Do almonds lower cholesterol?

Yes, a little. A 2025 meta-analysis of randomized trials in 2,485 adults without heart disease found almonds lowered LDL cholesterol by 0.13 mmol/L, about 5 mg/dL, against diets without nuts, at doses from 25 to 168 g a day. The authors found significant publication bias for that result, so the true drop may be smaller still. The effect was larger in people whose LDL started above the optimal range.

Established. Almonds lower LDL cholesterol by a small amount. A 2021 umbrella review of 108 systematic reviews rated the evidence for this as high certainty, and rated the size as small, below 0.20 mmol/L. Oats, barley, psyllium and plant sterols each did more, at 0.20 to 0.40 mmol/L.

What the trials found

Four meta-analyses land on nearly the same number. The 2025 review pooled 48 almond and control comparisons from 36 publications. Alongside LDL it found total cholesterol down 6.2 mg/dL (0.16 mmol/L) and apolipoprotein B down 4.55 mg/dL, with no effect on HDL. A 2021 review of 27 randomized trials found LDL down 5.65 mg/dL and total cholesterol down 4.92 mg/dL, with HDL unchanged. A 2019 review of 15 trials in 534 adults found LDL down 5.83 mg/dL, and also a slight fall in HDL of 1.26 mg/dL, with substantial differences in dose between trials. The earliest, from 2009, pooled 5 trials in 142 people. Total cholesterol fell by 6.95 mg/dL, and the LDL drop of 5.79 mg/dL did not reach significance.

Inside the 2025 review, LDL fell by 8.9 mg/dL (0.23 mmol/L) in groups whose starting LDL was above optimal and by 3.5 mg/dL (0.09 mmol/L) in groups already at optimal levels. Trials shorter than 12 weeks showed a larger drop than longer ones, 0.16 against 0.08 mmol/L. These subgroup comparisons are drawn across different trials, so they suggest who benefits more without proving it.

Among tree nuts, a 2020 network meta-analysis of 34 trials in 1,677 people ranked almonds second for lowering LDL, behind pistachios. Only pistachios and walnuts clearly beat the control diet in that analysis, and its authors rated the evidence low quality.

What single trials show about dose

In a crossover trial of 27 adults with high cholesterol, 2.6 oz (73 g) of almonds a day for a month lowered LDL by 9.4% from baseline, and half that dose by 4.4%. The trial was small and short. In a controlled feeding trial of 48 adults with LDL around 149 mg/dL, swapping a muffin for about 1.5 oz (43 g) of almonds a day for six weeks lowered LDL by 5.3 mg/dL, and HDL fell 1.7 mg/dL on the muffin diet only. In 84 overweight Korean adults, 73 of them women, 56 g a day for four weeks lowered LDL by 4.6% against cookies. In 77 adults with metabolic syndrome, 2 oz of roasted almonds a day for 12 weeks lowered total and LDL cholesterol against crackers, and the abstract does not give the size.

Where it did not show

Unsettled. In people who already have atherosclerotic heart disease, a 2024 meta-analysis of 5 nut trials in 439 people found no significant effect on blood lipids, apart from the atherogenic index, which fell by 0.32 on moderate-certainty evidence. The trials used almonds, pecans, Brazil nuts and mixed nuts at 5 to 85 g a day, they were few and small, and many participants were on statins. That leaves the question open for this group.

In 48 people already on a steady statin dose, adding 3.5 oz (100 g) of almonds a day, about 580 calories, for four weeks lowered non-HDL cholesterol by 4.9% while it rose 3.5% in the comparison group. The change in LDL itself did not reach significance.

One trial stands far apart from the rest. In 103 pregnant women in Karachi with high blood pressure or abnormal lipids, 0.88 oz (25 g) of almonds a day for 12 weeks went with a 27.3% fall in LDL. It was a single center, only 46 women were in the main analysis, the comparison group got nothing and was not blinded, and the effect is many times larger than anything in the reviews above.

Who should be careful

Not for everyone. Almond is a tree nut. A systematic review of 36 population studies found tree nut allergy confirmed by a supervised food challenge in under 2% of people, with probable allergy between 0.05 and 4.9%, and only seven of those studies used the challenge test. If you have a tree nut allergy, do not add almonds for cholesterol without your allergist's advice.

One case report describes a 59-year-old woman who ate five handfuls of almonds and six tablespoons of chia seeds every day to manage irritable bowel symptoms and developed calcium oxalate damage in her kidneys. She improved on a low-oxalate diet. This is one person, on a combined diet with chia seeds, and the report does not separate the share from almonds. If you have had oxalate kidney stones or have kidney disease, large daily amounts are worth raising with your doctor.

