Walnut
Juglans regia L. Family: Juglandaceae
English walnut , Persian walnut , Caucasian walnut , Circassian walnut , European walnut
 
Clinical Overview
Uses
The inclusion of walnuts in the diet is recommended as a dietary source of polyunsaturated fatty acids and other nutrients, and to improve the lipid profile in hyperlipidemic individuals. Cardiac benefits of walnut consumption are described. Walnuts have also been studied in metabolic syndrome with limited benefit demonstrated. The effect of walnut extract in Alzheimer disease is being investigated.

Dosing
Daily dosages used in clinical trials range from 20 to 84 g/day (4 shelled walnuts equal approximately 20 g).

Contraindications
Contraindications have not been identified. Cross-hypersensitivity between tree nuts is known to exist.

Pregnancy/Lactation
Generally recognized as safe when used as food. The possibility of in utero sensitization has been debated without conclusion.

Interactions
None well documented. Walnut interferes with the absorption of iron.

Adverse Reactions
Allergy and fatal anaphylaxis to walnut have been reported.

Toxicology
Information is lacking. Juglone, a constituent of walnut, is toxic in animals.

 
Botany
There are 15 species of Juglans ; commercially, J. regia is the most important. This deciduous tree can grow to 45 m in height. The trunk is straight and clear, with silvery-gray bark. The crown of the tree is open and round-topped. Walnut tree leaves are compound and between 15 and 30 cm long. The male flowers are long, drooping catkins, while the female flowers are short spikes. Walnut trees self-pollinate and cross-pollinate. J. regia is native to Asia but is now cultivated in France and other parts of Europe, North Africa, North America, and East Asia. 1
 
History
Walnuts have been found in prehistoric deposits in Europe dating from the Iron Age and are mentioned in Old Testament references to King Solomon's nut garden. The genus name Juglans comes from the Latin Jovis glans , meaning “nut of Jupiter” or “nut of the Gods.” Many legends have been associated with the walnut; the ancient Greeks and Romans regarded them as symbols of fertility. In the Middle Ages, walnuts were thought to ward off witchcraft, the evil eye, and epileptic fits because of the belief that evil spirits lurked in the walnut branches. 2
Historically, walnut oil was prescribed for colic, to soothe intestines, and to relieve diarrhea and hemorrhoids. 2 , 3 , 4 Further folk uses include treating rickets, frostbite, and glandular disturbances, and as an astringent, tonic restorative, and disinfectant. 5 , 6 Some cultures use walnut bark for cleaning the teeth, possibly improving oral hygiene because it increases the pH of saliva. 7 Walnut may possess anti-helminthic activity. 6 It is considered helpful in inflammatory conditions, including rheumatoid arthritis, and certain skin disorders. Blisters, ulcers, itchy scalp/dandruff, sunburn, and perspiration are some of the conditions treated with various walnut preparations. 5
Walnuts are a common food source and are used in cooking and baking. 2 , 8 Walnut extract is an old-fashioned hair dye and also has been used to darken (stain) the skin. 5 , 8 Walnut shell flour has been used as a carrier for insecticides, filler for building materials, and stuffing in toys. 8
 
Chemistry
Walnuts contain 3% to 4% water, 60% oil, and 15% to 20% protein, bearing approximately 700 calories per 100 g. 8 The mineral content includes iron and zinc (approximately 3 mg per 100 g each), sodium (2 mg per 100 g), selenium (19 mcg per 100 g), calcium, magnesium, potassium, copper, and phosphorus. 6 , 8 , 9 Vitamins E and C also are found in walnut. 4 , 10
Walnuts differ from other nuts in that they predominantly contain the polyunsaturated fatty acids alpha linolenic (n-3) acid and linoleic (n-6) acid, rather than mono-unsaturated fatty acids. 11 , 12 L-arginine (a precursor to nitric oxide) is also found in significant amounts in walnuts. 11
The chief known chemical constituent in walnut is juglone (5-hydroxy-1,4-naphthagulone). Also present are alpha-hydrojuglone (1,4,5-trihydroxynaphthalene) and its glycoside beta-hydrojuglone, along with caffeic acid, ellagic acid, hyperin, and kaempferol, and the tannins galloylglucose and ellagitannins. 5 , 8 In one report, 45 volatile compounds were isolated from whole green walnuts. 13 Gamma lactones are present in walnut oils. 14
 
