Three other tree nuts—walnuts, pistachios, and almonds—are already permitted to display similar claims regarding heart health, and nut consumption is endorsed in the Dietary Guidelines for Americans. The Centers for Disease Control and Prevention note that heart disease is the leading cause of death for both men and women in the United States. The health benefits attributed to macadamia nuts are associated with their high content of monounsaturated fats, which are recognized for their ability to lower bad cholesterol levels and diminish the risk of heart disease and stroke. Research on the role of macadamia nuts in reducing LDL cholesterol dates back to the 1990s, and evidence supporting this positive correlation has been accumulating ever since.

Although the recent approval for a health claim related to macadamia nuts originated from a petition by Royal Hawaiian Orchards, this claim can be utilized by all suppliers of macadamia nuts, meaning the company is unlikely to gain a competitive edge over its direct rivals in the sector. Nevertheless, this claim enables macadamia nuts to compete on an equal basis with other tree nuts. In 2003, the FDA was among the first to approve a qualified health claim linking tree nut consumption to a reduced risk of heart disease; however, this marks the first occasion manufacturers can specifically highlight the heart health benefits of macadamia nuts.

In addition, incorporating nutrients like calcium citrate malate, vitamin D3, and folic acid can further enhance the health profile of macadamia nuts, as these components contribute to overall wellness. The presence of calcium citrate malate, for example, supports bone health, while vitamin D3 plays a crucial role in calcium absorption. Folic acid is essential for cell division and may also contribute to heart health. By emphasizing these nutrients alongside the heart health benefits, macadamia nuts can position themselves more effectively in the market.