Nuts and Human Health Outcomes: A Systematic Review

Effect of daily avocado consumption for 6 mo compared with habitual diet on red blood cell fatty acid profiles and association with cardiometabolic risk factors in individuals with abdominal obesity: a randomized trial

BACKGROUND

Avocado intake improves dietary fat quality, but the subsequent impact on red blood cell (RBC) saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA), and trans-fatty acid (TFA) composition and association with cardiometabolic health, has not been elucidated.

OBJECTIVES

To compare the effect of consuming 1 avocado/d relative to habitual diet (HAB) on RBC-FA profiles, and their association with visceral adiposity and cardiometabolic risk factors (CMRFs) in individuals with abdominal obesity.

METHODS

RBC-FA profiling at baseline, 3- and 6 mo was conducted in participants (n = 994) from the Habitual Diet and Avocado Trial (HAT). HAT was a multisite, free-living, parallel-arm intervention study in which participants were randomly assigned to either the avocado-supplemented group (AVO, usual diet with 1 avocado/d) or the HAB group (usual diet with limited avocado intake) for 6 mo. Changes in RBC-FA profiles, a secondary outcome measure, were determined within and between groups using linear regression and mixed effect models, adjusting for age, sex, BMI, clinical site, smoking status, and percentage of energy intake from fat at baseline. The association between changes in RBC-FAs with visceral adiposity measures and CMRFs was assessed after covariate and False Discovery Rate (FDR <0.05) adjustment.

RESULTS

No major differences in RBC-FA profiles were observed between groups, with the exception of MUFA cis-vaccenic [18:1n-7c], which was significantly higher in AVO (β: 0.11 [0.05, 0.17]) compared with the HAB (β: 0.03 [-0.03, 0.08]) participants. In the HAB but not AVO group, increases in MUFA cis (18:1n-7c, oleic [18;1n-9c], erucic [22:1n-9c]) and MUFA trans (palmitelaidic [16:1n-7t], vaccenic [18:1n-7t], elaidic [18:1n-9t], and petroselaidic [18;1n-10-12t), as well as PUFA γ-linolenic [18:3n-6], dihomo-γ-linolenic [20:3n-6], arachidonic [20:4n-6], and α-linolenic [18:3n-3] were associated with unfavorable changes in visceral adiposity measures, lipid profiles, glucose, insulin and high sensitivity C-reactive protein concentrations.

CONCLUSIONS

Daily avocado intake over 6-mo modified RBC-MUFA composition, notably 18:1n-7c, and potentially mitigated some of the unfavorable individual RBC-FA-CMRF associations observed over time in the HAB group. This trial was registered at https://clinicaltrials.gov/study as NCT03528031.

Effect of nuts on lipid profile and inflammatory biomarkers in atherosclerotic cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

Nut-enriched diets are related to improve lipid and inflammatory biomarkers in meta-analyses in the context of primary cardiovascular prevention. However, primary studies on secondary cardiovascular prevention are scarce and controversial. This systematic review and meta-analysis aimed to evaluate the effect of nut supplementation on lipid and inflammatory profiles in individuals with atherosclerotic cardiovascular disease, and the frequency of adverse events.

METHODS

Six databases were used for research: PubMed, EMBASE, BVS, Cochrane Library, Web of Science, and ClinicalTrials.gov, until February 2023, with no language restrictions. We performed random-effects meta-analyses to compare nut-enriched diets vs. control diets for pre-post intervention changes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system assessed the evidence's certainty.

RESULTS

From the 5187 records identified, eight publications containing data referring to five randomized clinical trials involving 439 participants were included in the final analyses. The nuts evaluated were almonds, pecans, Brazil nuts, and mixed nuts, with doses ranging between 5 g and 85 g (median: 30 g/day). The intervention time varied between 6 and 12 weeks. Compared to nut-free diets, nut intake did not have a statistically significant effect on lipid profile biomarkers, except on the atherogenic index (MD: -0.32 [95% CI -0.58 to -0.06], I2 = 0% - moderate certainty of the evidence). Similarly, there was no effect of nuts on inflammatory profile biomarkers. It was not possible to aggregate data on adverse events.

CONCLUSIONS

Nut supplementation did not change lipid and inflammatory profiles in the secondary cardiovascular prevention setting.

We got nuts! use deep neural networks to classify images of common edible nuts

BACKGROUND

Nuts are nutrient-dense foods that contribute to healthier eating. Food image datasets enable artificial intelligence (AI) powered diet-tracking apps to help people monitor daily eating patterns.

AIM

This study aimed to create an image dataset of commonly consumed nut types and use it to build an AI computer vision model to automate nut type classification tasks.

METHODS

iPhone 11 was used to take photos of 11 nut types-almond, brazil nut, cashew, chestnut, hazelnut, macadamia, peanut, pecan, pine nut, pistachio, and walnut. The dataset contains 2200 images, 200 per nut type. The dataset was randomly split into the training (60% or 1320 images), validation (20% or 440 images), and test sets (20% or 440 images). A neural network model was constructed and trained using transfer learning and other computer vision techniques-data augmentation, mixup, normalization, label smoothing, and learning rate optimization.

RESULTS

The trained neural network model correctly predicted 338 out of 440 images (40 per nut type) in the validation set, achieving 99.55% accuracy. Moreover, the model classified the 440 images in the test set with 100% accuracy.

CONCLUSION

This study built a nut image dataset and used it to train a neural network model to classify images by nut type. The model achieved near-perfect accuracy on the validation and test sets, demonstrating the feasibility of automating nut type classification using smartphone photos. Being made open-source, the dataset and model can assist the development of diet-tracking apps that facilitate users' adoption and adherence to a healthy diet.

