The effect of pecan consumption on cardiometabolic risk factors: a systematic review and meta-analysis of randomized...

Pecans are rich in monounsaturated fats, phytosterols, fiber, and polyphenols, suggesting potential cardiometabolic benefits. However, evidence from randomized controlled trials (RCTs) remains inconsistent, and no prior synthesis has comprehensively quantified their effects on major metabolic risk factors. Therefore, we aimed to systematically evaluate the effects of pecan consumption on cardiometabolic outcomes in adults using data from RCTs.

A systematic search of PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL was conducted through November 2025. Eligible studies were RCTs assessing pecan consumption versus control diets and reporting changes in glycemic indices, anthropometric measures, lipid profiles, or blood pressure. Random-effects models were used to calculate weighted mean differences (WMDs).

A total of 10 randomized controlled trials were included. Pecan consumption significantly reduced total cholesterol (7 studies; WMD: - 8.49 mg/dL; 95% CI: - 12.61 to - 4.37; I²=0.0%), LDL-cholesterol (7 studies; WMD: - 7.42 mg/dL; 95% CI: - 10.83 to - 4.01; I²=0.0%), and triglycerides (7 studies; WMD: - 14.06 mg/dL; 95% CI: - 22.37 to - 5.75; I²=0.0%). Little evidence of an effect was observed for HDL-cholesterol (7 studies; I²=0.0%), fasting glucose (4 studies; I²=71.2%), insulin (4 studies; I²=44.6%), HOMA-IR (3 studies; I²=12.8%), body weight (4 studies; I²=0.0%), BMI (3 studies; I²=0.0%), waist circumference (4 studies; I²=0.0%), systolic blood pressure (4 studies; I²=88.8%), or diastolic blood pressure (4 studies; I²=89.6%). Subgroup analyses showed consistent LDL-C reductions across all doses and durations, whereas triglyceride reductions were evident only in interventions > 4 weeks. Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected.

Pecan consumption was associated with improvements in total cholesterol, LDL-cholesterol, and triglycerides but does not significantly influence glycemic control, adiposity, or blood pressure. Pecans represent a beneficial lipid-modifying component of cardioprotective dietary patterns. Larger, long-term RCTs in high-risk populations are warranted.