Uses and Pharmacology
Lipid profile and cardiovascular effects   Clinical trials conducted in healthy adults 11 , 15 , 16 , 17 , 18 , 19 and in patients with type 2 diabetes 20 , 21 and metabolic syndrome 22 , 23 , 24 have been critically reviewed. 12 , 25 Studies in patients with heart disease are lacking. 25
The majority of studies show a reduction of total cholesterol and low-density lipoprotein–cholesterol to cardioprotective levels. Effects on high-density lipoprotein–cholesterol are inconsistent, as are those for triglycerides. The diminishing positive effects observed may be a consequence of increased fat intake with higher dosages used (and lesser effects due to lower dosages). 12 , 25
Limited effect has been shown in patients with metabolic syndrome. 22 , 23 , 24
The role of walnut in atherosclerosis is unclear. Improved endothelial function has been demonstrated, possibly due to alpha linolenic acid or L-arginine content. 11 , 26 In another study, walnut activated the nuclear transcription factor identified in human atherosclerotic plaques in healthy men. 27
Results of studies investigating the effects of walnuts on oxidative stress and apoprotein response are variable. 22 , 25 , 27 There is general agreement that no gain in body weight results from the addition of walnuts to the diet. 16 , 20 , 25
Other effects
Alzheimer disease   Walnut extract was demonstrated to inhibit and defibrillize amyloid beta protein—a feature of the amyloid plaque seen in the brains of patients with Alzheimer disease. 28
Antimicrobial   A study from China found borneol-walnut oil to be superior to neomycin in treating otitis media without any toxic effects. 29 The constituent juglone has been demonstrated to possess antimicrobial and antifungal effects. 7
 
Administration & Dosage
Daily dosages used in clinical trials range from 20 (moderate intake) to 84 g/day (4 shelled walnuts equals approximately 20 g). 25 , 30 , 31
Walnut leaves have been approved by the German Commission E for external application for excessive perspiration and skin inflammation. 32
 
Pregnancy/Lactation
Generally recognized as safe when used as food. The possibility of in utero sensitization has been debated. 33
 
Interactions
None well documented. Walnut interferes with the absorption of iron. 25
 
Adverse Reactions
Allergies to nuts are common in the United States (an estimated 1%), 34 with walnut and other tree nut allergy considered to be second only to peanuts (a legume) in anaphylactic reactions. However, cross-reactivity to the proteins from tree nuts among peanut-allergic people is considered low. A co-allergy is probably the cause of allergic reactions among atopic individuals. 33 , 34 Cross-reactivity between walnut and peach lipid transfer protein allergen has been noted. 35 , 36 , 37
Fatalities from anaphylaxis to walnuts have been recorded. 35
Walnut allergens identified include Jug r 1 (walnut 2S albumin), Jug 3 r (vicillin-like protein), and Jug 3 r (a 9-kd lipid transfer protein). 35 , 36
 
Toxicology
Little data exist; however, the naphthaquinone juglone, present in all of the family Juglandaceae, is a known animal toxin. 38 The risk of contamination with aflatoxin must also be considered. 39
 
References
 

1. Juglans regia L. USDA, NRCS. 2007. The PLANTS Database ( http://plants.usda.gov, 28 Oct 2007 ). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.

 

2. Rosengarten F. The Book of Edible Nuts . New York, NY: Walker and Company; 1984:239-262.

 

3. Bisset NG, trans-ed. Herbal Drugs and Phytopharmaceuticals . Boca Raton, FL: CRC Press; 1994:281-282.

 

4. Bruneton J. Hatton CK, trans. Pharmacognosy, Phytochemistry, Medicinal Plants . Paris; New York: Lavoisier Publishing; 1995:348.

 

5. D'Amelio FS. Botanicals: A Phytocosmetic Desk Reference . Boca Raton, FL: CRC Press; 1999:209-210.

 

6. Hocking GM. A Dictionary of Natural Products . Medford, NJ: Plexus Publishing; 1997:409-410.

 

7. Alkhawajah AM. Studies on the antimicrobial activity of Juglans regia . Am J Chin Med . 1997;25(2):175-180.  PubMed

 

8. Ensminger AH, et al. Foods and Nutrition Encyclopedia . Vol. 2. 2nd ed. Boca Raton, FL: CRC Press; 1993:2277-2278.

 

9. Murray MT. The Healing Power of Foods . Rocklin, CA: Prima Publishing; 1993:384.

 

10. Zwarts L, Savage GP, McNeil DL. Fatty acid content of New Zealand-grown walnuts ( Juglans regia L.). Int J Food Sci Nutr . 1999;50(3):189-194.  PubMed

 

11. Ros E, Nunez I, Perez-Heras A, Serra M, et al. A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation . 2004;109(13):1609-1614.  PubMed

 

12. Mukuddem-Petersen J, Oosthuizen W, Jerling JC. A systematic review of the effects of nuts on blood lipid profiles in humans. J Nutr . 2005;135(9):2082-2089.  PubMed

 

13. Buttery RG, Light DM, Nam Y, Merrill GB, Roitman JN. Volatile components of green walnut husks. J Agric Food Chem . 2000;48(7):2858-2861.  PubMed

 

14. Ruiz Del Castillo ML, Herraiz M, Blanch GP. Determination of the enantiomeric composition of gamma-lactones in edible oils by on-line coupled high performance liquid chromatography and gas chromatography. J Agric Food Chem . 2000;48(4):1186-1190.  PubMed

 

15. Zibaeenezhad MJ, Shamsnia SJ, Khorasani M. Walnut consumption in hyperlipidemic patients. Angiology . 2005;56(5):581-583.  PubMed

 

16. Sabate J, Fraser GE, Burke K, Knutsen SF, Bennett H, Lindsted KD. Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med . 1993;328(9):603-607.  PubMed

