Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

The consumption of almonds has been associated with several health benefits, particularly concerning cardiovascular and intestinal health. In this comprehensive review, we compile and deliberate studies investigating the effects of almond consumption on cardiovascular disease (CVD) risk factors and gut health. Almonds are rich in monounsaturated fats, fiber, vitamins, minerals, and polyphenols, which contribute to their health-promoting properties. Regular intake of almonds has been shown to improve lipid profiles by reducing LDL cholesterol and enhancing HDL functionality. Additionally, almonds aid in glycemic control, blood pressure reduction, and chronic inflammation amelioration, which are critical for cardiovascular health. The antioxidant properties of almonds, primarily due to their high vitamin E content, help in reducing oxidative stress markers. Furthermore, almonds positively influence body composition by reducing body fat percentage and central adiposity and enhancing satiety, thus aiding in weight management. Herein, we also contemplate the emerging concept of the gut-heart axis, where almond consumption appears to modulate the gut microbiome, promoting the growth of beneficial bacteria and increasing short-chain fatty acid production, particularly butyrate. These effects collectively contribute to the anti-inflammatory and cardioprotective benefits of almonds. By encompassing these diverse aspects, we eventually provide a systematic and updated perspective on the multifaceted benefits of almond consumption for cardiovascular health and gut microbiome, corroborating their broader consideration in dietary guidelines and public health recommendations for CVD risk reduction.

The Cardioprotective Properties of Selected Nuts: Their Functional Ingredients and Molecular Mechanisms

Nuts have been known as a nutritious food since ancient times and can be considered part of our original diet: they are one of the few foods that have been eaten in the same form for thousands of years. They consist of various dry fruits and seeds, with the most common species being almonds (Prunus dulcis), hazelnuts (Corylus avellana), cashews (cashew nuts, Anacardium occidentale), pistachios (Pistacia vera), walnuts (Italian nuts, Juglans regia), peanuts (Arachia hypogaca), Brazil nuts (Bartholletia excels), pecans (Corya illinoinensis), macadamia nuts (Macademia ternifolia) and pine nuts. Both in vitro and in vivo studies have found nuts to possess a range of bioactive compounds with cardioprotective properties, and hence, their consumption may play a role in preventing and treating cardiovascular diseases (CVDs). The present work reviews the current state of knowledge regarding the functional ingredients of various nuts (almonds, Brazil nuts, cashew nuts, hazelnuts, macadamia nuts, peanuts, pecan nuts, pine nuts, pistachios, and walnuts) and the molecular mechanisms of their cardioprotective action. The data indicate that almonds, walnuts and pistachios are the best nut sources of bioactive ingredients with cardioprotective properties.

Can different types of tree nuts and peanuts induce varied effects on specific blood lipid parameters? A systematic review and network meta-analysis

Tree nuts and peanuts have shown cardioprotective effects through the modulation of blood lipid levels. Despite the abundance of scientific evidence available, it remains uncertain whether the type of nut consumed influences these changes. The objective of this study was to evaluate and rank the effects of six types of nuts on total cholesterol (total-c), low-density lipoprotein (LDL-c), triglyceride (TG) and high-density lipoprotein (HDL-c) levels through a systematic search of randomized controlled trials (RCTs), a frequentist network meta-analysis (NMA), and the estimation of SUCRA values. A total of 76 RCTs were ultimately analyzed. The total c for pistachios, almond, and walnuts; LDL-c for cashews, walnuts, and almond; and TG for hazelnuts and walnuts significantly decreased, while only peanuts exhibited a significant increase in HDL-c levels. According to the rankings, the most effective type of nut for reducing total cholesterol was pistachio, cashew for LDL-c, hazelnut for TG, and peanut for increasing HDL-c levels. It should be noted that every type of nut analyzed exhibited a significant positive impact on some parameters, and specific types demonstrated enhanced advantages for particular blood lipids. These results endorse the use of personalized nutritional strategies to address and prevent dyslipidemia.Registration: PROSPERO database CRD42021270779.

Development of Energy-Rich and Fiber-Rich Bars Based on Puffed and Non-Puffed Cereals

The purpose of this work is to develop two types of dietary supplements for celiac (energy-rich and fiber-rich bars) as well as to optimize the formulations of bars made from puffed and non-puffed cereals. To optimize the combination of components, a mixture design was created. Based on sensory evaluation, optimal bars were selected, which were then evaluated in terms of biochemical properties, color and antioxidant properties. The main results indicate that the combination of 37.5 g of cereals, 22.5 g of seeds, and 40 g of binder is optimal for the energy bars with non-puffed cereals, followed by 54.57 g of cereals, 10.43 g of seeds, and 35 g of a binder for fiber-rich bars with non-puffed cereals. In contrast, the optimal recipe for energy bars with puffed cereals consisted of 35.42 g of cereals, 20.07 g of seeds, and 44.51 g of binder, and for fiber-rich bars with puffed cereals, it consisted of 50 g of cereals, 15 g of seeds, and 35 g. The biochemical composition indicates that fiber-rich bars are also energetic, with more than 300 kcal/100 g. All bars are rich in antioxidants, with total polyphenol values exceeding 4.97 mg GAE/g d.w. Customers prefer the bars with puffed cereal the most.

Effect of Gamma Irradiation on Fat Content, Fatty Acids, Antioxidants and Oxidative Stability of Almonds, and Electron Paramagnetic Resonance (EPR) Study of Treated Nuts

Gamma irradiation has been applied as an efficient and inexpensive method for the sterilization of nuts for years. However, along with the benefits of such treatment, negative effects are possible because of the formation of reactive oxygen species with a toxic effect on important biologically active substances. Because of the scarce and contradictory information in the literature about gamma-irradiated almonds, the aim of our work was the examination of the lipid changes, antioxidant activity, and oxidative stability of almonds treated by 10 and 25 kGy gamma rays, as well as changes in intensity of the EPR spectra as an indicator for the stability of radiation-induced free radicals. The results revealed no significant differences in the EPR spectra of almonds treated at 10 and 25 kGy doses, neither in their intensity nor in kinetic behaviour. The EPR signals decayed exponentially over 250 days, with a decreasing of central line by 90%, with satellite lines by about 73%. No significant changes in the fat content, fatty acids composition, and acid value of irradiated almonds were observed. However, the amount of (alpha)tocopherols decreased from 292 to 175 mg/kg, whereas the conjugated dienes and trienes increased, K₂₃₂ from 1.3 to 3 and K₂₆₈ from 0.04 to 0.15, respectively, with the increasing of irradiation dose. The same was observed for total polyphenols in defatted almonds (1374 to 1520 mg/100 g), where in vitro antioxidant activity determined by ORAC and HORAC methods increased from 100 to 156 µmol TE/g and from 61 to 86 µmol GAE/g, respectively. The oxidative stability of oil decreased from 6 to 4 h at 120 °C and from 24.6 to 18.6 h at 100 °C (measured by Rancimat equipment). The kinetic parameters characterizing the oxidative stability of oil from 10 kGy irradiated almonds were studied before and after addition of different concentrations of ascorbyl palmitate as a synergist of tocopherols. Its effectiveness was concentration-dependent, and 0.75 mM ensured the same induction period as that of non-irradiated nut oil. Further enrichment with alpha-tocopherol in equimolar ratio with palmitate did not improve the oil stability. In conclusion, gamma irradiation is an appropriate method for the treatment of almonds without significant changes in fat content and fatty acids composition. The decreasing of oxidative stability after higher irradiation could be prevented by the addition of ascorbyl palmitate.