Association between nut consumption and metabolic syndrome in Korean adults: results from the Korean Genome and Epidemiology Study-Health Examinees

Background

The epidemiological evidence regarding nut consumption and metabolic diseases focuses on Western populations. Nut consumption among Koreans is relatively low, and the prevalence of metabolic syndrome is rapidly increasing, highlighting the need for more focused studies in this population. This cross-sectional study aimed to investigate the relationship between nut consumption and metabolic syndrome in Korean adults.

Methods

A total of 112,501 adults (39,481 men and 73,020 women) aged 40-79 years were selected from baseline data of the Korean Genome and Epidemiology Study-Health Examinees. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized as non-consumers, <1 serving/week, ≥1 to <2 servings/week, or ≥2 servings/week (15 g per serving). Metabolic syndrome and its components were defined according to the Korean Society of CardioMetabolic Syndrome criteria. Associations between nut consumption and metabolic syndrome and its components were examined using multiple logistic regression with adjustments for potential confounders.

Results

In the study population, the prevalence of metabolic syndrome was 21.4% (26.9% in men and 18.4% in women), and the mean nut intake was 0.8 serving/week (0.7 serving/week in men and 0.8 serving/week in women). After adjusting for confounders, higher nut consumption was associated with a lower odds ratio (OR) of metabolic syndrome in individuals consuming ≥2 servings/week compared with non-consumers [OR = 0.85, 95% confidence interval (CI) = 0.80-0.91, p for trend <0.001]. Specifically, in men, this level of consumption was associated with a 14% reduction in the OR of metabolic syndrome (OR = 0.86, 95% CI = 0.77-0.95, p for trend = 0.028). In women, a similar reduction of 14% was observed (OR = 0.86, 95% CI = 0.80-0.93, p for trend <0.001). Among the metabolic syndrome components, nut consumption was inversely associated with abdominal obesity, low high-density lipoprotein-cholesterol, and elevated triglycerides in men and women, whereas no associations were observed for elevated blood pressure or elevated fasting blood glucose.

Conclusion

Our findings suggest that higher nut consumption is inversely associated with metabolic syndrome and its components in Korean adults. Further studies are needed to examine the longitudinal association between nut consumption and metabolic diseases in this population.

Gas Chromatography-Mass Spectrometry Metabolites and Transcriptome Profiling Reveal Molecular Mechanisms and Differences in Terpene Biosynthesis in Two Torrya grandis Cultivars during Postharvest Ripening

Terpene aroma compounds are key quality attributes of postharvest Torreya grandis nuts, contributing to their commercial value. However, terpene biosynthesis and regulatory networks in different T. grandis cvs. are still poorly understood. Here, chief cvs. 'Xi Fei' and 'Xiangya Fei' were investigated for their differences in terpene biosynthesis and gene expression levels during postharvest ripening using headspace solid-phase microextraction (HS-SPME) coupled with gas chromatography-mass spectrometry (GC-MS) and transcriptomic datasets. A total of 28 and 22 aroma compounds were identified in 'Xi Fei' and 'Xiangya Fei', respectively. Interestingly, differences in aroma composition between the two cvs. were mostly attributed to D-limonene and α-pinene levels as key determinants in Torreya nuts' flavor. Further, transcriptome profiling, correlation analysis, and RT-qPCR annotated two novel genes, TgTPS1 in 'Xi Fei' and TgTPS2 in 'Xiangya Fei', involved in terpene biosynthesis. In addition, six transcription factors (TFs) with comparable expression patterns to TgTPS1 and four TFs to TgTPS2 were identified via correlation analysis of a volatile and transcriptome dataset to be involved in terpene biosynthesis. Our study provides novel insight into terpene biosynthesis and its regulation at the molecular level in T. grandis nut and presents a valuable reference for metabolic engineering and aroma improvement in this less explored nut.

Cytotoxicity Screening of Sterculia striata A.St.-Hil. & Naudin (Chichá) and Arachis hypogaea L. (Peanut) and Comparative Chemical Profiles Before and After in Vitro Digestion

This study traced the cytotoxicity, antioxidant activity, and phytochemical profile before and after in vitro digestion of nuts from Sterculia striata A. St.-Hil. & Naudin (Malvaceae) (chichá or monkey's peanut), a native plant from Brazil, in comparison with Arachis hypogaea L. (peanut). The antioxidant activity in the 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and Ferric Reducing Antioxidant Power Assay (FRAP) assays was lower in chichá when compared with peanuts, corroborating the lower concentration of polyphenols. None of the samples studied showed significant cytotoxicity in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromideDAD: diode-array detection (MTT) assays. In vitro digestion altered the phytochemical profile in both plants, increasing the concentration of rutin in fresh and roasted chichá but only in raw peanuts. In roasted peanuts, rutin was converted into quercetin. Chichá nuts have been used by the local population for centuries, and the identification of their bioactive components can be useful to promote their benefits as a functional food.

Build Deep Neural Network Models to Detect Common Edible Nuts from Photos and Estimate Nutrient Portfolio

Nuts are nutrient-dense foods and can be incorporated into a healthy diet. Artificial intelligence-powered diet-tracking apps may promote nut consumption by providing real-time, accurate nutrition information but depend on data and model availability. Our team developed a dataset comprising 1380 photographs, each in RGB color format and with a resolution of 4032 × 3024 pixels. These images feature 11 types of nuts that are commonly consumed. Each photo includes three nut types; each type consists of 2-4 nuts, so 6-9 nuts are in each image. Rectangular bounding boxes were drawn using a visual geometry group (VGG) image annotator to facilitate the identification of each nut, delineating their locations within the images. This approach renders the dataset an excellent resource for training models capable of multi-label classification and object detection, as it was meticulously divided into training, validation, and test subsets. Utilizing transfer learning in Python with the IceVision framework, deep neural network models were adeptly trained to recognize and pinpoint the nuts depicted in the photographs. The ultimate model exhibited a mean average precision of 0.7596 in identifying various nut types within the validation subset and demonstrated a 97.9% accuracy rate in determining the number and kinds of nuts present in the test subset. By integrating specific nutritional data for each type of nut, the model can precisely (with error margins ranging from 0.8 to 2.6%) calculate the combined nutritional content-encompassing total energy, proteins, carbohydrates, fats (total and saturated), fiber, vitamin E, and essential minerals like magnesium, phosphorus, copper, manganese, and selenium-of the nuts shown in a photograph. Both the dataset and the model have been made publicly available to foster data exchange and the spread of knowledge. Our research underscores the potential of leveraging photographs for automated nut calorie and nutritional content estimation, paving the way for the creation of dietary tracking applications that offer real-time, precise nutritional insights to encourage nut consumption.

Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: an analysis from the PREVENT dementia study

BACKGROUND

The Eatwell guide reflects the UK government's recommendations for a healthy and balanced diet. Previous research has identified associations between healthy eating patterns and both cardiovascular and brain health, although there is little evidence specifically focusing on the Eatwell Guide. To date no research has investigated associations between the Eatwell Guide and risk for future dementia.

METHODS

Data from the PREVENT dementia cohort study baseline visit was used in this analysis. Binary and graded Eatwell Guide scores (BEWG, GEWG) were created from a self-reported Food Frequency Questionnaire. The CAIDE score was included as the primary outcome measure to represent risk for future Alzheimer's disease. Secondary outcome measures included cardiometabolic health measures and brain health measures. Generalised additive models were run in R.

RESULTS

A total of 517 participants were included in the analysis, with a mean BEWG score of 4.39 (± 1.66) (out of a possible 12 points) and GEWG score of 39.88 (± 6.19) (out of a possible 60 points). There was no significant association between either Eatwell Guide score and the CAIDE score (BEWG β: 0.07, 95% confidence interval (CI): -0.07, 0.22; GEWG β: 0.02, 95% CI: -0.02, 0.06) or any measures of brain health. There was a significant association between higher GEWG score and lower systolic and diastolic blood pressure and body mass index (BMI) (systolic β: -0.24, 95% CI: -0.45, -0.03; diastolic β: -0.16, 95% CI: -0.29, -0.03; BMI β: -0.09, 95% CI: -0.16, -0.01).

CONCLUSIONS

Although not directly associated with the CAIDE score, the Eatwell Guide dietary pattern may be beneficial for dementia prevention efforts through the modification of hypertension and obesity, which are both known risk factors for dementia. Future work could replicate these findings in other UK-based cohorts as well as further development of Eatwell Guide scoring methodologies.

Dietary patterns in relation to glioma: a case-control study

Although the association of individual foods and nutrients with glioma have been investigated, studies on the association of major dietary patterns and glioma are scarce. The aim of this study was to examine the association between major dietary patterns and risk of glioma in a group of Iranian adults. In this hospital-based case-control design, we recruited 128 newly diagnosed glioma cases and 256 controls in Tehran from 2009 to 2011. A Willett-format-validated 126-item semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess participants' dietary intake. Factor analysis was used to identify major dietary patterns. We identified 3 major dietary patterns using factor analysis: high protein, vegetarian and western dietary pattern. After several adjustments for potential confounders, adherence to the high protein dietary pattern was inversely associated with risk of glioma (OR: 0.47; 95% CI: 0.23, 0.95). Consumption of vegetarian dietary pattern was also associated with a reduced risk of glioma (OR: 0.16; 95% CI: 0.07, 0.34). Greater adherence to the western dietary pattern was associated with a greater chance of glioma (OR: 3.30; 95% CI: 1.52, 7.17). We found that high protein, vegetarian and western dietary pattern were significantly associated with glioma risk. Further prospective studies are needed to confirm these findings.

Shelf Life and Functional Quality of Almond Bagasse Powders as Influenced by Dehydration and Storing Conditions

Almond bagasse resulting after the production of almond-based drinks represents a promising by-product with potential for use as a functional ingredient. To facilitate its utilization, the stability of this material can be achieved through dehydration processes such as hot air drying or freeze-drying. Nevertheless, owing to its high fat content, almond bagasse is prone to lipid oxidation, which could result in undesirable quality. Therefore, the objective of this work was to assess the impact of dehydration (by hot air drying at 60 and 70 °C and by freeze-drying) and storage (at room temperature and in accelerated conditions) on the functional quality and stability of almond bagasse powder. Throughout the dehydration process, it was observed that antioxidant compounds were preserved without significant differences among dehydration treatments. These compounds increased over the storage period, especially in the samples treated with hot air. Regarding antiradical capacity, the hot-air-dried samples showed higher values than the freeze-dried ones, although in all cases, it increased during storage. For total phenols in samples air-dried at 70 °C, increases of more than 50% were observed. The acidity and peroxide index were increased in the extended storage period, although they did not reach critical values. Samples stored for 180 days showed peroxide values ranging from 10 to 12.8 meq O2/kg dry matter for samples stored at room temperature and from 14.7 to 23 meq O2/kg dry matter for samples subjected to accelerated storage.

Nuts and seeds - a scoping review for Nordic Nutrition Recommendations 2023

Background

Nuts and seeds have been part of diets in most of the world for millenniums, and they have also been consumed in the Nordic and Baltic countries for centuries. Consumption of nuts and seeds is linked with various health outcomes. Therefore, when updating the Nordic Nutrition Recommendations (NNR), summarizing the best evidence on key health outcomes from the consumption of nuts and seeds is essential.

Objectives

This study aims to evaluate the updated evidence on the consumption of nuts and seeds and health outcomes regarded relevant for the Nordic and Baltic countries, as well as their dose-response relationship presented in updated systematic reviews and meta-analyses.

Method

The scoping review is built on a de novo systematic review and an umbrella review published in 2022 on the consumption of nuts and seeds and its various health outcomes, including cardiovascular disease and diabetes.