The statin trial above reports lipid results only, and we have no card on safety of almonds with statins or other medicines. We have no cards on almonds and cholesterol in children. The one pregnancy trial is described above and is too small to guide anyone.

What expert bodies say

Since 2003 the US Food and Drug Administration has allowed a qualified label claim for most nuts, almonds included. Its wording is that scientific evidence suggests but does not prove that eating 1.5 ounces a day as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease. A qualified claim means limited evidence, and it concerns heart disease rather than cholesterol itself.

The European Union has refused both relevant claims. One said a 28 g handful of almonds a day helps maintain healthy blood cholesterol. The other said 1.1 oz (30 g) of nuts a day helps maintain heart health. A refusal means the dossier did not satisfy the assessors at the time. It is not a finding that almonds do nothing, and the 2025 meta-analysis came years later.

How we searched

What would change this answer

• A long trial with heart attacks and strokes as outcomes. Every result here is a blood marker, and we found no such trial.
• Larger trials in people on statins and in people who already have heart disease, where the current pooled result is null.
• An independent repeat of the pregnancy trial, whose effect is far out of line with everything else.

Nutrition facts and more on the nut itself are on the almonds page.

Sources

1. ev-almch-01 · Meta-analysis or systematic review · systematic review and random-effects meta-analysis of RCTs · n = 2485
   Almond consumption significantly reduced LDL-C (-0.132 mmol/L; 95% CI: -0.190, -0.075 mmol/L; p < 0.001), TC (-0.160 mmol/L; 95% CI: -0.218, -0.101 mmol/L; p < 0.001), non-HDL-C (-0.204 mmol/L; 95% CI: -0.281, -0.127 mmol/L; p < 0.001), TC:HDL-C (-0.154; 95% CI: -0.246, -0.063; p = 0.001), LDL-C:HDL-C (-0.112; 95% CI: -0.199, -0.026; p = 0.011), ApoB (-4.552 mg/dL; 95% CI: -6.460, -2.645 mg/dL; p < 0.001), and ApoB:ApoA (-0.027; 95% CI: -0.046, -0.008; p = 0.006), with a borderline significant reduction in TG (-0.037 mmol/L; 95% CI: -0.079, 0.005; p = 0.085) and no effects on HDL-C, ApoA, or Lp[a].
   
   Who: adults without cardiovascular disease in RCTs of at least 4 weeks; 36 publications, 48 almond-control datasets
   Effect: LDL-C -5.1 mg/dL (95% CI -7.3 to -2.9; metric: -0.132 mmol/L, -0.190 to -0.075); total cholesterol -6.2 mg/dL (-8.4 to -3.9; metric: -0.160 mmol/L, -0.218 to -0.101); non-HDL-C -7.9 mg/dL (-0.204 mmol/L); ApoB -4.552 mg/dL; no effect on HDL-C, ApoA or Lp(a)
   Certainty: Quality rated with Health Canada tool; significant publication bias for LDL-C; doses 25 to 168 g/day.
   Nutrients, 2025 · checked 2026-10-07 · we read the abstract
2. ev-almch-02 · Meta-analysis or systematic review · subgroup and sensitivity analyses within a meta-analysis of RCTs · n = 46 strata
   However, the reduction in LDL-C was greater when strata in which the baseline LDL-C level was not optimal were pooled (−0.229 mmol/L) compared to when strata in which the baseline LDL-C level was optimal were pooled (−0.094 mmol/L); when strata that were crossover in design were pooled (−0.179 mmol/L) compared to when strata that were parallel in design were pooled (−0.090 mmol/L); and when strata that were <12 weeks in duration were pooled (−0.156 mmol/L) compared to when strata that were ≥12 weeks in duration were pooled (−0.083 mmol/L).
   
   Who: 46 almond-control strata of adults without cardiovascular disease
   Effect: LDL-C -8.9 mg/dL (-0.229 mmol/L) with non-optimal baseline vs -3.6 mg/dL (-0.094 mmol/L) with optimal baseline; crossover -0.179 vs parallel -3.5 mg/dL (-0.090 mmol/L); under 12 weeks -0.156 vs 12 weeks or more -0.083 mmol/L
   Certainty: Subgroup comparisons are observational across trials; shorter and crossover trials showed larger drops.
   Nutrients, 2025 · checked 2026-10-07 · we read the fulltext
3. ev-almch-03 · Meta-analysis or systematic review · systematic review and random-effects meta-analysis of RCTs · n = 27 studies
   The meta-analysis revealed that almond intake significantly changed the concentrations of triglycerides (WMD = -6.68 mg dL-1; 95% CI: -11.62, -1.75, p = 0.008), total cholesterol (WMD = -4.92 mg dL-1; 95% CI: -7.81, -2.03, p = 0.001), and low-density lipoproteins (WMD = -5.65 mg dL-1; 95% CI: -8.75, -2.55, p < 0.001); however it did not have a significant effect on high-density lipoprotein (WMD = -0.21 mg dL-1; 95% CI: -1.26, 0.84, p = 0.697) levels.
   
