Pistachios - Beneficial Foods

Pistachios — scientific infographic poster

The pistachio is the green, faintly sweet seed of Pistacia vera, a small desert tree that has fed people across Central and Western Asia for close to nine thousand years. It is the only nut in common use that tells you when it is ripe: the shell splits open by itself on the tree. That split is not just a curiosity — it is why pistachios are eaten more slowly than any other nut, and slow eating matters more for appetite than almost anything printed on a label.

Nutritionally the pistachio is unusual in three ways: it shares the top of the tree-nut protein table with almonds and its protein rates as a “good” source by the DIAAS scoring method, it carries more potassium than any comparable nut, and it is the only nut with a meaningful amount of lutein — one of the carotenoids the retina pulls from the bloodstream and concentrates at the center of vision. Those three things are its own. The fiber, the unsaturated fat, the vitamin B6 and the copper it shares with the rest of the nut family.

Table of Contents

  1. Introduction and History
  2. How the Pistachio Grows
  3. Nutritional Profile
  4. Protein and Protein Quality
  5. Potassium, Magnesium, B6 and Copper
  6. Lutein, Zeaxanthin and the Eyes
  7. Shelling Your Own and the Satiety Effect
  8. Blood Pressure and Blood Vessels
  9. Cholesterol and Blood Lipids
  10. Blood Sugar and Metabolic Markers
  11. Fiber and the Gut Microbiome
  12. Buying, Storing and Preparing
  13. Amounts Used in Studies
  14. Who the Research Raises Cautions For
  15. Connections
  16. Key Research Papers
  17. Featured Videos

Introduction and History

Pistachios are among the oldest nuts in the human diet, and the archaeology is unusually clear about it. Charred pistachio shells were recovered from the early farming settlement at Jarmo, in the hills of northeastern Iraq, in deposits dated to roughly 6750 BC — older than pottery there. Wild Pistacia trees grew across the dry uplands running from eastern Turkey through Syria and Iran into Turkmenistan and Afghanistan, and people gathered from them long before anyone planted them in rows. The domesticated tree almost certainly comes from what is now northeastern Iran and Central Asia; pistachios appear in the Hebrew Bible among the gifts Jacob sends into Egypt in Genesis 43:11, one of only two nuts named in that text.

The tree reached the Mediterranean through Rome; Pliny the Elder credits Lucius Vitellius, a Roman governor of Syria, with bringing pistachios to Italy around AD 35. Sicily still grows one of the most prized pistachios in the world on the volcanic slopes around Bronte, on Mount Etna — small, intensely green, resinous, harvested only in alternate years. Turkey built its own tradition around Gaziantep, where the smaller, darker Antep pistachio defines baklava, and Iran built the world's largest industry around Rafsanjan and Kerman.

The American story is recent and traceable to one man. In 1929 the USDA botanist William E. Whitehouse spent months collecting pistachio seed in Persia; from that collection came the 'Kerman' cultivar, which suited California's Central Valley almost perfectly. Commercial planting began in the 1960s, the first substantial harvest came in 1976, and California, Arizona and New Mexico now supply essentially the whole United States crop. Around the middle of the 2010s the United States overtook Iran as the world's largest producer.

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How the Pistachio Grows

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Nutritional Profile

Figures are for raw shelled kernels; dry-roasted unsalted pistachios differ too little to change any practical decision.

Per 100 grams — macronutrients:

Per 100 grams — minerals:

Per 100 grams — vitamins, carotenoids and other compounds:

Per one ounce (28 grams, about 49 kernels):

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Protein and Protein Quality

Pistachios share the top of the tree-nut protein table with almonds. At 20.2 grams per 100 grams they sit just below almonds (about 21.2 g; per ounce, almonds edge pistachios by a few tenths of a gram in the USDA data) and clearly ahead of cashews (18 g), walnuts and hazelnuts (15 g), pecans (9 g) and macadamias (8 g). The claim sometimes seen that the pistachio is the highest-protein nut is not what the USDA table shows. The gap between pistachios and almonds is smaller than the variation between cultivars and seasons, and peanuts — a legume rather than a tree nut — are higher again at about 26 grams per 100 grams. What is fair to say is that pistachios and almonds share the top of the list, and that an ounce delivers about 5.7 grams of protein, which is real food protein rather than a rounding error.