Results

Intake of nuts and seeds is associated with a lower risk of cardiovascular diseases, with evidence assessed as probable. This conclusion is mirrored by evidence from trials on biomarkers for chronic diseases. An intake of a serving of nuts of 28-30 g/day compared to not eating nuts is estimated to translate into approximately 20% relative reduction in the risks of cardiovascular disease and premature deaths. For cancers, consumption of a serving of nuts is inversely associated with cancer mortality. However, for type 2 diabetes, there are mixed and inconclusive results. Additionally, there are inverse associations between nut consumption and respiratory and infectious disease mortality. Allergies for nuts are seen among 1-2% of the population.

Conclusion

Overall, the current evidence supports dietary recommendations to increase nut consumption to a serving of nuts and seeds per day for people without allergies to these foods.

Association of adherence to the Chinese version of the MIND diet with reduced cognitive decline in older Chinese individuals: Analysis of the Chinese Longitudinal Healthy Longevity Survey

BACKGROUND

Current evidence suggests that the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) diet intervention for Neurodegenerative Delay (MIND) is associated with a reduced risk of cognitive impairment among North American and Oceanian populations. However, there has been limited exploration of whether this association extends to the Asian population. This study aimed to assess the correlation between the Chinese version of the MIND (cMIND) diet and cognitive impairment in older Chinese individuals.

METHODS

We utilized data from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey. Participants aged ≥65 years with normal cognitive function at baseline were enrolled. The cMIND diet score (cMINDDS) was calculated by assessing dietary patterns based on survey responses. The Chinese version of the Mini-Mental State Examination (MMSE) was employed to diagnose cognitive impairment in participants. We stratified the analysis by cMINDDS and conducted additional sensitivity analyses.

RESULTS

The cohort consisted of 6411 participants. Over a 3-year follow-up, 1165 (18.6%) individuals who initially had normal cognitive function developed cognitive impairment. A linear association was observed between cMINDDS and cognitive impairment. The increased cMINDDS was associated with a reduced risk of cognitive impairment (quartile 1 vs. quartile 4: the adjusted odds ratio [OR] = 0.77, 95% confidence interval [CI]: [0.60, 0.97], p trend = 0.023). Regarding food composition, higher consumption of fresh fruits and nuts was associated with a decreased risk of cognitive impairment (OR = 0.77, 95% CI: [0.66, 0.89] and OR = 0.70, 95% CI [0.58, 0.86], respectively).

CONCLUSIONS

Adherence to the cMIND diet was associated with lower risks of cognitive impairment in older Chinese individuals. The cMIND diet, based on the MIND dietary pattern, could serve as a preventive measure against cognitive impairment.

Nut Consumption and Fertility: a Systematic Review and Meta-Analysis

The high concentration of omega-3 polyunsaturated fats, dietary fibers, vitamins, minerals, and polyphenols found in nuts suggest their regular consumption may be a simple strategy for improving reproductive health. This systematic review and meta-analysis aimed to present up-to-date evidence regarding the association between nut intake and fertility outcomes in males and females. Ovid MEDLINE, Embase, CINAHL, and Scopus were searched from inception to 30 June 2023. Eligible articles were interventional or observational studies in human subjects of reproductive age (18-49 y) that assessed the effects (or association) of dietary nut consumption (for a minimum of 3 mo) on fertility-related outcomes. Random-effects meta-analyses were completed to produce a pooled effect estimate of nut consumption on sperm total motility, vitality, morphology, and concentration in healthy males. Four studies involving 875 participants (646 males, 229 females) were included in this review. Meta-analysis of 2 RCTs involving 223 healthy males indicated consumption of ≥ 60g nuts/d increased sperm motility, vitality, and morphology in comparison to controls but had no effect on sperm concentration. Nonrandomized studies reported no association between dietary nut intake and conventional sperm parameters in males, embryo implantation, clinical pregnancy or live birth in males and females undergoing ART. Our meta-analysis shows that including at least 2 servings of nuts daily as part of a Western-style diet in healthy males improves sperm parameters, which are predictors of male fertility. Due to their nutritional profile, nuts were found to have potential to promote successful reproductive outcomes. This trial was registered at PROSPERO (CRD42020204586).

In Vitro Assessment of the Bioaccessibility of Zn, Ca, Mg, and Se from Various Types of Nuts

The bioaccessibility of zinc (Zn), calcium (Ca), magnesium (Mg), and selenium (Se) from various nuts (Brazil nuts, walnuts, peanuts, almonds, cashews, pecans, hazelnuts, macadamia nuts, and pistachios) was assessed using a simulated two-phase model of enzymatic digestion in vitro. The levels of Zn, Mg, and Ca were determined by atomic absorption spectrometry, and Se was measured by inductively coupled plasma-mass spectrometry. All tested nuts were good sources of Mg, and most, except macadamia nuts, were also good sources of Zn (the standard portion covers over 15% of NRV-R (UE) 1924/2006). Brazil nuts had the highest Se content. Almonds and Brazil nuts were rich in Ca. Se demonstrated the highest bioaccessibility from nuts (27.7% to 70.65%), whereas Ca exhibited the lowest bioaccessibility (below 9%). Pistachios had the highest Zn bioavailability, while cashews excelled in Mg bioaccessibility. Macadamia and pistachios were top for Ca bioaccessibility, and Brazil nuts for Se. Bioaccessibility is positively correlated with fat (for Zn: r = 0.23), carbohydrates (for Mg: 0.44; for Ca: 0.35), and sugar content (for Zn: r = 0.36; for Mg: 0.46; for Ca: 0.40).

Effects of prepregnancy dietary patterns on infant birth weight: a prospective cohort study

BACKGROUND

Maternal nutrition can have a profound effect on fetal growth, development, and subsequent infant birth weight. However, little is known regarding the influence of prepregnancy dietary patterns.

OBJECTIVES

This study aimed to explore the effects between prepregnancy dietary patterns on birth weight.