   Who: adults in RCTs of almond intake; 1154 cases and 904 control subjects
   Effect: LDL WMD -5.65 mg/dL (95% CI -8.75 to -2.55); total cholesterol -4.92 mg/dL (-7.81 to -2.03); triglycerides -6.68 mg/dL; HDL -0.21 mg/dL (-1.26 to 0.84, NS)
   Certainty: Search to September 2020; overlaps heavily with the 2025 review.
   Food Funct, 2021 · checked 2026-10-07 · we read the abstract
4. ev-almch-04 · Meta-analysis or systematic review · systematic review and random-effects meta-analysis of RCTs · n = 534
   Almond intervention significantly decreased total cholesterol (summary net change: -10.69 mg/dL; 95% CI: -16.75, -4.63 mg/dL), LDL cholesterol (summary net change: -5.83 mg/dL; 95% CI: -9.91, -1.75 mg/dL); body weight (summary net change: -1.39 kg; 95% CI: -2.49, -0.30 kg), HDL cholesterol (summary net change: -1.26 mg/dL; 95% CI: -2.47, -0.05 mg/dL), and apolipoprotein B (apoB) (summary net change: -6.67 mg/dL; 95% CI: -12.63, -0.72 mg/dL).
   
   Who: adults healthy or at risk for cardiovascular disease, trials of 3 weeks or more, dose closest to 42.5 g selected
   Effect: total cholesterol -10.69 mg/dL (95% CI -16.75 to -4.63); LDL -5.83 mg/dL (-9.91 to -1.75); HDL -1.26 mg/dL (-2.47 to -0.05); apoB -6.67 mg/dL
   Certainty: Authors note substantial heterogeneity in almond doses and interventions.
   Adv Nutr, 2019 · checked 2026-10-07 · we read the abstract
5. ev-almch-05 · Meta-analysis or systematic review · meta-analysis of randomized trials · n = 142
   Upon meta-analysis, almond consumption ranging from 25 to 168 g/day significantly lowered total cholesterol [weighted mean difference -6.95 mg/dL (95% confidence interval [CI] -13.12 to -0.772) (-0.18 mmol/L [95% CI -0.34 to -0.02])] and showed a strong trend toward reducing LDL cholesterol [weighted mean difference -5.79 mg/dL (95% CI -11.2 to 0.00) (-0.15 mmol/L [95% CI -0.29 to 0.00])].
   
   Who: participants in 5 randomized trials of almonds, 25 to 168 g/day
   Effect: total cholesterol WMD -6.95 mg/dL (95% CI -13.12 to -0.772); LDL -5.79 mg/dL (-11.2 to 0.00); no effect on HDL, triglycerides or LDL:HDL
   Certainty: Small and superseded by larger reviews with the same LDL size but narrower intervals.
   J Am Diet Assoc, 2009 · checked 2026-10-07 · we read the abstract
6. ev-almch-06 · Meta-analysis or systematic review · systematic review of systematic reviews with GRADE · n = 108 systematic reviews
   Soy protein, tomatoes, flaxseeds, and almonds caused small reductions.
   
   Who: systematic reviews and meta-analyses of RCTs of foods and LDL cholesterol, at least 13 days
   Effect: almonds: small LDL reduction (below 7.7 mg/dL (0.20 mmol/L)), high certainty by GRADE; soluble-fiber foods and plant sterols: at least 7.7 to 15 mg/dL (0.20 to 0.40 mmol/L)
   Certainty: High-certainty rating applies to the direction and small size of the effect.
   Nutr Metab Cardiovasc Dis, 2021 · checked 2026-10-07 · we read the abstract
7. ev-almch-07 · Randomized controlled trial(s) · randomized controlled crossover trial · n = 27
   Significant reductions from baseline were seen on both half- and full-dose almonds for LDL cholesterol (4.4+/-1.7%, P=0.018, and 9.4+/-1.9%, P<0.001, respectively) and LDL:HDL cholesterol (7.8+/-2.2%, P=0.001, and 12.0+/-2.1%, P<0.001, respectively) and on full-dose almonds alone for lipoprotein(a) (7.8+/-3.5%, P=0.034) and oxidized LDL concentrations (14.0+/-3.8%, P<0.001), with no significant reductions on the control diet.
   