Effects of Nut Consumption on Blood Lipids and Lipoproteins: A Comprehensive Literature Update

In the present review, we provide a comprehensive narrative overview of the current knowledge on the effects of total and specific types of nut consumption (excluding nut oil) on blood lipids and lipoproteins. We identified a total of 19 systematic reviews and meta-analyses of randomized controlled trials (RCTs) that were available in PubMed from the inception date to November 2022. A consistent beneficial effect of most nuts, namely total nuts and tree nuts, including walnuts, almonds, cashews, peanuts, and pistachios, has been reported across meta-analyses in decreasing total cholesterol (mean difference, MD, -0.09 to -0.28 mmol/L), LDL-cholesterol (MD, -0.09 to -0.26 mmol/L), and triglycerides (MD, -0.05 to -0.17 mmol/L). However, no effects on HDL-cholesterol have been uncovered. Preliminary evidence indicates that adding nuts into the regular diet reduces blood levels of apolipoprotein B and improves HDL function. There is also evidence that nuts dose-dependently improve lipids and lipoproteins. Sex, age, or nut processing are not effect modifiers, while a lower BMI and higher baseline lipid concentrations enhance blood lipid/lipoprotein responses. While research is still emerging, the evidence thus far indicates that nut-enriched diets are associated with a reduced number of total LDL particles and small, dense LDL particles. In conclusion, evidence from clinical trials has shown that the consumption of total and specific nuts improves blood lipid profiles by multiple mechanisms. Future directions in this field should include more lipoprotein particle, apolipoprotein B, and HDL function studies.

Physiological characterization of the wild almond Prunus arabica stem photosynthetic capability

Leaves are the major plant tissue for transpiration and carbon fixation in deciduous trees. In harsh habitats, atmospheric CO2 assimilation via stem photosynthesis is common, providing extra carbon gain to cope with the detrimental conditions. We studied two almond species, the commercial Prunus dulcis cultivar "Um-el-Fahem" and the rare wild Prunus arabica. Our study revealed two distinctive strategies for carbon gain in these almond species. While, in P. dulcis, leaves possess the major photosynthetic surface area, in P. arabica, green stems perform this function, in particular during the winter after leaf drop. These two species' anatomical and physiological comparisons show that P. arabica carries unique features that support stem gas exchange and high-gross photosynthetic rates via stem photosynthetic capabilities (SPC). On the other hand, P. dulcis stems contribute low gross photosynthesis levels, as they are designed solely for reassimilation of CO2 from respiration, which is termed stem recycling photosynthesis (SRP). Results show that (a) P. arabica stems are covered with a high density of sunken stomata, in contrast to the stomata on P. dulcis stems, which disappear under a thick peridermal (bark) layer by their second year of development. (b) P. arabica stems contain significantly higher levels of chlorophyll compartmentalized to a mesophyll-like, chloroplast-rich, parenchyma layer, in contrast to rounded-shape cells of P. dulcis's stem parenchyma. (c) Pulse amplitude-modulated (PAM) fluorometry of P. arabica and P. dulcis stems revealed differences in the chlorophyll fluorescence and quenching parameters between the two species. (d) Gas exchange analysis showed that guard cells of P. arabica stems tightly regulate water loss under elevated temperatures while maintaining constant and high assimilation rates throughout the stem. Our data show that P. arabica uses a distinctive strategy for tree carbon gain via stem photosynthetic capability, which is regulated efficiently under harsh environmental conditions, such as elevated temperatures. These findings are highly important and can be used to develop new almond cultivars with agriculturally essential traits.

Perceptions of Nut Consumption amongst Australian Nutrition and Health Professionals: An Online Survey

Habitual nut consumption is associated with reduced risk of chronic diseases; however, consumption levels in Australia are below recommendations. This study examined perceptions and knowledge regarding nut consumption among Australian healthcare professionals and their provision of nut consumption recommendations. A cross-sectional online survey of Australian health professionals was conducted in February-April 2020. Questions in the survey included demographic details, participants' perceptions of nut consumption, and nut consumption recommendations they may make to clients and patients. A total of 204 health professionals completed the survey, of which 84% were dietitians or nutritionists. Health professionals demonstrated basic nutritional knowledge regarding nut consumption; however, non-dietitians/nutritionists lacked knowledge of long-term benefits of nut consumption. Dietitians/nutritionists were more likely to agree that nuts are healthy and do not cause weight gain when compared to non-dietitians/nutritionists (p = 0.021). A total of 63% of health professionals advised at least some of their clients to eat more nuts, and this was higher among dietitians/nutritionists (68%) than non-dietitians/nutritionists (31%). While basic nutritional knowledge regarding nut consumption was observed among all health professionals, there is scope for further education, particularly for non-dietitians/nutritionists, to ensure that nutrition information provided to patients and clients is accurate and reflects the current evidence base.

The Relevance of Discovering and Recovering the Biodiversity of Apulian Almond Germplasm by Means of Molecular and Phenotypic Markers

Almond cultivation has great traditional and economic relevance in Southern Italy, especially in the Apulia region, where almond trees feature an ample and ancient varietal richness. To contrast the loss of plant genetic erosion and to safeguard the available bioresources, as well as to reinforce the local production, the regional Re.Ge.Fru.P. project aimed to re-evaluate, identify, and characterize the Apulian almond germplasm that is still uncharacterized and not jet studied using a dual (genetic and morphological) approach. Collection was conducted in the regional territory of 187 among the most widespread and minor or marginalized genotypes that were molecularly fingerprinted by means of 18 nuclear microsatellites (simple sequence repeats, SSRs). The high number of scored alleles reflected the great level of diversification within the Apulian germplasm, as also confirmed by neighbor joining and structure analysis, that clearly distinguished different genotype clusters. The phenotypic characterization using 17 morphological and phenological descriptors mirrored the genetic results, revealing a high degree of variability. The morphological traits with the best discriminatory ability were nut ventral suture, shell softness and shape and petal color. This work emphasizes the importance of recovering the genetic variability of Apulian almond germplasm, and the need to promote added value and enhance the local agri-food economy.