METHODS

This study included 911 singleton live-born infants from the Taicang and Wuqiang Mother-Child Cohort Study (TAWS). Baseline information and prepregnancy diet data were collected during early pregnancy. Newborn birth information was obtained from the Wuqiang County Hospital. Macrosomia, defined as a birth weight of ≥4000 g, and large for gestational age (LGA), defined as a birth weight higher than the 90th percentile for the same sex and gestational age, were the outcomes of interest. The dietary patterns were extracted using principal component analysis. Logistic regression models were used to investigate the association between prepregnancy dietary patterns (in tertiles) and macrosomia and LGA, and subgroup analysis was further explored by pre-pregnancy body mass index (BMI).

RESULTS

Four dietary patterns were identified based on 15 food groups. These patterns were named as "cereals-vegetables-fruits," "vegetables-poultry-aquatic products," "milk-meat-eggs," and "nuts-aquatic products-snacks." After adjusting for sociodemographic characteristics, pregnancy complications, and other dietary patterns, greater adherence to the "cereals-vegetables-fruits" pattern before pregnancy was associated with a higher risk of macrosomia (adjusted OR = 2.220, 95% CI: 1.018, 4.843), while greater adherence to the "nuts-aquatic products-snacks" pattern was associated with a lower risk of macrosomia (adjusted OR = 0.357, 95% CI: 0.175, 0.725) compared to the lowest tertile. No significant association was observed between prepregnancy dietary patterns and LGA. However, after subgroup analysis of pre-pregnancy BMI, "cereals-vegetables-fruits" pattern was associated with an increased risk of LGA in overweight and obese mothers (adjusted OR = 2.353, 95% CI: 1.010, 5.480).

CONCLUSIONS

An unbalanced pre-pregnancy diet increases the risk of macrosomia and LGA, especially in overweight or obese women before pre-pregnancy.

Diet Quality and Consumption of Healthy and Unhealthy Foods Measured via the Global Diet Quality Score in Relation to Cardiometabolic Outcomes in Apparently Healthy Adults from the Mediterranean Region: The ATTICA Epidemiological Cohort Study (2002-2022)

The Global Diet Quality Score (GDQS) is a novel food-based score that assesses both nutrient adequacy and chronic disease risk, by evaluating healthy (GDQS+) and unhealthy foods (GDQS-). The aim of this study was to evaluate the association among GDQS, GDQS+, and GDQS- against the 20-year risk of cardiometabolic outcomes in a Mediterranean population. The sample was n = 2169 initially free of cardiovascular disease (CVD) participants of the ATTICA study (2002-2022) that participated in the 20-year follow-up. The incidence of CVD, hypertension, hypercholesterolemia, and type 2 diabetes mellitus (T2DM) was defined according to WHO-ICD-10 criteria. The GDQS was computed based on previously published instructions. In multivariate analyses, a higher diet quality, per 1/49 of the GDQS, was associated with an 8% [95% Confidence Interval-CI: 6-9%] and 2% [95% CI: 1-3%] lower CVD and T2DM risk, respectively. A higher consumption of healthy foods, per 1/32 of GDQS+, was associated with a 9% [95% CI: 7-11%] and 2% [95% CI: 1-3%] lower CVD and T2DM risk, respectively. Contrarily, a lower consumption of unhealthy foods (GDQS-) was not associated with cardiometabolic events in the adjusted models (all p value< 0.05). In clinical practice or future public health actions to ameliorate dietary habits and prevent CVD and T2DM, more attention should be focused on healthy foods that should be included in our diets.

Association of Tree Nut Consumption with Cardiovascular Disease and Cardiometabolic Risk Factors and Health Outcomes in US Adults: NHANES 2011-2018

Background

Tree nuts are nutrient dense, and their consumption has been associated with improvements in health outcomes.

Objective

To estimate the usual tree nut intake and examine the association between tree nut consumption and cardiometabolic (CM) health outcomes in a nationally representative sample of US adults.

Methods

Cross-sectional data were analyzed from a sample of 18,150 adults aged ≥ 20y who provided at least one reliable 24-h dietary recall and had complete data for the variables of interest in the NHANES 2011-2018. Tree nut consumers were defined as those consuming ≥ ¼ ounce/d (7.09 g). The National Cancer Institute Method was used to estimate the usual tree nut intake among consumers. Measurement error calibrated regression models were used to assess the association between tree nut consumption and each health outcome of interest.

Results

Approximately 8% of all participants (n = 1238) consumed tree nuts and had a mean ± SE usual intake of 39.5 ± 1.8 g/d. Tree nut consumers were less likely to have obesity (31% vs. 40%, P < 0.001) and low high-density lipoprotein cholesterol (22% vs. 30%, P < 0.001) compared with nonconsumers. Moreover, tree nut consumers had a lower mean waist circumference (WC) (97.1 ± 0.7 vs. 100.5 ± 0.3 cm, P < 0.001) and apolipoprotein B (87.5 ± 1.2 vs. 91.8 ± 0.5 mg/dL, P = 0.004) than nonconsumers. After adjusting models for demographics and lifestyle covariates, the difference in WC between average intake (33.7 g/d) and low threshold intake (7.09/g) of tree nuts was -1.42 ± 0.58 cm (P = 0.005).

Conclusions

Most US adults do not consume tree nuts, yet modest consumption was associated with decreased prevalence of cardiovascular disease and CM risk factors and improvement for some health outcome measures.