   Who: hyperlipidemic men and women on a therapeutic diet, 3 isoenergetic 1-month supplements vs whole-wheat muffins
   Effect: LDL -9.4% on full dose (73 g/day), -4.4% on half dose; LDL:HDL -12.0% and -7.8%; no reduction on control muffins
   Certainty: Small and short; reductions reported from baseline within each phase.
   Circulation, 2002 · checked 2026-10-07 · we read the abstract
8. ev-almch-08 · Randomized controlled trial(s) · randomized crossover controlled-feeding trial · n = 48
   The almond diet, compared with the control diet, decreased non-HDL-C (-6.9±2.4 mg/dL; P=0.01) and LDL-C (-5.3±1.9 mg/dL; P=0.01); furthermore, the control diet decreased HDL-C (-1.7±0.6 mg/dL; P<0.01).
   
   Who: individuals with elevated LDL-C (149 mg/dL) on a cholesterol-lowering diet, 6-week periods
   Effect: LDL-C -5.3 mg/dL; non-HDL-C -6.9 mg/dL vs isocaloric muffin; HDL kept, fell 1.7 mg/dL on control
   Certainty: Single food swap with identical diet otherwise; NCT01101230.
   J Am Heart Assoc, 2015 · checked 2026-10-07 · we read the abstract
9. ev-almch-09 · Randomized controlled trial(s) · randomized crossover trial, free-living · n = 84
   Almonds in overweight and obese Korean adults decreased TC, LDL-C, and non-HDL-C by 5.5, 4.6, and 6.4%, respectively, compared to the cookie control (P ≤ 0.05).
   
   Who: overweight or obese Korean adults (11 men, 73 women) on a typical Korean diet
   Effect: total cholesterol -5.5%, LDL-C -4.6%, non-HDL-C -6.4% vs isocaloric cookies; body weight unchanged
   Certainty: Short; shows the effect outside Western diets.
   Eur J Nutr, 2018 · checked 2026-10-07 · we read the abstract
10. ev-almch-10 · Randomized controlled trial(s) · randomized controlled trial · n = 77
    Compared with participants consuming crackers, almond consumption resulted in lower plasma total and low-density lipoprotein-cholesterol concentrations, a modest improvement in waist circumference (week 4), and improved dietary intakes of α-tocopherol, soluble fiber, copper, biotin, magnesium, polyunsaturated fatty acids, and monounsaturated fatty acids.
    
    Who: adults with metabolic syndrome; almonds 2 oz whole dry roasted (n = 38) vs crackers of equal calories (n = 39)
    Effect: lower plasma total and LDL cholesterol vs crackers; body weight, glucose, insulin and CRP unchanged; size not given in abstract
    Certainty: Abstract gives no size of the LDL change.
    Nutr Res, 2025 · checked 2026-10-07 · we read the abstract
11. ev-almch-11 · Randomized controlled trial(s) · randomized controlled trial · n = 48
    The almond group experienced a 4.9% reduction in non-HDL-C compared with a 3.5% increase for the non-almond group (P = .02).
    
    Who: subjects on a consistent statin dose; 100 g almonds plus diet counseling (n = 22) vs counseling alone (n = 26)
    Effect: non-HDL-C -4.9% vs +3.5% in controls (P = .02); LDL-C and triglycerides P = .068; almond group ate more calories
    Certainty: Very high dose (about 580 calories); abstract reports lipid outcomes only, not safety with statins; NCT00603876.
    J Clin Lipidol, 2015 · checked 2026-10-07 · we read the abstract
12. ev-almch-12 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs with GRADE · n = 439
    Compared to nut-free diets, nut intake did not have a statistically significant effect on lipid profile biomarkers, except on the atherogenic index (MD: -0.32 [95% CI -0.58 to -0.06], I2 = 0% - moderate certainty of the evidence).
    
    Who: individuals with atherosclerotic cardiovascular disease; almonds, pecans, Brazil nuts, mixed nuts, 5 to 85 g/day for 6 to 12 weeks
    Effect: no significant change in lipid biomarkers vs nut-free diets; atherogenic index MD -0.32 (95% CI -0.58 to -0.06), moderate certainty
    Certainty: Mixed nuts, not almonds alone; few small trials, many on statins.
    Eur J Nutr, 2024 · checked 2026-10-07 · we read the abstract
13. ev-almch-13 · Meta-analysis or systematic review · network meta-analysis of randomized clinical trials · n = 1677
    Regarding LDL cholesterol reduction, the almond-enriched diet was ranked second best.
    