The more interesting story is quality. Plant proteins are usually limited by one or two indispensable amino acids — grains run short of lysine, legumes short of methionine — and quality scoring penalizes them accordingly. The current method, the Digestible Indispensable Amino Acid Score (DIAAS), measures how much of each essential amino acid actually survives digestion and gets absorbed. A score of 100 or above means the food can meet requirements on its own, which is normally the preserve of eggs, dairy and meat.

In 2020 a protein-quality study by Bailey and Stein measured raw and roasted pistachios with DIAAS, using digestibility measured in pigs (the standard animal model for this test, not people). Both scored above 75, the threshold for a “good” protein source, but below 100: for children over three, adolescents and adults the DIAAS was 86 for raw and 83 for roasted pistachios, with lysine the limiting amino acid. Roasting lowered the digestibility of almost every essential amino acid. The full detail is on the Protein and Fiber deep dive.

Pistachio protein is also rich in arginine, at roughly 2.1 grams per 100 grams. Arginine is the substrate the vascular endothelium uses to make nitric oxide, the signal that relaxes artery walls — one of the plausible mechanisms behind the blood-pressure findings below, and part of why pistachios keep appearing in cardiovascular trials rather than only in weight studies.

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Potassium, Magnesium, B6 and Copper

Potassium is the pistachio's quiet distinction. At 1,025 mg per 100 grams, or 291 mg in a one-ounce handful, pistachios carry more potassium than any other commonly eaten nut — a handful delivers roughly what a small banana does, in a fifth of the weight. That matters because dietary potassium has a real effect on blood pressure; the NIH Office of Dietary Supplements lists an Adequate Intake of 3,400 mg a day for adult men and 2,600 mg for adult women. Potassium relaxes vascular smooth muscle, promotes sodium excretion at the kidney, and blunts the pressor effect of a salty diet. When a pistachio trial reports lower blood pressure, potassium is part of the explanation alongside the arginine and the unsaturated fat.

Vitamin B6 is where pistachios lead outright. At 1.7 mg per 100 grams they are the richest nut source by a wide margin, and one ounce supplies about 28 percent of the Daily Value. B6, as pyridoxal-5-phosphate, is the working cofactor for well over a hundred enzymes: it builds serotonin, dopamine, GABA and melatonin from their amino acid precursors, it is required for heme synthesis, and it drives the transsulfuration pathway that clears homocysteine. Deficiency is not rare in older adults, heavy drinkers, or people taking isoniazid, hydralazine, penicillamine or long-term oral contraceptives.

Copper is unusually concentrated — about 41 percent of the Daily Value per ounce. Copper sits at the center of ceruloplasmin, cytochrome c oxidase, lysyl oxidase and superoxide dismutase — the machinery of iron transport, mitochondrial energy, collagen cross-linking and antioxidant defense.

The rest of the panel is solid rather than remarkable. Magnesium at 121 mg per 100 grams contributes to a diet that is chronically short of it, phosphorus at 490 mg is high, and manganese at 1.2 mg covers roughly half a day's requirement. Iron is present at 3.9 mg per 100 grams, but as non-heme iron in a phytate-containing food it is modestly absorbed; vitamin C eaten in the same meal is known to improve the absorption of non-heme iron.

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Lutein, Zeaxanthin and the Eyes

The green tint in a pistachio kernel is not decoration. It comes from chlorophyll and from carotenoids, and the main carotenoid is lutein. USDA reports lutein together with zeaxanthin, but laboratory analyses that separate the two found lutein and no measurable zeaxanthin in pistachios. Lutein and zeaxanthin are two xanthophylls the human retina actively transports out of the bloodstream and stacks at the fovea, the pinhead of tissue responsible for reading, faces and fine detail. That deposit is the macular pigment, and it does two jobs: it absorbs blue light before it reaches the photoreceptors, and it quenches the reactive oxygen species that a lifetime of light exposure generates in the retina.

