Three other tree nuts—walnuts, pistachios, and almonds—are already permitted to feature similar heart health claims, and the consumption of nuts is advised in the Dietary Guidelines for Americans. According to the Centers for Disease Control and Prevention, heart disease remains the leading cause of death for both men and women in the United States. The alleged advantages of macadamia nuts are attributed to their high levels of monounsaturated fats, which are known to lower bad cholesterol levels and decrease the risk of heart disease and stroke. Researchers first investigated the impact of macadamia nuts on reducing LDL cholesterol in the 1990s, and evidence supporting this positive connection has been accumulating ever since. Although this recent label claim for macadamia nuts emerged from a petition by Royal Hawaiian Orchards, it can be utilized by all macadamia nut suppliers, meaning the company is unlikely to gain a competitive edge over its direct rivals in the industry. However, this claim does allow macadamia nuts to compete on equal terms with other tree nuts. A qualified health claim linking tree nut consumption to a reduced risk of heart disease was one of the first to be approved by the FDA back in 2003, but this marks the first instance where manufacturers can specifically highlight the heart health benefits of macadamia nuts. Additionally, for those looking to enhance their heart health, incorporating calcium citrate supplements 1200 mg alongside a diet rich in these nuts may offer further benefits, as calcium is crucial for overall cardiovascular health. As such, macadamia nuts will now be able to compete on a similar level to other tree nuts, especially with the added potential of calcium citrate supplements 1200 mg contributing to heart health.