The purpose of this nut is to put the required axial preload on the bearing. By definition, this will also remove sideways play in the crank. A BB bearing has to support the crank in two directions - perpendicular to the axle and along the axis and without preload the bearing will fail quickly. How quickly? Compare the life of a Shimano Hollowtech BB to that of BB30. Over the average of bikes with serviced in a bike shop, the Shimano set-up lasts about three times longer than BB30.
Now, I'm sure some of you have an aunt Edna who's BB30 bike has done 300 000 kms without any problems, including our American friend here, but as I said, on average as calculated in a bike shop.