USDA lists about 2,900 mcg of lutein plus zeaxanthin per 100 grams of raw pistachios and about 1,160 mcg for dry-roasted ones (separate samples, so the gap is not a measured roasting loss) — roughly 330 to 820 mcg in a one-ounce handful. No other tree nut comes close; almonds, walnuts, cashews and pecans carry trace amounts at best. Dark leafy greens remain the heavyweight sources, with kale and spinach running to several thousand micrograms per 100 grams. But the pistachio has one advantage over a leaf: carotenoids are fat-soluble, and the nut arrives with 13 grams of fat per ounce already attached. Lutein absorbed from a meal containing almost no fat is poor; from a nut it is not.

The evidence has moved past composition tables. A randomized controlled trial from the Tufts nutrition group, published in the Journal of Nutrition, gave 36 middle-aged and older healthy adults with low lutein intake 2 ounces of pistachios a day for 12 weeks and measured macular pigment optical density directly — the pigment itself, in the living eye, not a blood level. It increased significantly in the pistachio group. Macular pigment optical density is a biomarker: higher values are associated with eye health in observational research, but the trial did not measure eye disease or eyesight. The full detail is on the Eye Health deep dive.

What this does not mean is that pistachios treat eye disease. Nobody has shown they prevent macular degeneration or slow it once it has started; the trials are short, the outcome is a pigment measurement, and the participants had healthy eyes. What it does show is that, in this one trial, 2 ounces a day raised both blood lutein and macular pigment in people who started low.

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Shelling Your Own and the Satiety Effect

Researchers at Eastern Illinois University ran a pair of simple studies, published in Appetite in 2011, that have been quoted ever since. In the first, 140 university students who served themselves in-shell pistachios during a class ate about 125 calories, against 211 calories for students given already-shelled kernels — 86 calories, or 41 percent, fewer — and reported the same fullness. In the companion study, 118 faculty and staff kept in-shell pistachios on their desks for a working day: when the empty shells stayed in view they ate an average of 216 calories, and when the shell bowl was emptied every two hours they ate 264 — 48 calories fewer with the shells left in sight. Both were single-session studies that did not measure body weight.

Two mechanisms are proposed, and neither is exotic:

  1. Time. Cracking a shell takes a couple of seconds; across 49 kernels, eating an ounce becomes a several-minute activity rather than two handfuls. The gut's satiety signals — cholecystokinin, GLP-1, peptide YY — take fifteen to twenty minutes to register. Slowing the eating rate lets them arrive before the bowl is empty.
  2. Visible evidence. The pile of empty shells is an honest running total. Almost every other snack erases the record of what you have eaten; the pistachio leaves it in front of you, and it works whether or not you are consciously counting.

There is a second, purely physiological reason a pistachio calorie is worth slightly less than the label says. Baer, Gebauer and Novotny measured the actual metabolizable energy of pistachios in people rather than assuming the standard Atwater factors, and found it about 5 percent lower than the calculated value. The reason is the cell wall: some fat stays locked inside intact plant cells that chewing does not fully rupture and passes through undigested. Five percent is not a diet plan, but it points the same way as everything else here — the whole pistachio behaves better than its nutrient list suggests.

In these studies the in-shell form, and the visible pile of shells, went with eating less in a single sitting. No long-term trial has compared in-shell with shelled pistachios for body weight. More on the Weight and Mindful Eating page.

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Blood Pressure and Blood Vessels

Pistachios have been studied for blood pressure more carefully than most foods, partly because they combine three plausible mechanisms in one package: a high potassium load, a high arginine content feeding nitric-oxide production, and a fat profile that is roughly 80 percent unsaturated.

