Is peanut butter bad for cholesterol?

No, on the trial evidence we have. A 2022 meta-analysis of 11 peanut trials in 643 adults found that peanuts and peanut butter, at 25 to 200 g a day for 2 to 24 weeks, did not change LDL or total cholesterol overall. Triglycerides fell by 12 mg/dL (95% CI 6.2 to 18; metric: 0.13 mmol/L, 0.07 to 0.20), on moderate quality evidence. The quality behind the LDL and total cholesterol results was low, mostly small trials. The open question is whether peanut butter lowers cholesterol, and there the evidence is thinner.

Myth. Peanuts and peanut butter did not push blood cholesterol up in the trials that tested them. In the 2022 meta-analysis LDL and total cholesterol did not change across the whole group, and in the 110 healthy people among them total cholesterol fell by 15 mg/dL (95% CI 3.5 to 27; metric: 0.40 mmol/L, 0.09 to 0.71), a subgroup result on low quality evidence.

What the trials found

Peanut trials

The 2022 review, which we read in full, pooled the ARISTOTLE trial with 10 others. Participants were 18 to 84 and ranged from healthy to having metabolic syndrome, type 2 diabetes or high cholesterol. The triglyceride fall held in the peanut and peanut butter subgroup (12 mg/dL (95% CI 6.2 to 18; metric: 0.14 mmol/L, 0.07 to 0.20)). In healthy people the ratio of LDL to HDL fell by 0.19, and there was no sign that eating more did more.

In a tightly controlled feeding trial of 22 adults, diets high in monounsaturated fat, one of them built around peanuts and peanut butter, lowered LDL by 14% against an average American diet. The paper reports that figure for the high monounsaturated diets together. The peanut diet was 36% fat and 8% saturated fat, so the effect is of swapping saturated fat for peanut fat. The paper gives the change in percent only, and the trial was partly funded by the peanut industry.

In 118 adults in Brazil, Ghana and the US, 56 g a day of peanut butter acted on blood lipids the same as raw, roasted or salted peanuts over 4 weeks. That trial had about 24 people per arm and no peanut-free control, so it shows the forms behave alike and cannot show any of them lowers cholesterol. A 12-week crossover in 61 older adults with obesity found high oleic peanuts made no difference to lipids against a nut-free diet, with energy intake 10% higher and weight up about 1.1 lb (0.5 kg).

Nut trials, with peanuts inside them

A 2025 meta-analysis of 113 nut trials in 8,060 adults found LDL fell by 4.6 mg/dL (95% CI 3.5 to 5.4; metric: 0.12 mmol/L, 0.09 to 0.14) at a median 1.6 oz (45.5 g) of nuts a day, with certainty moderate to low. Peanut trials are a minority of those, so the number belongs to nuts as a group. In type 2 diabetes, a 2021 meta-analysis of 16 trials in 1,041 patients found peanuts and tree nuts did not significantly change LDL.

Unsettled. Whether peanut butter lowers LDL is not settled. A 2023 meta-analysis of 129 tree nut and peanut trials found LDL and total cholesterol fell, and graded the certainty of both as very low. The trial results were inconsistent, and the reviewers judged publication bias likely. The fall is plausible on the data. It rests on the lowest grade of evidence the scale has.

Long-term observational data

In 566,398 US adults followed for 15.5 years, people eating the most peanut butter had the same death rate as those eating the least (HR 1.00, 95% CI 0.98 to 1.04), while nut eaters had lower mortality (HR 0.78). The Netherlands Cohort Study of 120,852 adults found the same split. These are associations from food questionnaires, and the Dutch authors suggested added salt and trans fats in the peanut butter of that era as one possible reason. Neither study measured cholesterol.

Who should be careful

Not for everyone. People with peanut allergy, for whom any amount of peanut butter is the question. Among people with peanut allergy tested in food challenges, an individual-data meta-analysis of 19 studies and 3,151 people found 4.5% (95% CI 1.9% to 10.1%) reacted with anaphylaxis to 5 mg of peanut protein or less. The same person's threshold varied widely from one challenge to the next.