The Almond (Prunus dulcis): Chemical Properties, Utilization, and Valorization of Coproducts

Almonds (Prunus dulcis) are one of the most consumed tree-nuts worldwide, with commercial production in arid environments such as California, Spain, and Australia. The high consumption of almonds is partly due to their versatile usage in products such as gluten-free flour and dairy alternatives as well as them being a source of protein in vegetarian diets. They contain high concentrations of health-promoting compounds such as Vitamin E and have demonstrated benefits for reducing the risk of cardiovascular disease and improving vascular health. In addition, almonds are the least allergenic tree nut and contain minute quantities of cyanogenic glycosides. Production has increased significantly in the past two decades with 3.12 billion pounds of kernel meat produced in California alone in 2020 (USDA 2021), leading to a new emphasis on the valorization of the coproducts (e.g., hulls, shells, skins, and blanch water). This article presents a review of the chemical composition of almond kernels (e.g., macro and micronutrients, phenolic compounds, cyanogenic glycosides, and allergens) and the current research exploring the valorization of almond coproducts. Expected final online publication date for the Annual Review of Food Science and Technology, Volume 13 is March 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Partial Replacement of Animal Fat with Full-Fat Almond in Broiler Chicken Diets: Performance, Nutrient Digestibility, Blood Profile, Cecal-Fecal Microflora Composition, and Foot-Pad Dermatitis

Simple Summary

Recently, as the price of grains in feed increases worldwide, interest in new raw materials that can replace protein and fat sources is increasing. This study evaluated the effect of full-fat almonds (FFA) on broiler nutrition. In the study, the formulation of FFA as a raw material showed higher growth performance than the basic feed. This seems to be due to the high digestibility of protein and fat and the promotion of intestinal health through the reduction of harmful microorganisms in the intestine. Therefore, FFA can be used as a high-quality protein and fat substitute as a raw material for broiler feed.

Abstract

The purpose of this study was to evaluate the effect of full-fat almonds (FFA) as an alternative protein and fat source for broiler feed on broiler productivity, nutrient digestibility, blood characteristics, cecal-fecal microflora, and foot-pad dermatitis (FPD). A total of 96, one-day-old broiler chickens (Arbor Acres) with initial body weight 41.61 ± 0.36 g were placed in 16 cages. In each trial, four treatments were set up: a basal diet partially replacing animal fat with FFA 0% (Control, CON), a basal diet partially replacing animal fat with FFA 1% (T1), a basal diet partial replacing animal fat with FFA 2% (T2), a basal diet partially replacing animal fat with FFA 4% (T3). The experiment was conducted for a total of 4 weeks. Feed conversion ratio (FCR) was higher (p < 0.05) in the T3 group of broilers at weeks 0 to 1 than in the CON group of broilers. From weeks 3 to 4, and for the entire experimental period, FCR was lower (p < 0.05) in the T3 group of broilers than in the CON and T1 groups of broilers. The apparent ileal digestibility (AID) of the ether extract (EE) was higher (p < 0.05) in the T3 group than in the other treatment groups, and AID of crude protein (CP) was higher (p < 0.05) in the T3 group than in the CON group. The apparent total tract digestibility (ATTD) of EE was lower (p < 0.05) in the CON group than in the other treatment groups, and the ATTD of CP and energy was higher (p < 0.05) in the T3 group of broilers than in the CON group of broilers. The AID and ATTD of total amino acids were higher (p < 0.05) in the T3 group than in the other treatment groups. Blood cholesterol levels were lower (p < 0.05) in the T3 group of broilers than in the CON and T1 groups of broilers, and higher (p < 0.05) in the CON group of broilers than in the T2 and T3 groups of broilers. The amount of E. coli in the cecal and fecal was lower (p < 0.05) in the T3 group than in CON and T1 groups. FPD score was higher (p < 0.05) in the T3 group of broilers than in the CON group of broilers. In conclusion, replacing a partial of animal fat with at least 4% FFA in broiler diets can increase growth performance and nutrient digestibility in broiler nutrition.

Effect of Almond Consumption on Metabolic Risk Factors-Glucose Metabolism, Hyperinsulinemia, Selected Markers of Inflammation: A Randomized Controlled Trial in Adolescents and Young Adults

A large percentage of the Indian population has diabetes or is at risk of pre-diabetes. Almond consumption has shown benefits on cardiometabolic risk factors in adults. This study explored the effect of almond consumption on determinants of metabolic dysfunction—blood glucose, lipids, insulin and selected inflammatory markers in adolescents and young adults aged 16–25 years from Mumbai city. This randomized controlled trial was conducted for a period of 90 days on individuals with impaired levels of fasting glucose levels between 100–125 mg/dL (5.6–6.9 mmol/L) and 2-h post-glucose value 140–199 mg/dL (7.8–11.0 mmol/L) and/or fasting insulin (≥15 mIU/ml)/stimulated insulin (≥80 mIU/ml). Of 1,313 individuals screened, 421 met the inclusion criteria, of which 275 consented to participate and 219 completed the trial. The trial was registered with Clinical Trials Registry India (CTRI) CTRI/2018/02/011927. The almonds group (n = 107) consumed 56 g almonds daily, the control group (n = 112) was provided an iso-caloric cereal-pulse based snack. At baseline and endline, blood glucose, insulin, HbA₁c, LDL-c, HDL-c, total and ox-cholesterol, triglycerides, hs-CRP, IL-6, TNF-α, adiponectin, leptin were measured and HOMA-IR and FG:FI ratios were calculated. Dietary intakes were assessed. The anthropometric measurements, biochemical markers as well as macronutrient intakes did not differ significantly between the two groups at baseline. Almond consumption significantly decreased HbA₁c, total cholesterol and LDL-c. Stimulated insulin decreased post-intervention in both groups, but the decrease was greater in the almonds group. Fasting glucose was reduced post intervention in the controls with no change in the almonds group. FG:FI ratio decreased in the almonds group. TNF-α and IL-6 decreased in the almonds group, while it increased in the control group. Our results showed that almonds reduced HbA1c, LDL-c and total cholesterol levels in just 12 weeks of consumption in these adolescents and young adults who were at risk for developing diabetes. Almonds can be considered as part of food-based strategies for preventing pre-diabetes.

Clinical Trial Registration:ClinicalTrials.gov, identifier: CTRI/2018/02/011927.

Almond oil: A comprehensive review of chemical composition, extraction methods, preservation conditions, potential health benefits, and safety

Almond oil, a rich source of macronutrients and micronutrients, is extracted for food flavorings and the cosmetics industry. In recent years, the need for high-quality and high-quantity production of almond oil for human consumption has been increased. The present review examines the chemical composition of almond oil, storage conditions, and clinical evidence supporting the health benefits of almond oil. From the reviewed studies, it appears that almond oil contains a significant proportion of poly and monounsaturated fatty acids, with oleic acid as the main compound, and an important amount of tocopherol and phytosterol content. Some variations in almond oil composition can be found depending on the kernel's origin and the extraction system used. Some new technologies such as ultrasonic-assisted extraction, supercritical fluid extraction, subcritical fluid extraction, and salt-assisted aqueous extraction have emerged as the most promising extraction techniques that allow eco-friendly and effective recovery of almond oil. This safe oil was reported by several clinical studies to have potential roles in cardiovascular risk management, glucose homeostasis, oxidative stress reduction, neuroprotection, and many dermatologic and cosmetic applications. However, the anticarcinogenic and fertility benefits of almond oil have yet to be experimentally verified.