One detailed trial came from Penn State. Sauder, McCrea, Ulbrecht, Kris-Etherton and West fed 30 adults with well-controlled type 2 diabetes a pistachio diet (20 percent of energy) and a low-fat control diet for 4 weeks each. Blood pressure measured at rest and during a mental-stress test did not differ between the diets. The pistachio diet reduced total peripheral resistance by 3.7 percent, raised cardiac output and improved some measures of heart rate variability (a window on the nervous system's control of the heart), and in a subset of 21 people 24-hour ambulatory systolic pressure was 3.5 mmHg lower (P = 0.046). An earlier controlled-feeding trial from the same group, in 28 adults with dyslipidemia, found greater average systolic reductions across rest and stress with one serving a day than with two (−4.8 vs −2.4 mmHg), lower peripheral resistance and heart rate after two servings, and no effect on flow-mediated dilation. A three-month open-label trial in 60 adults with mild dyslipidemia reported less arterial stiffness with 40 grams of shelled pistachios a day, but the pooled analysis of flow-mediated dilation (an ultrasound test of how well the artery lining widens the vessel) found no significant effect, so whether pistachios improve endothelial function remains unsettled.

Three meta-analyses of pistachio trials each found systolic pressure (the top number) about 2 to 3 mmHg lower, with no change in diastolic pressure (the bottom number). The honest summary: effect sizes run to a few millimetres of mercury, which is unimpressive for one person and substantial across a population, since a few millimetres sustained over decades measurably changes stroke and heart-attack rates. No pistachio trial selected people because they had hypertension, pistachios have not been tested as a treatment for it, and decisions about blood-pressure medicines belong with a clinician. More on the Blood Pressure and Blood Vessels page.

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Cholesterol and Blood Lipids

The cleanest lipid data comes from a dose-response feeding study by Gebauer, West, Kay, Alaupovic, Bagshaw and Kris-Etherton, published in the American Journal of Clinical Nutrition in 2008. Participants with moderately raised cholesterol ate a controlled background diet with either no pistachios, roughly one serving a day, or roughly two servings a day. On the two-serving diet LDL cholesterol fell 11.6 percent and total cholesterol 8 percent compared with the control diet; the ratios of total, LDL and non-HDL cholesterol to HDL fell in a dose-dependent way across one and two servings (for LDL to HDL, 3 and 11 percent) (PMID 18779280). Dose-response is what makes the study persuasive: an effect that scales with intake is much harder to explain away than a single-dose difference.

Two ingredients are proposed to contribute (no trial has separated their effects):

Beyond the standard panel, Kay, Gebauer, West and Kris-Etherton reported something more specific in the Journal of Nutrition in 2010: a pistachio diet raised serum antioxidants — lutein, gamma-tocopherol, beta-carotene — and lowered oxidized LDL. That distinction matters. LDL particles do their damage mainly after oxidative modification; oxidized LDL is what scavenger receptors on macrophages recognize, and that recognition turns a macrophage into a foam cell and starts a plaque. The authors' reading was that most of the drop in oxidized LDL came from the cholesterol lowering itself, with a possible added contribution from the nut's antioxidants. In these trials pistachios replaced other foods rather than being added on top of an unchanged diet; a review of nine pistachio studies noted that the favourable lipid effects depended on pistachios not raising usual calorie intake (see cholesterol management). More on the Cholesterol and Lipids page.

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Blood Sugar and Metabolic Markers

Pistachios have a very low glycemic impact on their own — the carbohydrate is wrapped in fiber, fat and protein — and they also flatten the response to carbohydrate eaten with them. Work from the Toronto group led by Kendall and Jenkins fed pistachios alone and alongside high-carbohydrate foods such as bread and rice, and found that adding pistachios reduced the post-meal glucose rise in proportion to the amount added: 28 grams added to white bread made no significant difference, while 56 and 84 grams did. Fat and protein slow gastric emptying, fiber slows absorption at the brush border, and the peak comes lower and later.