Touching or smelling it is a different matter. In a randomized blinded study of 30 children with severe peanut allergy, skin contact with peanut butter and breathing it in caused no whole-body or breathing reactions, though up to 10 had redness, itch or a wheal where it touched the skin. Eating it is the risk.

In people with or at risk of metabolic syndrome, adding peanut products raised body weight by about 2.2 lb (1 kg) across 6 trials in the 2022 meta-analysis (2.1 lb (95% CI 1.2 to 3.1; metric: 0.97 kg, 0.54 to 1.41)). There was no weight change in the full sample. Peanut butter carries about 590 calories per 3.5 oz (100 g), and the gain appears when it is added to a diet rather than swapped for other foods.

We found no trial comparing commercial peanut butter with added sugar, salt or palm oil against plain peanut butter on cholesterol. The trials above say nothing about those additions either way.

What expert bodies say

The European Union refused a health claim that two tablespoons, about 30 g, of peanut butter a day as part of a diet low in saturated fat helps achieve healthy cholesterol levels. All three register entries mentioning peanuts are non-authorized. The refusal judges the dossier and its wording, and it does not contradict the trial results above.

The US Food and Drug Administration has allowed a qualified label claim covering peanuts since 2003. It says evidence suggests but does not prove that 1.5 ounces of most nuts a day, in a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. That claim is about nuts in general, and the FDA found no significant scientific agreement behind it. We did not find a position from the American Heart Association specific to peanut butter.

How we searched

What would change this answer

• A large randomized trial that isolates peanut butter against a diet of equal calories, with LDL and apolipoprotein B as its main outcomes. We found none registered.
• Peanut-specific trials of better quality than the small ones behind the 2022 review, which would firm up the low quality rating on LDL.
• A trial of commercial peanut butter with added sugar, salt or palm oil against plain peanut butter.

Nutrition per serving, other studies and how peanut butter compares with other spreads are on the peanut butter page.

Sources

1. ev-pbch-01 · Meta-analysis or systematic review · randomized clinical trial (ARISTOTLE) plus systematic review and meta-analysis of 11 RCTs · n = 643
   As shown in Figure 3, the level of triglycerides in blood decreased significantly after interventions with peanut products compared to the control interventions (MD: −0.13; 95% CI: −0.20 to −0.07; p < 0.0001).
   
   Who: adults aged 18 to 84, healthy or with metabolic syndrome, overweight, type 2 diabetes or high cholesterol; peanuts, peanut butter or high oleic peanuts at 25 to 200 g a day for 2 to 24 weeks
   Effect: triglycerides MD -12 mg/dL (95% CI -18 to -6.2; metric: -0.13 mmol/L, -0.20 to -0.07); peanuts or peanut butter subgroup MD -0.14 (-0.20 to -0.07); no significant change in total, LDL or HDL cholesterol
   Certainty: Best peanut-specific synthesis. Evidence quality moderate for triglycerides, low for LDL and total cholesterol; mostly small trials with unclear risk of bias. Not in the local corpus; full text read in PMC.
   Parilli-Moser et al., Frontiers in Nutrition · checked 2026-10-06 · we read the fulltext
2. ev-pbch-02 · Meta-analysis or systematic review · randomized clinical trial (ARISTOTLE) plus systematic review and meta-analysis of 11 RCTs · n = 110
   Although no significant changes were observed in the other lipid analytes, healthy subjects that consumed peanut products had lower total cholesterol and LDL-cholesterol/HDL-cholesterol ratio (MD: −0.40; 95% CI: −0.71 to −0.09; p = 0.010 and MD: −0.19; 95% CI: −0.36 to −0.01; p = 0.030, respectively) in comparison with control groups (Supplementary Table 6).
   