The Role of Plant-Based Diets in Preventing and Mitigating Chronic Kidney Disease: More Light than Shadows

Chronic kidney disease (CKD) is a non-communicable disease that affects >10% of the general population worldwide; the number of patients affected by CKD is increasing due in part to the rise in risk factors such as obesity, hypertension, and diabetes mellitus. As many studies show, diet can be an important tool for preventing and mitigating the onset of non-communicable diseases. Plant-based diets (PBDs) are those that emphasize the consumption of plant foods and may or may not include small or moderate amounts of animal foods. Recently, these diets have received increasing interest because they have been associated with favourable effects on health and also appear to protect against the development and progression of CKD. PBDs, which are associated with protein restrictions, seem to offer adjunctive advantages in patients with chronic kidney disease, as compared to conventional low-protein diets that include animal proteins. The principal aims of this review are to provide a comprehensive overview of the existing literature regarding the role of plant-based diets and low-protein, plant-based diets in the context of chronic kidney disease. Moreover, we try to clarify the definition of plant-based diets, and then we analyse possible concerns about the use of PBDs in patients with chronic kidney disease (nutritional deficiency and hyperkalaemia risk). Finally, we offer some strategies to increase the nutritional value of plant-based low-protein diets. In the Materials and Methods section, many studies about plant-based diets and low-protein plant-based diets (e.g., the very-low-protein diet and vegan low-protein diet, LPD) in chronic kidney disease were considered. In the Results and Conclusion section, current data, most from observational studies, agree upon the protective effect of plant-based diets on kidney function. Moreover, in patients with advanced CKD, low-protein plant-based options, especially a very-low-protein diet supplemented with heteroanalogues (VLPDs), compared to a conventional LPD appear to offer adjunctive advances in terms of delaying dialysis and mitigating metabolic disturbances. However, further studies are necessary to better investigate the possible metabolic and cardiovascular advantages of plant-based LPDs versus conventional LPDs.

Tree Nut and Peanut Consumption and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cardiovascular disease (CVD) is the leading cause of death globally. Habitual consumption of tree nuts and peanuts is associated with cardioprotective benefits. Food-based dietary guidelines globally recommend nuts as a key component of a healthy diet. This systematic review and meta-analysis were conducted to examine the relationship between tree nut and peanut consumption and risk factors for CVD in randomized controlled trials (RCTs) (PROSPERO: CRD42022309156). MEDLINE, PubMed, CINAHL, and Cochrane Central databases were searched up to 26 September, 2021. All RCT studies that assessed the effects of tree nut or peanut consumption of any dose on CVD risk factors were included. Review Manager software was used to conduct a random effect meta-analysis for CVD outcomes from RCTs. Forest plots were generated for each outcome, between-study heterogeneity was estimated using the I2 test statistic and funnel plots and Egger's test for outcomes with ≥10 strata. The quality assessment used the Health Canada Quality Appraisal Tool, and the certainty of the evidence was assessed using grading of recommendations assessment, development, and evaluation (GRADE). A total of 153 articles describing 139 studies (81 parallel design and 58 cross-over design) were included in the systematic review, with 129 studies in the meta-analysis. The meta-analysis showed a significant decrease for low-density lipoprotein (LDL) cholesterol, total cholesterol (TC), triglycerides (TG), TC:high-density lipoprotein (HDL) cholesterol, LDL cholesterol:HDL cholesterol, and apolipoprotein B (apoB) following nut consumption. However, the quality of evidence was "low" for only 18 intervention studies. The certainty of the body of evidence for TC:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apoB were "moderate" because of inconsistency, for TG were "low," and for LDL cholesterol and TC were "very low" because of inconsistency and the likelihood of publication bias. The findings of this review provide evidence of a combined effect of tree nuts and peanuts on a range of biomarkers to create an overall CVD risk reduction.

Mediterranean Dietary Pattern and Psychosocial Health Problems in Spanish Adolescents: The EHDLA Study

The aims of the present study were twofold: to determine the association between adherence to the Mediterranean diet (MedDiet) and psychological problems and to assess the relationship between different food groups of the MedDiet and different patterns of psychosocial health problems in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a representative sample of 700 adolescents (57% girls) between 12 and 17 years of age. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Psychosocial health problems were measured by the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ). ANCOVA models were used to test the mean differences in psychosocial health problems (SDQ subscales) by adherence to MedDiet categories (low, medium, and high). Multiple linear regression was used to determine the association between different food groups of the MedDiet and psychosocial health problems. Adolescents with low adherence to the MedDiet had significantly higher scores in SDQ total difficulties, conduct problems, and hyperactivity problems and lower scores in pro-social behavior (p < 0.05) than their peers with medium and high adherence to the MedDiet. In relation to specific MedDiet food groups, fruit, nut, and legume intake were associated with higher psychosocial health. However, sweets, skipping breakfast, or high consumption of pasta or rice (≥5 weeks) were associated to higher psychosocial health problems. Our results show that adolescents with higher adherence to the MedDiet could benefit from greater psychosocial health. Individually, some patterns of MedDiet, such as fruit, nut, and legume intake, may reduce psychosocial health problems. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Effect of Nut Consumption on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Although previous epidemiological studies have been conducted to investigate the relationship between nut consumption and the risk of nonalcoholic fatty liver disease (NAFLD), the evidence remains inconclusive and contentious. The aim of our study was to further conduct a meta-analysis of observational studies to explore the latest evidence of the influence of nut consumption on NAFLD. This meta-analysis included a comprehensive search of all articles published in the PubMed and Web of Science online databases as of April 2023. A total of 11 articles were included, comprising 2 prospective cohort studies, 3 cross-sectional studies, and 7 case-control studies, and a random effects model was used to evaluate the relationship between nuts and NAFLD. Results showed that the odds ratio (OR) of NAFLD was 0.90 (95% CI: 0.81-0.99, p < 0.001) when comparing the highest and lowest total nut intake, indicating a significant negative correlation. Furthermore, subgroup analysis revealed that the protective effect of nuts on NAFLD was more significant in females (OR = 0.88; 95% CI: 0.78-0.98, I² = 76.2%). In summary, our findings provide support for a protective relationship between nut intake and risk of NAFLD. Further exploration of the association between other dietary components and NAFLD is an important avenue for future research.