The strongest evidence in people who actually need it comes from a Spanish randomized crossover trial by Hernández-Alonso, Salas-Salvadó, Baldrich-Mora, Juanola-Falgarona and Bulló, published in Diabetes Care in 2014. Adults with prediabetes ate about 57 grams of pistachios a day for four months in one arm and a matched control diet in the other. In the pistachio arm, fasting glucose, fasting insulin and HOMA-IR — the standard index of insulin resistance — all fell, as did fibrinogen, oxidized LDL and platelet factor 4. This is the population where the finding matters most: prediabetes is the window in which type 2 diabetes is still avoidable. Fewer trials have been done in people who already have type 2 diabetes; meta-analyses pooling them with prediabetes and metabolic-syndrome trials agree on a small fall in fasting glucose but are split on HbA1c, fasting insulin and HOMA-IR. More on the Blood Sugar and Diabetes page.

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Fiber and the Gut Microbiome

Ten and a half grams of fiber per 100 grams makes pistachios one of the higher-fiber nuts; a one-ounce handful carries about 3 grams. USDA reports total fiber only, not the soluble–insoluble split; much of it is the cell-wall material that keeps a fraction of the nut's fat out of circulation.

Ukhanova and colleagues, working with USDA researchers, ran two randomized crossover feeding studies, one of almonds (18 volunteers) and one of pistachios (16 volunteers), with 18-day diet periods, and sequenced participants' gut bacteria. The authors reported that the pistachio effect on the microbial community was much stronger than the almond effect and included an increase in potentially beneficial butyrate-producing bacteria; butyrate itself was not measured. Butyrate is the short-chain fatty acid colonocytes prefer as fuel; it strengthens the epithelial barrier, suppresses inflammatory signalling in gut-associated immune tissue, and regulates gene expression in the colonic lining through histone deacetylase inhibition. A rise in butyrate producers is often read as a potentially favourable change, but no pistachio study has linked the shift to a health outcome. The fat and fiber that escape absorption (the missing 5 percent of metabolizable energy) are one proposed source of the material these bacteria feed on.

A sudden rise in fiber from any source commonly brings temporary gas and bloating while gut bacteria adjust. Pistachios pair well with fermented foods such as whole-milk yogurt and kefir. More on the Gut Microbiome page.

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Buying, Storing and Preparing

In-shell and shelled. The shell slows eating, and it also protects the kernel from light and oxygen, so in-shell nuts keep longer than shelled kernels. A high proportion of naturally split shells means mature, well-filled kernels, while a bag heavy with closed shells is lower grade and often hollow.

Unsalted, or lightly salted. The raw nut contains 1 mg of sodium per 100 grams. A salted roasted pistachio can carry 300 to 500 mg per 100 grams, and heavily salted ones far more — which quietly cancels the potassium advantage that makes the pistachio interesting for blood pressure in the first place. Flavored coatings such as chili-lime, honey-roasted and barbecue add sugar, maltodextrin and flavorings that the plain nut does not contain.

Judge the kernel, not the shell. Good kernels are pale green to yellow-green with a purplish skin, firm, and smell sweet and faintly resinous. A smell like old crayons or paint is rancidity, and with 14 grams of polyunsaturated fat per 100 grams it happens faster than in a peanut. Shrivelled, discolored, dusty-looking or visibly moldy kernels are a warning sign — pistachios are one of the tree nuts most often flagged for aflatoxin, and visible mold is the one signal a home kitchen can see.

Storage is about oxygen, light and heat. In an airtight container in a dark pantry, shelled kernels keep about two to three months and in-shell nuts longer. The refrigerator extends that to about a year and the freezer to two years or more — pistachios freeze well, need no thawing and lose nothing in texture. A warm cabinet above a stove speeds rancidity.

Preparation. Raw pistachios need nothing. To roast, spread shelled kernels in a single layer in a moderate oven — around 160 to 175 °C (325 to 350 °F) — for 5 to 8 minutes, shaking once, and pull them while they still look underdone; residual heat finishes them, and they go from perfect to bitter in about a minute. Mild heat improves protein digestibility without destroying the carotenoids; high or prolonged heat degrades both the carotenoids and the green color. For vivid green in baking, blanch kernels in boiling water for one minute and rub off the purple skins.