   Who: healthy adults in the peanut trials (110 of 643 participants)
   Effect: total cholesterol MD -15 mg/dL (95% CI -27 to -3.5; metric: -0.40 mmol/L, -0.71 to -0.09); LDL/HDL ratio MD -0.19 (-0.36 to -0.01); no dose-response trend
   Certainty: Subgroup finding in few small trials; low-quality evidence for total cholesterol.
   Parilli-Moser et al., Frontiers in Nutrition · checked 2026-10-06 · we read the fulltext
3. ev-pbch-03 · Meta-analysis or systematic review · randomized clinical trial (ARISTOTLE) plus systematic review and meta-analysis of 11 RCTs · n = 6 trials
   In general, no significant changes were detected in the anthropometric measurements (Figure 1), but a significant increase in body weight was observed in the subjects with or at risk of MetS included in the six studies analyzed separately (MD: 0.97; 95% CI: 0.54 to 1.41; P < 0.0001) (Supplementary Table 6).
   
   Who: adults with or at risk of metabolic syndrome in 6 of the peanut trials
   Effect: body weight MD +2.1 lb (95% CI 1.2 to 3.1; metric: 0.97 kg, 0.54 to 1.41); dose-response +0.033 kg per g/day; no overall change in the full sample
   Certainty: Peanut butter is about 590 calories per 3.5 oz (100 g); the gain appears when it is added rather than swapped for other foods.
   Parilli-Moser et al., Frontiers in Nutrition · checked 2026-10-06 · we read the fulltext
4. ev-pbch-04 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 8,060
   Overall, nut consumption resulted in moderate reductions in total cholesterol (mean difference, -0.14 mmol/L [95 % confidence interval, -0.18 to -0.10 mmol/L]) and LDL-C (-0.12 mmol/L [-0.14 to -0.09 mmol/L]), with small reductions in triglycerides (-0.05 mmol/L [-0.07 to -0.03 mmol/L]), TC:HDL-C (-0.11 [-0.16 to -0.06]), LDL-C:HDL-C (-0.19 [-0.24 to -0.12]), and apolipoprotein B (-0.04 g/L [-0.06 to -0.02 g/L]).
   
   Who: adults with various health status eating a median 45.5 g/day of nuts versus a non-nut control
   Effect: total cholesterol MD -5.4 mg/dL (95% CI -7 to -3.9; metric: -0.14 mmol/L, -0.18 to -0.10); LDL-C MD -0.12 (-0.14 to -0.09); triglycerides -0.05; apoB -0.04 g/L; no change in HDL; certainty moderate to low
   Certainty: Nuts as a group; peanut trials are a minority, so the LDL number is for nuts in general.
   Nutr Metab Cardiovasc Dis, 2025 · checked 2026-10-06 · we read the abstract
5. ev-pbch-05 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials with GRADE · n = 129 studies in meta-analysis
   The certainty of the body of evidence for TC:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apoB were "moderate" because of inconsistency, for TG were "low," and for LDL cholesterol and TC were "very low" because of inconsistency and the likelihood of publication bias.
   
   Who: adults in randomized trials of tree nuts or peanuts at any dose
   Effect: significant falls in LDL, total cholesterol, triglycerides, TC:HDL, LDL:HDL and apoB; GRADE moderate for ratios and apoB, low for TG, very low for LDL and TC
   Certainty: Same direction as 39638677, with stricter grading.
   Adv Nutr, 2023 · checked 2026-10-06 · we read the abstract
6. ev-pbch-06 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled-feeding trials with GRADE · n = 1,041
   The results showed that peanuts and tree nuts supplementation did not induce significant changes in low-density lipoprotein-cholesterol (LDL-C) (mean difference = -0.11; 95%CI: -0.25 - 0.03, p = 0.117) and high-density lipoprotein-cholesterol (HDL-C) (mean difference = 0.01; 95%CI: -0.01 - 0.04, p = 0.400) in patients with type 2 diabetics.
   
   Who: patients with type 2 diabetes in randomized controlled-feeding trials of peanuts or tree nuts
   Effect: LDL-C MD -0.11 (95% CI -0.25 to 0.03); total cholesterol MD -0.14 (-0.26 to -0.02); triglycerides MD -0.10 (-0.17 to -0.02); low quality for LDL
   Certainty: Peanuts and tree nuts pooled.
   Front Nutr, 2021 · checked 2026-10-06 · we read the abstract
7. ev-pbch-07 · Randomized controlled trial(s) · randomized, double-blind, 5-period crossover controlled-feeding trial · n = 22
   The high-MUFA diets lowered total cholesterol by 10% and LDL cholesterol by 14%.
   