The effect of almond intake on lipid profile: a systematic review and meta-analysis of randomized controlled trials

A number of clinical trials have examined the effect of almond intake on lipid profile in recent years; however, the results remain equivocal. Therefore, the present study aims to summarize and quantitatively examine the available evidence on the effectiveness of almond intake on lipid parameters by employing a systematic review and meta-analytic approach. Online databases including PubMed, Scopus, Embase, and Cochrane Library were searched up to September 2020 for randomized controlled trials that examined the effect of almond intake on lipid profile in adults. Treatment effects were expressed as weighted mean difference (WMD) and the corresponding standard error (SE) in the concentrations of serum lipids. To estimate the overall effect of almond intake, we employed the random-effect model. In total, 27 studies with 36 effect sizes were included in our analysis (1154 cases and 904 control subjects). The meta-analysis revealed that almond intake significantly changed the concentrations of triglycerides (WMD = -6.68 mg dL-1; 95% CI: -11.62, -1.75, p = 0.008), total cholesterol (WMD = -4.92 mg dL-1; 95% CI: -7.81, -2.03, p = 0.001), and low-density lipoproteins (WMD = -5.65 mg dL-1; 95% CI: -8.75, -2.55, p < 0.001); however it did not have a significant effect on high-density lipoprotein (WMD = -0.21 mg dL-1; 95% CI: -1.26, 0.84, p = 0.697) levels. Meta-regression analysis indicated a linear relationship between the dose of almond and change in TG (P = 0.021). This meta-analysis concludes that almond intake can significantly reduce lipid parameters. To draw straightforward conclusions regarding generalized recommendations for almond intake for improving lipid profile, there is a need for more well-controlled trials exclusively targeting patients with dyslipidaemia.

Tree Nuts and Peanuts as a Source of Natural Antioxidants in our Daily Diet

Tree nuts and peanuts are healthy foods with a proven track record of helping to reduce the incidence of chronic diseases, most notably cardiovascular disease. At the point of consumption, all nuts contain low moisture and ≥ 50% lipid contents, but this is where similarities end. The levels of key nutrients and bioactives including vitamin C, vitamin E, L-arginine, minerals (such as selenium and zinc), and phenolics can differ markedly. Distinctions in the types and quantities of phenolic constituents for tree nut species, as well as the impact of digestion, will affect the nuts' antioxidant potential in vivo. This work provides some insight into the different types of phenolics found in tree nuts and peanuts, the antioxidant potential of their phenolic extracts using in vitro chemical assays, the effect of thermal processing on the stability of the nuts' endogenous phenolics, and the impact on biomarkers of human health arising from randomized clinical trials. Key biomarkers include measures in the reduction of LDL oxidation as well as increases in the levels of vitamin E and selected phenolic compounds in blood plasma postprandially from those of baseline.

Healthcare Cost Implications of Utilizing a Dietary Intervention to Lower LDL Cholesterol: Proof of Concept Actuarial Analysis and Recommendations

PURPOSE OF REVIEW

To determine if subsidizing the cost of a food-based intervention for managing hyperlipidemia could be cost-effective under commercial insurance and/or Medicare coverage scenarios.

RECENT FINDINGS

A large number of patients eligible for pharmaceutical treatment of hyperlipidemia either cannot or will not use lipid lowering drugs, leaving them at increased cardiovascular risk. Lipid levels can be modified by diet, but food has never enjoyed covered benefit status. We evaluated the financial implications of providing insurance coverage for a specifically formulated suite of food products previously documented to yield statistically significant lipid reductions, using multiple product uptake and lipid impact scenarios in both commercially covered and Medicare-covered populations. Even after controlling for multiple confounders, we noted positive payback on subsidizing the cost of lipid-lowering foods under all scenarios. Addressing a root cause of hyperlipidemia by directly encouraging dietary modification provides a cost-effective alternative for cholesterol management, especially for statin intolerant or statin unwilling patients.

The effect of almond intake on blood pressure: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

The present systematic review and meta-analysis aimed determine the efficacy of almond intake on blood pressure (BP).

METHODS

PubMed, Scopus, ISI Web of Science, Cochrane library and Google Scholar were comprehensively searched to infinity until December 2019. Randomized clinical trials (RCTs) reporting effects of almond intake on aortic and brachial BP were included. Weighted mean differences (WMDs) were pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias.

RESULTS

A total of 16 RCTs (1128 participants) were included in the meta-analysis. Pooled analysis suggested that almond intake can reduced diastolic BP (DBP) (WMD = -1.30 mmHg; 95 % CI: -2.31,-0.30, p = 0.01, I² = 0.0 %). However, there was not any impact of almond intake on systolic BP (SBP) (WMD = -0.83 mmHg; 95 % CI: -2.55, 0.89, p = 0.34, I² = 58.9 %). Subgroup analysis revealed a significant reduction in SBP levels in subjects with lower SBP and lower dose of almonds.

CONCLUSION

We found that almonds might have a considerable favorite effect in BP and especially in DBP, and it could be encouraged as part of a healthy diet; however due to the high calorie content, the intake should be part of healthy diet.

Almonds (Prunus Dulcis Mill. D. A. Webb): A Source of Nutrients and Health-Promoting Compounds

Almonds (Prunus dulcis Miller D. A. Webb (the almond or sweet almond)), from the Rosaceae family, have long been known as a source of essential nutrients; nowadays, they are in demand as a healthy food with increasing popularity for the general population and producers. Studies on the composition and characterization of almond macro- and micronutrients have shown that the nut has many nutritious ingredients such as fatty acids, lipids, amino acids, proteins, carbohydrates, vitamins and minerals, as well as secondary metabolites. However, several factors affect the nutritional quality of almonds, including genetic and environmental factors. Therefore, investigations evaluating the effects of different factors on the quality of almonds were also included. In epidemiological studies, the consumption of almonds has been associated with several therapeutically and protective health benefits. Clinical studies have verified the modulatory effects on serum glucose, lipid and uric acid levels, the regulatory role on body weight, and protective effects against diabetes, obesity, metabolic syndrome and cardiovascular diseases. Moreover, recent researchers have also confirmed the prebiotic potential of almonds. The present review was carried out to emphasize the importance of almonds as a healthy food and source of beneficial constituents for human health, and to assess the factors affecting the quality of the almond kernel. Electronic databases including PubMed, Scopus, Web of Science and SciFinder were used to investigate previously published articles on almonds in terms of components and bioactivity potentials with a particular focus on clinical trials.

Prospective randomized controlled pilot study on the effects of almond consumption on skin lipids and wrinkles

OBJECTIVE

Almonds are a rich source of fatty acids and antioxidants, and their supplementation is known to significantly modulate serum lipids. The effects of almond on the skin's lipid barrier and the appearance of wrinkles have not yet been elucidated. The aim of this study was to investigate the effects of almond consumption on facial sebum production and wrinkles.