Kitchen uses. Chopped over whole-milk yogurt with honey. Crushed as a crust for salmon or chicken. Blitzed with garlic, basil, olive oil and hard cheese into the Sicilian pistachio pesto. Ground into a paste for cakes and ice cream. Scattered over roasted carrots, beets or Brussels sprouts, where the sweetness of the nut works against the char. Stirred through rice, lentils or a grain salad.

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Amounts Used in Studies

The trials mostly used one to two ounces a day — 28 to 57 grams, roughly 49 to 100 kernels, 160 to 320 calories. The lipid dose-response study compared roughly one and two servings a day, the prediabetes and macular-pigment trials used 57 grams, and the weight-loss trials 42 to 53 grams. The 2003 FDA qualified health claim for nuts names 1.5 ounces (about 42 grams) a day. In the shell, an ounce is roughly a heaped half-cup of whole nuts.

Most trials substituted rather than added. Pistachios are calorie-dense at 560 calories per 100 grams. The studies that showed benefit either held total calories constant or recorded people spontaneously eating less of other foods. Two ounces a day added on top of an unchanged diet is about 320 calories a day, or more than 2,200 a week, with no compensation; that situation is different from the one the trials tested. In the trials pistachios usually took the place of other snacks or fats, or were eaten with a carbohydrate meal in the glucose studies.

Different nuts, different strengths. No single nut has everything: pistachios lead on potassium, B6, lutein and the lysine content of their protein, walnuts on alpha-linolenic acid, almonds on vitamin E and calcium, pumpkin seeds on zinc and magnesium, and cashews and peanuts each their own.

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Who the Research Raises Cautions For

Tree-nut allergy. Pistachio is a recognized tree-nut allergen and reactions can be severe, including anaphylaxis. The point that matters most is botanical family: pistachio belongs to the Anacardiaceae, along with cashew, mango and — less appetizingly — poison ivy and poison oak. Cross-reactivity between pistachio and cashew is strong and well documented, because their major storage proteins are closely related; a large share of people allergic to one react to the other, and in a cashew oral-immunotherapy study all 35 patients allergic to both who were desensitised to cashew were also desensitised to pistachio. Whether a person with one of these allergies tolerates the other is a question for an allergist. Pistachio allergy does not predict allergy to almonds or walnuts, which belong to entirely different families, but cross-contamination in bulk bins and processing plants is a real and separate hazard.

Aflatoxin. Pistachios, along with Brazil nuts, figs and maize, are among the foods most often found carrying aflatoxins — potent liver carcinogens made by Aspergillus flavus and A. parasiticus. The risk is created in the first day after harvest, when a damaged or slowly hulled nut holds moisture, and it grows again during humid storage. Regulators cap total aflatoxins in pistachios sold for direct consumption in the low single digits of micrograms per kilogram, and pistachios are one of the most intensively sampled commodities at import. The risk at home rises with long, warm or humid storage, and shrivelled, discolored or moldy kernels are the visible warning sign. The toxin is not confined to the visibly affected nuts, so picking moldy kernels out of a batch does not remove it from the rest.

Advanced kidney disease and potassium-raising drugs. This is the one group for whom the pistachio's strengths become liabilities. At 1,025 mg of potassium and 490 mg of phosphorus per 100 grams, pistachios are a concentrated source of both minerals that advanced chronic kidney disease and dialysis diets restrict. Potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers and potassium supplements also raise blood potassium. For people on a potassium-restricted or phosphorus-restricted diet, or taking these medicines, nuts are a food whose place in the diet is usually managed with a clinician.

Phytate and mineral absorption. Like all nuts and seeds, pistachios contain phytic acid, which binds iron, zinc and calcium in the gut and reduces their absorption. In a varied diet this is a minor accounting adjustment — the nut brings more minerals than the phytate withholds — but it matters more for people whose diets rely heavily on nuts, seeds, whole grains and legumes and who are already short of iron or zinc. Soaking or roasting reduces phytate somewhat. Pistachios are low to moderate in oxalate; questions about portions for people with a history of calcium-oxalate kidney stones belong with a clinician.