   Who: adults on five 24-day controlled diets: average American, Step II low-fat, olive oil, peanut oil, peanuts and peanut butter (36% fat, 8% saturated)
   Effect: high-MUFA diets incl. peanut butter: total cholesterol -10%, LDL -14%, triglycerides -13%, HDL not lowered; estimated CVD risk -21% for the peanut and peanut butter diet
   Certainty: Peanut butter replaced saturated fat in a fully controlled diet; the effect is of the swap, partly funded by the peanut industry.
   Am J Clin Nutr, 1999 · checked 2026-10-06 · we read the abstract
8. ev-pbch-08 · Randomized controlled trial(s) · multicentre randomized parallel trial · n = 118
   Peanut form and processing did not differentially affect body weight or fasting plasma lipid responses in the total sample.
   
   Who: 118 adults (mean BMI 30) randomized to 56 g/day raw, roasted, roasted salted or honey roasted peanuts, or peanut butter
   Effect: no difference between forms in fasting lipids or body weight; HDL rose at group level; total, LDL and TAG fell in people with elevated lipids
   Certainty: Four weeks, about 24 per arm, no peanut-free control arm.
   Br J Nutr, 2010 · checked 2026-10-06 · we read the abstract
9. ev-pbch-09 · Randomized controlled trial(s) · randomized crossover trial · n = 61
   Consistent with other nut studies, there were no differences in lipids, CRP, glucose and insulin with peanut consumption.
   
   Who: 61 adults aged about 65 with BMI about 31, high oleic peanuts at 15 to 20% of energy vs nut-free diet
   Effect: no differences in lipids, CRP, glucose or insulin; energy intake 10% higher with peanuts, weight up about 1.1 lb (0.5 kg)
   Certainty: Null result; shows benefit is not universal.
   Nutrients, 2015 · checked 2026-10-06 · we read the abstract
10. ev-pbch-10 · Observational data · prospective cohort · n = 566,398
    We observed no significant associations between peanut butter consumption and all-cause (HR C4 vs C1 = 1.00, 95% CI = 0.98, 1.04, p = 0.001) and cause-specific mortality.
    
    Who: NIH-AARP Diet and Health Study, adults aged 50 to 71 at baseline, without chronic disease
    Effect: peanut butter highest vs none all-cause mortality HR 1.00 (95% CI 0.98 to 1.04); nuts HR 0.78 (0.76 to 0.81)
    Certainty: Food frequency questionnaire; peanut butter often eaten with bread and jam.
    Nutrients, 2019 · checked 2026-10-06 · we read the abstract
11. ev-pbch-11 · Observational data · case-cohort analysis plus meta-analysis of cohorts · n = 120,852
    Peanuts and tree nuts were inversely related to mortality, whereas peanut butter was not.
    
    Who: men and women aged 55 to 69 in 1986, Netherlands, 10-year mortality follow-up
    Effect: nuts 10+ g/day vs none total mortality HR 0.77 (95% CI 0.66 to 0.89); peanut butter not related to mortality
    Certainty: Authors suggest added salt and trans fats in peanut butter of that era as a possible reason.
    Int J Epidemiol, 2015 · checked 2026-10-06 · we read the abstract
12. ev-pbch-12 · Observational data · systematic review with individual participant data meta-analysis of food challenge studies · n = 3,151
    At individual participant data meta-analysis, 4.5% (95% CI, 1.9% to 10.1%) of individuals reacted to 5 mg or less of peanut protein with anaphylaxis (moderate heterogeneity [I2 = 57%]).
    
    Who: individuals with peanut allergy reacting at double-blind placebo-controlled food challenge, studies 2010 to 2020
    Effect: anaphylaxis at <=5 mg peanut protein 4.5% (95% CI 1.9% to 10.1%); thresholds varied up to 3 logs within a person
    Certainty: Synthesis of challenge studies, not RCTs of an intervention, so level C (n6 2026-10-06, was A); the outcome is a risk estimate for allergic people.
    J Allergy Clin Immunol, 2021 · checked 2026-10-06 · we read the abstract
13. ev-pbch-13 · Randomized controlled trial(s) · double-blind, placebo-controlled, randomized exposure study · n = 30
    None experienced a systemic or respiratory reaction.
    