METHODS

This was a prospective, investigator-blinded, randomized controlled trial in which subjects consumed 20% of their daily energy consumption in either almonds or a calorie-matched snack for 16 weeks. This study was completed at the UC Davis Dermatology clinic. Participants were a volunteer sample of generally healthy postmenopausal females with Fitzpatrick skin types 1 and 2. A facial photograph and image analysis system was used to obtain standardized photographs and information on wrinkle width and severity at 0, 8, and 16 weeks. Measurements of transepidermal water loss and sebum production were also completed at 0, 8, and 16 weeks.

RESULTS

Fifty healthy postmenopausal females were recruited, 31 participants were enrolled, and 28 completed the study. Under photographic analysis, the almond group had significantly decreased wrinkle severity and width compared with the control group at 16 weeks (p < .02). Changes in skin barrier function were nonsignificant, measured by the transepidermal water loss (p = .65) between the almond and control groups relative to baseline after 16 weeks. No adverse effects were reported.

CONCLUSION

Our study demonstrates that daily almond consumption may reduce wrinkle severity in postmenopausal females to potentially have natural antiaging benefits.

High-resolution magic angle spinning nuclear magnetic resonance (HR-MAS-NMR) as quick and direct insight of almonds

Almonds are the tasty seeds of Prunus dulcis plants globally appreciated for the pleasant palatability and remarkable nutritional value, therefore it is very spread as snack and as basic ingredient of the confectionery products. The HR-MAS-NMR is a simple spectroscopy able to directly and quickly explore the chemical composition of powdered seed samples dispersed in D₂O. ¹H spectra witness the remarkable presence of triglyceride fatty esters together with sucrose; other minor water soluble metabolites are also detectable. This very rough approach is effectively providing chemical profiles featuring almond samples. In this analysis we were able to statistically distinguish the "Avola" almonds from other marketed products submitted to the same analysis. This is just a first investigation based on the main compounds but it might pave the way toward the quantitative evaluation of many other compounds in the almond therefore implementing the HR-MAS-NMR knowledge of these precious seeds.

Almond oil for patients with hyperlipidemia: A randomized open-label controlled clinical trial

BACKGROUND

Cardiovascular diseases currently account for nearly half of non-communicable diseases. It was shown that enjoying a handful of nuts every day can significantly reduce the risk of developing heart diseases as they contain a variety of nutrients and other bioactive substances contributing to lowering the risk of heart diseases and controlling the cholesterol. The aim of this study was to determine the effect of almond oil on the lipid profile of patients with hyperlipidemia.

METHODS

Ninety-seven patients were divided into the intervention (n = 49) and control (n = 48) groups. The intervention group received 10 ml of almond oil two times daily for 30 days. There was no intervention for the control group. The serum lipoproteins were measured before and after the study.

RESULTS

The total cholesterol and LDL levels decreased significantly in the intervention group (treatment difference = -16.12 ± 26.16, P = 0.009; treatment difference = -20.88 ± 18.4, p < 0.001 respectively). But regular almond oil consumption did not significantly affect the triglyceride and HDL in this sample of hyperlipidemic patients.

CONCLUSION

Consumption of almond could reduce the total cholesterol and LDL in dyslipidemic patients.

Genetic, Phenotypic, and Commercial Characterization of an Almond Collection from Sardinia

Background: Recent nutritional and medical studies have associated the regular consumption of almonds with a wide range of health benefits. As a consequence, kernel quality has become an important goal for breeding, considering not only the chemical composition conferring a specific organoleptic quality but also physical traits related to industrial processing. Methods: We characterized an almond collection from Sardinia through analysis of 13 morpho-physiological traits and eight essential oil profiles. The genetic structure of the collection was studied by analyzing the polymorphism of 11 simple sequence repeats (SSR). Results: Both commercial and phenotypic traits showed wide ranges of variation. Most genotypes were early flowering with low yield potential. Several genotypes showed moderate to high yield and very interesting oil compositions of kernels. Based on 11 SSR profiles and Bayesian clustering, the Sardinian cultivars were assigned to groups which were differentiated for several agronomic and commercial traits. Conclusions: Several cultivars showed a high kernel oil content and high oleic to linoleic content ratio. Based on morphological traits, we propose that some of the analyzed cultivars could be interesting for industrial applications. Finally, we highlight the importance of characterizing early blooming cultivars for sites which are experiencing a rise in mean temperatures due to the effects of global climate changes.

Almonds and Cardiovascular Health: A Review

Several preventive strategies to reduce dyslipidemia have been suggested, of which dietary modification features as an important one. Dyslipidemia is a major risk factor for coronary heart disease and strategies to manage dyslipidemia have been shown to reduce the incidence of cardiovascular disease (CVD). Although there are proven pharmacological therapies to help manage this condition, nutritional interventions are a safer option to help prevent and manage dyslipidemia. Addition of almonds in the daily diet has been proposed to beneficially impact the lipid profile. This review critically examines the available evidence assessing the effect of almonds on dyslipidemia in the South Asian (particularly Indian) context. An extensive review comprised of epidemiological studies, clinical trials, meta-analyses, and systematic reviews was conducted from published literature from across the world. Studies examining the effect of almonds on different aspects of dyslipidemia viz. high low-density lipoprotein-cholesterol (LDL-C), low high-density lipoprotein-cholesterol (HDL-C), triglyceridaemia, and high total cholesterol levels have been included. In several studies, almonds have been shown to reduce LDL-C-which is a known risk factor for CHD-and the effect of almonds has been well documented in systematic reviews and meta-analysis of clinical trials. Addition of almonds in the diet has been shown to not only to reduce LDL-C levels, but also to maintain HDL-C levels. This review provides information about the use of this simple nutritional strategy which may help manage known major risk factors for heart disease, such as high LDL-C and low HDL-C levels especially in the context of South Asians.

Genotypic and Environmental Effects on Tocopherol Content in Almond

Almond is the most important nut species worldwide and almond kernels show the highest levels of tocopherols among all nuts. In almond, tocopherols not only play a substantial role as a healthy food for human consumption, but also in protecting lipids against oxidation and, thus, lengthening the storage time of almond kernels. The main tocopherol homologues detected in almond in decreasing content and biological importance are α-, γ-, δ-, and β-tocopherol. Tocopherol concentration in almond depends on the genotype and the environment, such as the climatic conditions of the year and the growing management of the orchard. The range of variability for the different tocopherol homologues is of 335-657 mg/kg of almond oil for α-, 2-50 for γ-, and 0.1-22 for β-tocopherol. Drought and heat have been the most important stresses affecting tocopherol content in almond, with increased levels at higher temperatures and in water deficit conditions. The right cultivar and the most appropriate growing conditions may be selected to obtain crops with effective kernel storage and for the most beneficial effects of almond consumption for human nutrition and health.