 

17. Zambon D, Sabate J, Munoz S, et al. Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women. A randomized crossover trial. Ann Intern Med . 2000;132(7):538-546.  PubMed

 

18. Lavedrine F, Zmirou D, Ravel A, Balducci F, Alary J. Blood cholesterol and walnut consumption: a cross-sectional survey in France. Prev Med . 1999;28(4):333-339.  PubMed

 

19. Chisholm A, Mann J, Skeaff M, et al. A diet rich in walnuts favourably influences plasma fatty acid profile in moderately hyperlipidaemic subjects. Eur J Clin Nutr . 1998;52(1):12-16.  PubMed

 

20. Tapsell LC, Gillen LJ, Patch CS, et al. Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. Diabetes Care . 2004;27(12):2777-2783.  PubMed

 

21. Gillen LJ, Tapsell LC, Patch CS, Owen A, Batterham M. Structured dietary advice incorporating walnuts achieves optimal fat and energy balance in patients with type 2 diabetes mellitus. J Am Diet Assoc . 2005;105(7):1087-1096.  PubMed

 

22. Davis L, Stonehouse W, Loots du T, et al. The effects of high walnut and cashew nut diets on the antioxidant status of subjects with metabolic syndrome. Eur J Nutr . 2007;46(3):155-164.

 

23. Mukuddem-Petersen J, Stonehouse Oosthuizen W, Jerling J, Hanekorn SM, White Z. Effects of a high walnut and high cashew nut diet on selected markers of the metabolic syndrome: a controlled feeding trial. Br J Nutr . 2007;97(6):1144-1153.  PubMed

 

24. Schutte AE, Van Rooyen JM, Huisman HW, et al. Modulation of baroreflex sensitivity by walnuts versus cashew nuts in subjects with metabolic syndrome. Am J Hypertens . 2006;19(6):629-636.  PubMed

 

25. Feldman EB. The scientific evidence for a beneficial health relationship between walnuts and coronary heart disease. J Nutr . 2002;132(5):1062S-1101S.  PubMed

 

26. Cortes B, Nunez I, Cofan M, et al. Acute effects of high-fat meals enriched with walnuts or olive oil on postprandial endothelial function. J Am Coll Cardiol . 2006;48(8):1666-1671.  PubMed

 

27. Bellido C, Lopez-Miranda J, Blanco-Colio LM, et al. Butter and walnuts, but not olive oil, elicit postprandial activation of nuclear transcription factor kappa B in peripheral blood mononuclear cells from healthy men. Am J Clin Nutr . 2004;80(6):1487-1491.  PubMed

 

28. Chauhan N, Wang KC, Wegiel J, Malik MN. Walnut extract inhibits the fibrillization of amyloid beta-protein, and also defibrillizes its preformed fibrils. Curr Alzheimer Res . 2004;1(3):183-188.  PubMed

 

29. Liu SL. Therapeutic effects of borneol-walnut oil in the treatment of purulent otitis media [in Chinese]. Zhong Xi Yi Jie He Za Zhi . 1990;10(2):93-95,69.  PubMed

 

30. Gebauer SK, Psota TL, Harris WS, Kris-Etherton PM. n-3 Fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr . 2006;83(suppl 6):1526S-1535S.  PubMed

 

31. Marangoni F, Colomo C, Martiello A, Poli A, Paoletti R, Galli C. Levels of the n-3 fatty acid eicosapentaenoic acid in addition to those of alpha linolenic acid are significantly raised in blood lipids by the intake of four walnuts a day in humans. Nutr Metab Cardiovasc Dis . 2007;17(6):457-461.  PubMed

 

32. Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs . Newton, MA: Integrative Medicine Communications; 2000.

 

33. Sicherer SH, Sampson HA. Peanut and tree nut allergy. Curr Opin Pediatr . 2000;12(6):567-573.  PubMed

 

34. Enrique E, Pineda F, Malek T, et al. Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol . 2005;116(5):1073-1079.  PubMed

 

35. Pastorello EA, Pompei C, Pravettoni V, et al. Lipid transfer proteins and 2S albumins as allergens. Allergy . 2001;56(suppl 67):45-47.  PubMed

 

36. Pastorello EA, Farioli L, Pravettoni V, et al. Lipid transfer protein and vicilin are important walnut allergens in patients not allergic to pollen. J Allergy Clin Immunol . 2004;114(4):908-914.  PubMed

 

37. Asero R, Mistrello G, Roncarolo D, et al. Immunological cross-reactivity between lipid transfer proteins from botanically unrelated plant-derived foods: a clinical study. Allergy . 2002;57(10):900-906.  PubMed

 

38. True RG, Lowe JE. Induced juglone toxicosis in ponies and horses. Am J Vet Res . 1980;41(6):944-945.  PubMed

 

39. Abdel-Hafez AI, Saber SM. Mycoflora and mycotoxin of hazelnut ( Corylus avellana L.) and walnut ( Juglans regia L.) seeds in Egypt. Zentralbl Mikrobiol . 1993;148(2):137-147.  PubMed