ARE allergic, do you if coconut/coconut oil could be a substitute?

  2. January 20, 2015 at 10:39 am

    Hi Dollie, the effect seems to hold for both tree nuts and peanuts so perhaps try the one type rather than the other; allergies are not always to both types. I try not to make claims beyond the evidence and while I think coconut and coconut oils are fine I do not know if they are equally effective at preventing heart disease. Dr. Mike

  3. Kevin
    July 11, 2016 at 7:33 pm

    Walnuts reduce cholesterol and plaque

  4. Guy Boyd
    December 29, 2016 at 9:33 am

    In the post above, in regards to statins I saw “They reduce heart attacks 35% for some groups, but increase death elsewhere, negating the benefit.” Having suffered a heart attack in May of 2016, I have done much research on what the absolute (not relative) benefits of statins for secondary prevention of a heart attack are, and the highest I have seen is 2%, possibly up to 3%. Based on that I have decided to stop taking statins, and instead have changed my lifestyle to prevent further attacks. For example, I have naturally lowered my triglycerides from 195 to 68. My question is where did you get the 35% figure from? That is a relative, not absolute benefit, correct?

  5. January 13, 2017 at 1:50 am

    All cardiovascular disease can be reversed by nutrients and nutrition.

    80% of your, my, our food must be organic vegetables and fruit.

    Nuts included. I’m a stroke survivor so the diet of high protein meat and shit took me here, going raw and eat 80% veg will take me away from it.

    Happy to help any one.

  6. February 12, 2017 at 10:04 am

    Well definitely you get more out of your space using some custom glass display cases.Also you can better design your display cases to fit the specificity of your products.

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