Benefits of Nut Consumption on Insulin Resistance and Cardiovascular Risk Factors: Multiple Potential Mechanisms of Actions

Epidemiological and clinical studies have indicated that nut consumption could be a healthy dietary strategy to prevent and treat type 2 diabetes (T2DM) and related cardiovascular disease (CVD). The objective of this review is to examine the potential mechanisms of action of nuts addressing effects on glycemic control, weight management, energy balance, appetite, gut microbiota modification, lipid metabolism, oxidative stress, inflammation, endothelial function and blood pressure with a focus on data from both animal and human studies. The favourable effects of nuts could be explained by the unique nutrient composition and bioactive compounds in nuts. Unsaturated fatty acids (monounsaturated fatty acids and polyunsaturated fatty acids) present in nuts may play a role in glucose control and appetite suppression. Fiber and polyphenols in nuts may also have an anti-diabetic effect by altering gut microbiota. Nuts lower serum cholesterol by reduced cholesterol absorption, inhibition of HMG-CoA reductase and increased bile acid production by stimulation of 7-α hydroxylase. Arginine and magnesium improve inflammation, oxidative stress, endothelial function and blood pressure. In conclusion, nuts contain compounds that favourably influence glucose homeostasis, weight control and vascular health. Further investigations are required to identify the most important mechanisms by which nuts decrease the risk of T2DM and CVD.

Valorization Challenges to Almond Residues: Phytochemical Composition and Functional Application

Almond is characterized by its high nutritional value; although information reported so far mainly concerns edible kernel. Even though the nutritional and commercial relevance of the almond is restricted to almond meat; to date; increasing attention has been paid to other parts of this fruit (skin; shell; and hull); considered by-products that are scarcely characterized and exploited regarding their properties as valuable sources of bioactive compounds (mainly represented by phenolic acids and flavonoids). This lack of proper valorization procedures entails the continuation of the application of traditional procedures to almond residues that nowadays are mainly addressed to livestock feed and energy production. In this sense; data available on the physicochemical and phytochemical composition of almond meat and its related residues suggest promising applications; and allow one to envisage new uses as functional ingredients towards value-added foods and feeds; as well as a source of bioactive phytochemicals to be included in cosmetic formulations. This objective has prompted investigators working in the field to evaluate their functional properties and biological activity. This approach has provided interesting information concerning the capacity of polyphenolic extracts of almond by-products to prevent degenerative diseases linked to oxidative stress and inflammation in human tissues and cells; in the frame of diverse pathophysiological situations. Hence; this review deals with gathering data available in the scientific literature on the phytochemical composition and bioactivity of almond by-products as well as on their bioactivity so as to promote their functional application.

Low-density lipoprotein oxidation biomarkers in human health and disease and effects of bioactive compounds

Based on the significance of oxidized low-density lipoprotein (LDL) in health and disease, this review focuses on human studies addressing oxidation of LDL, including three lines of biomarkers, (i) ex vivo LDL resistance to oxidation, a "challenge test" model, (ii) circulating oxidized LDL, indicating the "current in vivo status", and (iii) autoantibodies against oxidized LDL as fingerprints of an immune response to oxidized LDL, along with circulating oxysterols and 4-hydroxynonenal as biomarkers of lipid peroxidation. Lipid peroxidation and oxidized LDL are hallmarks in the development of various metabolic, cardiovascular and other diseases. Changes further occur across life stages from infancy to older age as well as in athletes and smokers. Given their responsiveness to targeted nutritional interventions, markers of LDL oxidation have been employed in a rapidly growing number of human studies for more than 2 decades. There is growing interest in foods, which, besides providing energy and nutrients, exert beneficial effects on human health, such as protection of DNA, proteins and lipids from oxidative damage. Any health claim, however, needs to be substantiated by supportive evidence derived from human studies, using reliable biomarkers to demonstrate such beneficial effects. A large body of evidence has accumulated, demonstrating protection of LDL from oxidation by bioactive food compounds, including vitamins, other micronutrients and secondary plant ingredients, which will facilitate the selection of oxidation biomarkers for future human intervention studies and health claim support.

Characterization of metabolite profiles from the leaves of green perilla ( Perilla frutescens ) by ultra high performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry and screening for their antioxidant properties

The objective of this research was to access the determination of metabolite profiles and antioxidant properties in the leaves of green perilla (Perilla frutescens), where these are considered functional and nutraceutical substances in Korea. A total of 25 compositions were confirmed as six phenolic acids, two triterpenoids, eight flavonoids, seven fatty acids, and two glucosides using an ultra high performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-Q-TOF-MS/MS) technique from the methanol extract of this species. The individual and total compositions exhibited significant differences, especially rosmarinic acid (10), and linolenic acids (22 and 23) were detected as the predominant metabolites. Interestingly, rosmarinic acid (10) was observed to have considerable differences with various concentrations in three samples (Doryong, 6.38 μg/g; Sinseong, 317.60 μg/g; Bongmyeong, 903.53 μg/g) by UPLC analysis at 330 nm. The scavenging properties against 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) radicals also showed potent effects with remarkable differences at a concentration of 100 μg/mL, and their abilities were as follows: Sinseong (DPPH, 86%; ABTS, 90%) > Bongmyeong (71% and 84%, respectively) > Doryong (63% and 73%, respectively). Our results suggest that the antioxidant activities of green perilla leaves are correlated with metabolite contents, especially the five major compositions 10 and 22–25. Moreover, this study may be useful in evaluating the relationship between metabolite composition and antioxidant activity.

Almonds ameliorate glycemic control in Chinese patients with better controlled type 2 diabetes: a randomized, crossover, controlled feeding trial

BACKGROUND

Almonds can decrease glycemic index of co-consumed foods and are a rich source for oleic acid and α-tocopherol. The aim of the randomized, crossover, controlled feeding trial was to examine whether as compared to NCEP step II diet as control (CON), ~60 g/d almonds (ALM) added to CON would improve glucoregulation and cardiovascular disease (CVD) risk factors in 33 Chinese T2DM patients.

METHODS

Forty T2DM patients were enrolled and randomly assigned to receive CON or ALM for 12 wks after a 2-wk. run-in period. Blood and urine samples were collected in the beginning and at the end of each dietary intervention phase for the assessment of biomarkers of glucoregulation, lipid profile, inflammation, and oxidative stress.

RESULTS

While ALM had a better overall nutritional quality than CON, neither ALM nor CON improved the glycemic status as the primary study outcome and other CVD risk factors, except the circulating nitric oxide being decreased by ALM compared to CON. Among 27 of 33 patients with the baseline HbA1c ≤8, ALM decreased post-interventional fasting serum glucose and HbA1c by 5.9% and 3.0% as compared to that of CON, respectively (P = 0.01 and 0.04). Mean total and LDL-cholesterol concentrations were not changed by both diets.

CONCLUSIONS

These results suggest almonds incorporated into healthful diets can improve glycemic status in diabetic patients with a better glycemic control.

TRIAL REGISTRATION

NCT01656850, registered 13 January 2012.