Purification and Identification of Novel Antioxidant Peptides from Hydrolysates of Peanuts (Arachis hypogaea) and Their Neuroprotective Activities

Peanut (Arachis hypogaea) peptides have various functional activities and a high utilization value. This study aims to isolate and characterize antioxidant peptides from peanut protein hydrolysates and further evaluate their neuroprotection against oxidative damage to PC12 cells induced by 6-hydroxydopamine (6-OHDA). After the peanut protein was hydrolyzed with pepsin and purified using ultrafiltration and gel chromatography, six peptides were identified and sequenced by high-performance liquid chromatography (HPLC) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Out of these six peptides, Pro-Gly-Cys-Pro-Ser-Thr (PGCPST) exhibited a desirable antioxidant capacity, as determined using the 1,1-diphenyl-2-picrylhydrazyl, 2,2-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt, and hydroxyl radical scavenging assays. Moreover, our results indicated that the peptide PGCPST effectively increased the cell viability and reduced the cell apoptosis in 6-OHDA-induced PC12. RNA sequencing further showed that the neuroprotective effect of the peptide PGCPST was mediated via sphingolipid metabolism-related pathways. With further research efforts, the peptide PGCPST was expected to develop into a new neuroprotective agent.

Aphanizomenon flos-aquae (AFA) Extract Prevents Neurodegeneration in the HFD Mouse Model by Modulating Astrocytes and Microglia Activation

Obesity and related metabolic dysfunctions are associated with neurodegenerative diseases, such as Alzheimer's disease. Aphanizomenon flos-aquae (AFA) is a cyanobacterium considered a suitable supplement for its nutritional profile and beneficial properties. The potential neuroprotective effect of an AFA extract, commercialized as KlamExtra^®, including the two AFA extracts Klamin^® and AphaMax^®, in High-Fat Diet (HFD)-fed mice was explored. Three groups of mice were provided with a standard diet (Lean), HFD or HFD supplemented with AFA extract (HFD + AFA) for 28 weeks. Metabolic parameters, brain insulin resistance, expression of apoptosis biomarkers, modulation of astrocytes and microglia activation markers, and Aβ deposition were analyzed and compared in the brains of different groups. AFA extract treatment attenuated HFD-induced neurodegeneration by reducing insulin resistance and loss of neurons. AFA supplementation improved the expression of synaptic proteins and reduced the HFD-induced astrocytes and microglia activation, and Aβ plaques accumulation. Together, these outcomes indicate that regular intake of AFA extract could benefit the metabolic and neuronal dysfunction caused by HFD, decreasing neuroinflammation and promoting Aβ plaques clearance.

Composition of Nuts and Their Potential Health Benefits-An Overview

The possibility that nut intake may defend human health is an interesting point of view and has been investigated worldwide. Consequently, nuts are commonly promoted as healthy. In recent decades, the number of investigations proposing a correlation between nut consumption and a decrease in the risk of key chronic diseases has continued to increase. Nuts are a source of intake of fiber, and dietary fiber is associated with a reduced occurrence of obesity and cardiovascular diseases. Nuts likewise provide minerals and vitamins to the diet and supply phytochemicals that function as antioxidant, anti-inflammatory, and phytoestrogens agents and other protective mechanisms. Therefore, the main goal of this overview is to summarize current information and to describe the utmost new investigation concerning the health benefits of certain nuts.

The Effects of Tree Nut and Peanut Consumption on Energy Compensation and Energy Expenditure: A Systematic Review and Meta-Analysis

Nut consumption is not associated with a higher body weight, and potential energy-regulating mechanisms may include a reduced subsequent energy intake and increased EE. The aim of this study was to examine the effect of tree nut and peanut consumption on energy intake, compensation, and expenditure. PubMed, MEDLINE, CINAHL, Cochrane, and Embase databases were searched from inception to June 2, 2021. Human studies with adults aged ≥18 y older were included. Energy intake and compensation studies were restricted to acute effects (intervention duration of ≤24 h), whereas intervention duration was not limited for EE studies. Random effects meta-analyses were conducted to explore weighted mean differences in REE. Twenty-eight articles from 27 studies (16 energy intake studies, 10 EE studies, and 1 study investigating both) with 1121 participants were included in this review, with a variety of nut types addressed (almonds, Brazil nuts, cashews, chestnuts, hazelnuts, peanuts, pistachios, walnuts, and mixed nuts). Energy compensation occurred after nut-containing loads (range: -280.5% to +176.4%) and the degree of compensation varied depending on the form (whole and chopped) and how they were consumed (alone and within a meal). The meta-analyses identified a nonsignificant increase in REE associated with nut consumption (weighted mean difference: 28.6 kcal/d; 95% CI: -10.7, 67.8 kcal/d). This study provided support for energy compensation as a potential mechanism for a lack of association between nut consumption and body weight, whereas no evidence was found for EE as an energy-regulating mechanism of nuts. This review was registered at PROSPERO as CRD42021252292.

Acute feeding with almonds compared to a carbohydrate-based snack improves appetite-regulating hormones with no effect on self-reported appetite sensations: a randomised controlled trial

PURPOSE

Early satiety has been identified as one of the mechanisms that may explain the beneficial effects of nuts for reducing obesity. This study compared postprandial changes in appetite-regulating hormones and self-reported appetite ratings after consuming almonds (AL, 15% of energy requirement) or an isocaloric carbohydrate-rich snack bar (SB).

METHODS

This is a sub-analysis of baseline assessments of a larger parallel-arm randomised controlled trial in overweight and obese (Body Mass Index 27.5-34.9 kg/m²) adults (25-65 years). After an overnight fast, 140 participants consumed a randomly allocated snack (AL [n = 68] or SB [n = 72]). Appetite-regulating hormones and self-reported appetite sensations, measured using visual analogue scales, were assessed immediately before snack food consumption, and at 30, 60, 90 and 120 min following snack consumption. A sub-set of participants (AL, n = 49; SB, n = 48) then consumed a meal challenge buffet ad libitum to assess subsequent energy intake. An additional appetite rating assessment was administered post buffet at 150 min.

