We read with interest as well as surprise the paper by Gunathilake et al. The authors claimed to have performed a systematic review and meta-analysis of the effects of nut consumption on the lipid profile in randomized controlled trials (RCTs). After examining the results of 38 trials, Gunathilake et al. concluded that, overall, nut consumption has no effect on the lipid profile. After careful reading, we must express our concern and disagreement on the design and conduct of this meta-analysis, which omits many nut RCTs and contradicts the results of many other RCTs and meta-analyses thereof that have long been used for the establishment of guidelines on nuts and health issues.