Effect of Amygdalus scoparia kernel oil consumption on lipid profile of the patients with dyslipidemia: a randomized, open-label controlled clinical trial

Background

Amygdalus scoparia kernel (ASK) oil is traditionally used for Hyperlipidemia. Compared to olive oil, it has higher proportion of unsaturated to saturated fatty acid besides exhibiting higher index of oxidative stability. The lipid-lowering effects of ASK oil however, has not been investigated yet. This study is the first one to evaluate such effects in patients with dyslipidemia.

Results

Serum triglyceride levels significantly decreased in the intervention compared to control group (24.80 ± 51.70 vs 3.13 ± 44.80, p-value = 0.03). Serum total cholesterol, LDL and HDL cholesterol levels did not change significantly (p = 0.28 and p = 0.68 and p = 0.10 respectively).

Materials and Methods

In a double arm, open-label, randomized controlled trial,101 hyperlipidemic patients were recruited. The designation of hyperlipidemia was upon meeting either of the three criteria: having serum low-density lipoprotein (LDL) cholesterol level 130-190 (mg/dl), serum triglyceride level 150-400 (mg/dl), and serum high-density lipoprotein (HDL) cholesterol level less than 50 (mg/dl) for women and 40 (mg/dl) for men. Patients who have ever been prescribed with an antihyperlipidemic medication were excluded. They were randomly assigned to intervention group, receiving the ASK oil, for 60 days and control group. Serum lipid measurements were repeated at the end of the intervention period.

Conclusions

ASK oil supplementation may have a positive effect in reducing serum triglyceride level in patients with dyslipidemia without significant effect on serum cholesterol levels.

Perceptions and Knowledge of Nuts amongst Health Professionals in New Zealand

Despite their nutritional value, population-level nut consumption remains low. Studies suggest that individuals would eat more nuts on their doctor’s advice, making health professionals potentially important for promoting nut consumption. This cross-sectional study aimed to examine the perceptions and knowledge of nuts and the predictors of nut promotion among health professionals in New Zealand. Dietitians, general practitioners (GPs), and practice nurses were identified from the Electoral Roll and invited to complete a questionnaire (n = 318, 292, and 149 respondents respectively). Over one-fifth of GPs and practice nurses believed that eating nuts could increase blood cholesterol concentrations and cause weight gain. The most common perceptions overall were that nuts are healthy; high in protein, fat, and calories; and are satiating. Nut consumption was recommended for reasons relating to these perceptions and because of nuts’ selenium content. Conversely, reasons for suggesting the consumption of fewer nuts included that they were high in calories and fat, would cause weight gain, and concerns regarding allergies and cost. All groups of health professionals were more likely to promote nut consumption if they perceived nuts to reduce the risk of diabetes (all p ≤ 0.034). Education could improve health professionals’ knowledge regarding the effects of nut consumption on blood cholesterol and body weight, alongside other health benefits, which should improve the advice given to patients and may thereby increase nut consumption.

State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health

Obesity and 4 of the leading causes of death—heart disease, cancer, stroke, and type 2 diabetes mellitus—are related to lifestyle. The combination of a healthy weight, prudent diet, and daily physical activity clearly plays a role in primary, secondary, and tertiary prevention of these and other chronic diseases. Because nearly 65% of the adult population is overweight or obese, weight loss and maintenance are central to this review article. Improved lipid profiles, blood pressure, insulin sensitivity, and euglycemia are associated with weight loss or a normal body weight; thus, maintaining a healthy weight is a universal recommendation for health. The methods for improving lifestyle described in the section on obesity include assessing nutritional status and stages of change of the client, setting realistic goals, eating a diet high in fruits and vegetables with low-fat sources of dairy and protein, and achieving appropriate physical activity levels. The importance of physicians discussing weight with clients and vice versa is stressed. The common features of lifestyle-related diseases make them amenable to similar lifestyle interventions.

In vitro and in vivo evaluation of the prebiotic effect of raw and roasted almonds (Prunus amygdalus)

BACKGROUND

Almonds contain considerable amounts of potential prebiotic components, and the roasting process may alter these components. The aim of this study was to compare the in vitro fermentation properties and in vivo prebiotic effect of raw and roasted almonds.

RESULTS

In vitro, predigested raw and roasted almonds promoted the growth of Lactobacillus acidophilus (La-14) and Bifidobacterium breve (JCM 1192), and no significant differences were found between these two nuts. In a 4-week animal trial, daily intake of raw or roasted almonds promoted the population of Bifidobacterium spp. and Lactobacillus spp. and inhibited the growth of Enterococcus spp. in faeces and caecal contains of rats. Compared with roasted almonds, raw almonds had a greater bifidobacteria promotion effect. Besides, significantly higher β-galactosidase activity and lower β-glucuronidase and azoreductase activities in faeces or caecal contents of rats were observed with raw almonds than with roasted almonds. While, in terms of metabolic effects, the ingestion of roasted almonds resulted in significantly greater intestinal lipase activities.

CONCLUSION

Both raw and roasted almonds exhibit potential prebiotic effects, including regulation of intestinal bacteria and improved metabolic activities. The roasting process may slightly reduce the prebiotic effects of almonds but significantly improve the metabolic effects

Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials

BACKGROUND

The effects of nuts on major cardiovascular disease (CVD) risk factors, including dose-responses and potential heterogeneity by nut type or phytosterol content, are not well established.

OBJECTIVES

We examined the effects of tree nuts (walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts) on blood lipids [total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein, and triglycerides], lipoproteins [apolipoprotein A1, apolipoprotein B (ApoB), and apolipoprotein B100], blood pressure, and inflammation (C-reactive protein) in adults aged ≥18 y without prevalent CVD.

DESIGN

We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two investigators screened 1301 potentially eligible PubMed articles in duplicate. We calculated mean differences between nut intervention and control arms, dose-standardized to one 1-oz (28.4 g) serving/d, by using inverse-variance fixed-effects meta-analysis. Dose-response for nut intake was examined by using linear regression and fractional polynomial modeling. Heterogeneity by age, sex, background diet, baseline risk factors, nut type, disease condition, duration, and quality score was assessed with meta-regression. Publication bias was evaluated by using funnel plots and Egger's and Begg's tests.

RESULTS

Sixty-one trials met eligibility criteria (n = 2582). Interventions ranged from 3 to 26 wk. Nut intake (per serving/d) lowered total cholesterol (-4.7 mg/dL; 95% CI: -5.3, -4.0 mg/dL), LDL cholesterol (-4.8 mg/dL; 95% CI: -5.5, -4.2 mg/dL), ApoB (-3.7 mg/dL; 95% CI: -5.2, -2.3 mg/dL), and triglycerides (-2.2 mg/dL; 95% CI: -3.8, -0.5 mg/dL) with no statistically significant effects on other outcomes. The dose-response between nut intake and total cholesterol and LDL cholesterol was nonlinear (P-nonlinearity < 0.001 each); stronger effects were observed for ≥60 g nuts/d. Significant heterogeneity was not observed by nut type or other factors. For ApoB, stronger effects were observed in populations with type 2 diabetes (-11.5 mg/dL; 95% CI: -16.2, -6.8 mg/dL) than in healthy populations (-2.5 mg/dL; 95% CI: -4.7, -0.3 mg/dL) (P-heterogeneity = 0.015). Little evidence of publication bias was found.