Fructans and FODMAP sensitivity. Pistachios are high in fructans and galacto-oligosaccharides and are among the nuts restricted during the elimination phase of a low-FODMAP diet for irritable bowel syndrome. People who react badly to onions, garlic and legumes often react to a large portion the same way, while a small portion is frequently tolerated.

Claims that outrun the evidence. Pistachios are sometimes marketed as a sleep food because laboratory analyses report a relatively high melatonin content for a plant food; no trial has shown that eating them improves sleep, and the amounts are far below what sleep research uses. A small Turkish study reporting improved erectile function on a pistachio diet is likewise cited far beyond what one short, unblinded trial can support. Pistachios are a good food with a genuinely interesting evidence base for lipids, blood pressure, glucose and macular pigment. They are not a remedy and not a supplement — they are a whole food that earns its place in a bowl.

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Connections

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Key Research Papers

  1. Dreher ML. Pistachio nuts: composition and potential health benefits. Nutrition Reviews. 2012;70(4):234-40. PubMed PMID: 22458696
  2. Bailey HM, Stein HH. Raw and roasted pistachio nuts (Pistacia vera L.) are ‘good’ sources of protein based on their digestible indispensable amino acid score as determined in pigs. Journal of the Science of Food and Agriculture. 2020;100(10):3878-3885. PubMed PMID: 32323331
  3. Gebauer SK, West SG, Kay CD, Alaupovic P, Bagshaw D, Kris-Etherton PM. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. American Journal of Clinical Nutrition. 2008;88(3):651-9. PubMed PMID: 18779280
  4. Kay CD, Gebauer SK, West SG, Kris-Etherton PM. Pistachios increase serum antioxidants and lower serum oxidized-LDL in hypercholesterolemic adults. Journal of Nutrition. 2010;140(6):1093-8. PubMed PMID: 20357077
  5. Sauder KA, McCrea CE, Ulbrecht JS, Kris-Etherton PM, West SG. Pistachio nut consumption modifies systemic hemodynamics, increases heart rate variability, and reduces ambulatory blood pressure in well-controlled type 2 diabetes: a randomized trial. Journal of the American Heart Association. 2014;3(4):e000873. PubMed PMID: 24980134
  6. West SG, Gebauer SK, Kay CD, Bagshaw DM, Savastano DM, Diefenbach C, Kris-Etherton PM. Diets containing pistachios reduce systolic blood pressure and peripheral vascular responses to stress in adults with dyslipidemia. Hypertension. 2012;60(1):58-63. PubMed PMID: 22665124
  7. Hernández-Alonso P, Salas-Salvadó J, Baldrich-Mora M, Juanola-Falgarona M, Bulló M. Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care. 2014;37(11):3098-105. PubMed PMID: 25125505
  8. Kennedy-Hagan K, Painter JE, Honselman C, Halvorson A, Rhodes K, Skwir K. The effect of pistachio shells as a visual cue in reducing caloric consumption. Appetite. 2011;57(2):418-20. PubMed PMID: 21704666
  9. Honselman CS, Painter JE, Kennedy-Hagan KJ, Halvorson A, Rhodes K, Brooks TL, Skwir K. In-shell pistachio nuts reduce caloric intake compared to shelled nuts. Appetite. 2011;57(2):414-7. PubMed PMID: 21645565
  10. Baer DJ, Gebauer SK, Novotny JA. Measured energy value of pistachios in the human diet. British Journal of Nutrition. 2012;107(1):120-5. PubMed PMID: 21733319
  11. Ukhanova M, Wang X, Baer DJ, Novotny JA, Fredborg M, Mai V. Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study. British Journal of Nutrition. 2014;111(12):2146-52. PubMed PMID: 24642201
  12. Scott TM, Ogunbodede O, McKay DL, et al. Pistachio Consumption Increases Macular Pigment Optical Density in Healthy Adults: A Randomized Controlled Trial. The Journal of Nutrition. 2025;155(1):168-174. PubMed PMID: 39426460

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