    Who: children with significant peanut allergy (median IgE >100 kIU/L), skin contact and inhalation of peanut butter vs placebo
    Effect: no systemic or respiratory reactions; local skin redness, itch or wheal at the contact site in up to 10 children
    Certainty: Casual exposure only; eating even small amounts is the risk (ev-pbch-12).
    J Allergy Clin Immunol, 2003 · checked 2026-10-06 · we read the abstract
14. ev-pbch-14 · Position of an expert body · EU Register on nutrition and health claims, claim POL-HC-7733, snapshot of 2026-09-21 · n = —
    POL-HC-7733 Peanuts, Peanut butter, Peanut oil Consuming a small handful, about 30 grams, of peanuts a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Consuming two tablespoons, about 30g, of peanut butter a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Consuming two tablespoons, about 30 grams of peanut oil a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Non-authorised
    
    Who: —
    Effect: claim POL-HC-7733 status Non-authorized
    Certainty: The refusal judges the dossier and wording, not the trial evidence on lipids.
    EU Register on nutrition and health claims, claim POL-HC-7733, snapshot 2026-09-21 · checked 2026-10-06 · we read the row
15. ev-pbch-15 · Position of an expert body · FDA letter of enforcement discretion for a qualified health claim · 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 labeling; peanuts and nine tree nuts named in the petition
    Effect: qualified health claim under enforcement discretion since 14 July 2003; FDA found no significant scientific agreement
    Certainty: Archived FDA page (archive-it, captured 2017); about peanuts, not specifically peanut butter.
    US Food and Drug Administration, Qualified Health Claims: Letter of Enforcement Discretion, Nuts and Coronary Heart Disease, 14 July 2003 · checked 2026-10-06 · we read the full text
16. pnb-dr-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials of any dose, four databases searched to 26 September 2021, random-effects pooling, Health Canada quality appraisal and GRADE, PROSPERO CRD42022309156 · n = 139 studies
    The certainty of the body of evidence for TC:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apoB were "moderate" because of inconsistency, for TG were "low," and for LDL cholesterol and TC were "very low" because of inconsistency and the likelihood of publication bias.
    
    Who: 153 articles describing 139 studies, 81 parallel and 58 crossover, with 129 studies in the meta-analysis
    Effect: significant falls in LDL cholesterol, total cholesterol, triglycerides, the total-to-HDL and LDL-to-HDL ratios and apolipoprotein B; GRADE certainty moderate for the two ratios and apoB, low for triglycerides, and very low for LDL cholesterol and total cholesterol because of inconsistency and likely publication bias
    Certainty: the outcomes are blood markers rather than heart attacks, and the certainty rating on the headline marker is the lowest the GRADE scale has. Peanuts are pooled with nine other nuts throughout
    Adv Nutr, 2023 · checked 2026-09-22 · we read the abstract
17. pnb-dr-07 · Position of an expert body · EU Register on nutrition and health claims, claim POL-HC-7733, snapshot of 2026-09-21 · n = —
    POL-HC-7733 Peanuts, Peanut butter, Peanut oil Consuming a small handful, about 30 grams, of peanuts a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Consuming two tablespoons, about 30g, of peanut butter a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Consuming two tablespoons, about 30 grams of peanut oil a day as part of a diet low in saturated fat helps to achieve healthy cholesterol levels and promotes heart health. Non-authorised
    
    Who: —
    Effect: status Non-authorized; all three register entries mentioning peanuts are non-authorized, including the 30 g a day wording for nuts generally
    Certainty: the refusal judges a dossier and its wording at the time of assessment. It does not contradict the trial evidence above; it says the case put to the regulator did not meet the bar for a label claim
    EU Register on nutrition and health claims, claim POL-HC-7733, snapshot 2026-09-21 · checked 2026-09-22 · we read the row