CONCLUSIONS

Tree nut intake lowers total cholesterol, LDL cholesterol, ApoB, and triglycerides. The major determinant of cholesterol lowering appears to be nut dose rather than nut type. Our findings also highlight the need for investigation of possible stronger effects at high nut doses and among diabetic populations.

Dietary Almonds Increase Serum HDL Cholesterol in Coronary Artery Disease Patients in a Randomized Controlled Trial

BACKGROUND

More than one-half of coronary artery disease (CAD) patients have low HDL cholesterol despite having well-managed LDL cholesterol. Almond supplementation has not been shown to elevate circulating HDL cholesterol concentrations in clinical trials, perhaps because the baseline HDL cholesterol of trial subjects was not low.

OBJECTIVE

This clinical trial was designed to test the effect of almond supplementation on low HDL cholesterol in CAD patients.

METHODS

A total of 150 CAD patients (50 per group), with serum LDL cholesterol ≤100 mg/dL and HDL cholesterol ≤40 mg/dL in men and ≤50 mg/dL in women, were recruited from the Aga Khan University Hospital. After recording vital signs and completing a dietary and physical activity questionnaire, patients were randomly assigned to 1 of the following 3 groups: the no-intervention group (NI), the Pakistani almonds group (PA), and the American almonds group (AA). The respective almond varieties (10 g/d) were given to patients with instructions to soak them overnight, remove the skin, and eat them before breakfast. Blood samples for lipid profiling, body weight, and blood pressure were collected, and assessment of dietary patterns was done at baseline, week 6, and week 12.

RESULTS

Almonds significantly increased HDL cholesterol. At weeks 6 and 12, HDL cholesterol was 12-14% and 14-16% higher, respectively, in the PA and AA than their respective baselines. In line with previous reports, serum concentrations of total cholesterol, triglycerides, LDL cholesterol, and VLDL cholesterol; total-to-HDL and LDL-to-HDL cholesterol ratios, and the atherogenic index were reduced in both the PA and AA at weeks 6 and 12 compared with baseline (P < 0.05). Effects on serum lipids did not differ between the 2 almond groups. Dietary patterns, body weight, and blood pressure did not change in any of the 3 groups during the trial.

CONCLUSION

A low dose of almonds (10 g/d) consumed before breakfast can increase HDL cholesterol, in addition to improving other markers of abnormal lipid metabolism in CAD patients with low initial HDL cholesterol. This trial was registered at the Australian New Zealand Clinical Trial Registry as ACTRN12614000036617.

Effect of almond consumption on vascular function in patients with coronary artery disease: a randomized, controlled, cross-over trial

OBJECTIVE

Almonds reduce cardiovascular disease risk via cholesterol reduction, anti-inflammation, glucoregulation, and antioxidation. The objective of this randomized, controlled, cross-over trial was to determine whether the addition of 85 g almonds daily to a National Cholesterol Education Program (NCEP) Step 1 diet (ALM) for 6 weeks would improve vascular function and inflammation in patients with coronary artery disease (CAD).

RESEARCH DESIGN AND METHODS

A randomized, controlled, crossover trial was conducted in Boston, MA to test whether as compared to a control NCEP Step 1 diet absent nuts (CON), incorporation of almonds (85 g/day) into the CON diet (ALM) would improve vascular function and inflammation. The study duration was 22 weeks including a 6-weeks run-in period, two 6-weeks intervention phases, and a 4-weeks washout period between the intervention phases. A total of 45 CAD patients (27 F/18 M, 45-77 y, BMI = 20-41 kg/m(2)) completed the study. Drug therapies used by patients were stable throughout the duration of the trial.

RESULTS

The addition of almonds to the CON diet increased plasma α-tocopherol status by a mean of 5.8%, reflecting patient compliance (P ≤0.05). However, the ALM diet did not alter vascular function assessed by measures of flow-mediated dilation, peripheral arterial tonometry, and pulse wave velocity. Further, the ALM diet did not significantly modify the serum lipid profile, blood pressure, C-reactive protein, tumor necrosis factor-α or E-selectin. The ALM diet tended to decrease vascular cell adhesion molecule-1 by 5.3% (P = 0.064) and increase urinary nitric oxide by 17.5% (P = 0.112). The ALM intervention improved the overall quality of the diet by increasing calcium, magnesium, choline, and fiber intakes above the Estimated Average Requirement (EAR) or Recommended Dietary Allowance (RDA).

CONCLUSIONS

Thus, the addition of almonds to a NECP Step 1 diet did not significantly impact vascular function, lipid profile or systematic inflammation in CAD patients receiving good medical care and polypharmacy therapies but did improve diet quality without any untoward effect.

TRIAL REGISTRATION

The trial was registered with the ClinicalTrials.Gov with the identifier: NCT00782015.

The Effect of the Mediterranean Diet on Serum Total Antioxidant Capacity in Obese Patients: A Randomized Controlled Trial

OBJECTIVE

The aim of this work was to evaluate the combined effect of physical activity and 1 and 12 months' adherence to Mediterranean diet (MD) on serum total antioxidant capacity (TAC) in obese patients, as well as factors contributing to TAC.

METHODS

One hundred twenty-four patients were randomly assigned to either MD combined with physical activity or standard hypolypemic diet (SHD) with physical activity. Both groups received counseling and education during the initial week and were invited for the follow-up visits, where data on body weight and blood samples were collected. TAC was determined by Trolox equivalent antioxidant capacity and urate was determined using a uricase spectrophotometric method at the initial visit and after 1 and 12 months.

RESULTS

Eighty-four patients finished the 12-month program and were analyzed. The baseline and 1- and 12-month mean (±SD) TAC values in the MD group (n = 40) were 2.38 ± 0.48, 2.51 ± 0.47, and 2.47 ± 0.45 mmol Trolox equivalent (TE)/L, respectively. In the SHD group (n = 44), TAC values were 2.37 ± 0.49, 2.48 ± 0.49, and 2.31 ± 0.51 mmol TE/L, respectively. There was a statistically significant main effect for time (p < 0.001), as well as statistically significant time-diet interaction effect (p = 0.009). There was no statistically significant correlation between TAC and uric acid after 1 month (p = 0.733) or 12 months (p = 0.844) of the intervention. Based on the regression model, which included gender, diet, physical activity level, and percentage body weight change, the type of diet was the only significantly contributing factor to TAC change after the 12-month period, F = 3.867, df = 3, p = 0.012, R = 0.358, R(2) = 0.128.

CONCLUSION

This randomized controlled trial with diet and physical activity intervention and TAC as a primary outcome demonstrated initial antioxidant improvement in both MD and SHD groups and a long-term beneficial effect of MD. The results imply that diet composition-olive oil, nuts, and fish in particular-combined with physical activity modify antioxidant capacity.