    Who: participants of trials comparing walnut, pistachio, hazelnut, cashew, almond-enriched and control diets
    Effect: LDL ranking: pistachio first (SUCRA 87%), almond second; only pistachio and walnut clearly beat control
    Certainty: Authors rate the evidence as low quality.
    Am J Clin Nutr, 2020 · checked 2026-10-07 · we read the abstract
14. ev-almch-14 · Randomized controlled trial(s) · single-center randomized controlled trial · n = 103
    TC, TG, and LDL levels improved dose-dependently, with the A25 group showing the greatest reductions in TC (-22.5%), TG (-33.8%), and LDL (-27.3%) (P < 0.001).
    
    Who: pregnant women (20 weeks or more) with hypertension and/or dyslipidemia; 46 with both in primary analysis; 10 g/d or 25 g/d almonds vs no intervention
    Effect: A25 group: total cholesterol -22.5%, triglycerides -33.8%, LDL -27.3%; HDL unchanged
    Certainty: Single center, small analyzed sample, effects far larger than in other trials; no blinding of an unsupplemented control.
    J Nutr, 2026 · checked 2026-10-07 · we read the abstract
15. ev-almch-15 · Position of an expert body · agency enforcement discretion letter · n = —
    Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts [, such as name of specific nut,] as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.
    
    Who: US food labels for almonds, hazelnuts, pecans, pistachios, walnuts
    Effect: qualified health claim under enforcement discretion; condition: diet low in saturated fat and cholesterol
    Certainty: Qualified claim means limited evidence; it concerns heart disease, not cholesterol directly.
    US FDA, Qualified Health Claims: Letter of Enforcement Discretion, Nuts and Coronary Heart Disease, 14 July 2003 · checked 2026-10-07 · we read the section
16. ev-almch-16 · Position of an expert body · EU register entry · n = —
    POL-HC-7666 Nuts - peanuts and tree nuts (almonds, hazelnuts, pecans, pistachios and walnuts), excluding brazil, macadamia and cashew nuts Eating 30g of nuts per day as part of a balanced diet helps maintain heart health. Non-authorised
    
    Who: EU food labeling
    Effect: claim non-authorized
    Certainty: Non-authorized means evidence did not meet the bar at assessment, not proof of no effect; no almond cholesterol claim is authorized in the EU.
    EU Register on nutrition and health claims, claim POL-HC-7666, snapshot 2026-09-21 · checked 2026-10-07 · we read the section
17. ev-almch-17 · Observational data · systematic review of prevalence studies · n = 36 studies
    Challenge-confirmed IgE-mediated tree nut allergy prevalence was less than 2 % (although only seven studies used this gold standard) while probable tree nut allergy prevalence ranged from 0.05 to 4.9 %.
    
    Who: children and adults in 36 population prevalence studies of tree nut allergy
    Effect: challenge-confirmed IgE-mediated tree nut allergy prevalence below 2%; probable 0.05 to 4.9%
    Certainty: Only 7 studies used food challenge.
    Curr Allergy Asthma Rep, 2015 · checked 2026-10-07 · we read the abstract
18. ev-almch-18 · Laboratory or animal data · case report · n = 1
    Diet included six tablespoons of chia seeds and five handfuls of almonds daily to manage IBS symptoms.
    
    Who: a 59-year-old woman on a high-oxalate diet for IBS
    Effect: calcium oxalate nephropathy; improved on a low-oxalate diet
    Certainty: One case on a combined almond and chia diet; almond amount not given in grams; relevant to people with oxalate stones or kidney disease.
    BMJ Case Rep, 2020 · checked 2026-10-07 · we read the abstract
19. alm-dr-06 · Position of an expert body · EU Register on nutrition and health claims, claim POL-HC-6583, snapshot of 2026-09-21 · n = —
    POL-HC-6583 Almonds Consuming a handful (28 grams) of almonds a day as part of a diet low in saturated fat, helps to maintain healthy blood cholesterol and promotes a healthy heart Non-authorised
    
    Who: —
    Effect: three register entries name almonds and all three carry the status Non-authorized; the refused wording is that a handful of 0.99 oz (28 g) of almonds a day within a diet low in saturated fat helps maintain healthy blood cholesterol and promotes a healthy heart
    Certainty: a refusal means the submitted dossier did not establish the relationship to the assessors' satisfaction at that time, and the meta-analysis quoted above was published years later. Read together the two say something useful: the effect on cholesterol is real and small, and it was not enough for a regulator to let a package make a heart claim
    EU Register on nutrition and health claims, claim POL-HC-6583, snapshot 2026-09-21 · checked 2026-09-22 · we read the row