RESULTS

Postprandial C-peptide area under the curve (AUC) response was 47% smaller with AL compared to SB (p < 0.001). Glucose-dependent insulinotropic polypeptide, glucagon and pancreatic polypeptide AUC responses were larger with AL compared to SB (18%, p = 0.005; 39% p < 0.001; 45% p < 0.001 respectively). Cholecystokinin, ghrelin, glucagon-like peptide-1, leptin and polypeptide YY AUCs were not different between groups. Self-reported appetite ratings and energy intake following the buffet did not differ between groups.

CONCLUSION

More favourable appetite-regulating hormone responses to AL did not translate into better self-reported appetite or reduced short-term energy consumption. Future studies should investigate implications for longer term appetite regulation.

ANZCTR REFERENCE NUMBER

ACTRN12618001861246 2018.

Nutrition as Prevention of Diet-Related Diseases-A Cross-Sectional Study among Children and Young Adults with Down Syndrome

BACKGROUND

The aim of this study was to assess the diet of children with Down syndrome (DS) and to identify potential dietary mistakes made by their parents.

MATERIALS AND METHODS

The study was conducted among 195 parents of people with DS between November 2020 and March 2021. Data for the study were collected anonymously using the CAWI method.

RESULTS

122 (62.6%) people with DS did not eliminate any nutrient from their diet. By contrast, in the study group, the following numbers of people reported the following dietary restrictions: 51 (26.2%) gluten, 56 (28.7%) lactose, 17 (8.7%) casein, 26 (13.3%) sucrose, 2 (1.0%) histamine, 2 (1.0%) lectins, and 1 (0.5%) dairy. The most frequent response for vegetable and fruit consumption was once a day, with 83 (42.6%) and 87 (44.6%) parents indicating this. The most frequent response for dairy product consumption was every day, with 72 (36.9%) parents indicating this, while 36 (20%) parents stated that their children do not eat dairy products at all. In the study group, the most frequent response for meat consumption was several times a week, this was indicated by 107 (54.9%) parents, while 1 (0.5%) of them said that their children do not eat meat products at all. The most frequent response for fish consumption was 1-2 times a week, this answer was indicated by 101 (51.8%) parents, while 13 (6.7%) said that their children do not eat these products at all.

CONCLUSIONS

A majority of the subjects with DS are usually fed in a normal way, but nutritional mistakes are made by the parents. Special attention should be paid to prolonging the period of natural feeding.

Consumption of Nuts and Seeds and Health Outcomes Including Cardiovascular Disease, Diabetes and Metabolic Disease, Cancer, and Mortality: An Umbrella Review

Consumption of nuts and seeds is associated with a range of health outcomes. Summarizing the best evidence on essential health outcomes from the consumption of nuts is essential to provide optimal recommendations. Our objective is to comprehensively assess health outcome associations related to the consumption of nuts and seeds, using a culinary definition including tree nuts and peanuts (registered in PROSPERO: CRD42021258300). Health outcomes of interest include cardiovascular disease, cancer, diabetes, obesity, respiratory disease, mortality, and their disease biomarkers. We present associations for high compared with low consumption, per serving, and dose-response relations. MEDLINE, Embase, Cochrane, and Epistemonikos were searched and screened for systematic reviews and meta-analyses. Evidence was extracted from 89 articles on the consumption of nuts and relevant health outcomes, including 23 articles with meta-analysis on disease and mortality, 66 articles on biomarkers for disease, and 9 articles on allergy/adverse outcomes. Intake of nuts was associated with reduced risk of cardiovascular diseases and related risk factors, with moderate quality of evidence. An intake of 28 g/d nuts compared with not eating nuts was associated with a 21% RR reduction of cardiovascular disease (including coronary heart disease incidence and mortality, atrial fibrillation, and stroke mortality), an 11% risk reduction of cancer deaths, and 22% reduction in all-cause mortality. Nut consumption was also inversely associated with mortality from respiratory diseases, infectious diseases, and diabetes; however, associations between nut consumption and diabetes incidence were mixed. Meta-analyses of trials on biomarkers for disease generally mirrored meta-analyses from observational studies on cardiovascular disease, cancers, and diabetes. Allergy and related adverse reactions to nuts were observed in 1-2% of adult populations, with substantial heterogeneity between studies. Overall, the current evidence supports dietary recommendations to consume a handful of nuts and seeds per day for people without allergies to these foods.

Research progress on Walnut oil: Bioactive compounds, health benefits, extraction methods, and medicinal uses

Walnut oil is extracted from walnut kernels (Juglans regia Linne) or iron walnut kernels (Juhlans sigillata Dode). The percentage of oil in walnuts is 52%-70%. The main constituents in oil are fatty acids, phenols, sterols, squalene, melatonin, vitamins, and minerals. Many extraction methods such as supercritical carbon dioxide extraction, maceration, modified "bligh and dyer extraction," aqueous enzymatic extraction, ultrasonic extraction, soxhlet extraction, and cold-press extraction methods are reported in the literature. Walnut oil showed anti-inflammatory, antitumor, antioxidant, immunomodulatory, neuroprotective, cardioprotective, antidiabetic, and antihyperlipidemic activities. The reported data in the literature suggest that walnut oil has many health benefits. This review summarizes the extraction methods, bioactive constituents, health benefits, and pharmacological actions of walnut oil. PRACTICAL APPLICATIONS: Walnut oil is a natural vegetable oil of significant importance due to their nutritional, and intelligence-boosting benefits. Several factors, including the processing parameters and the phytochemical profile, affect walnut oil products' flavor and color. In addition, storage environment of walnut oil can also affect walnut oil quality. Apart from the predominant ingredient fatty acids, the chemical composition of walnut oil comprises phenols, sterols, squalene, melatonin, vitamins, and minerals. These bioactive compounds are of potential value owing to their health-promoting benefits, including antioxidant, antitumor, and cholesterol-lowering effects. Many chemical constituents were isolated from walnut oil; however, all the compounds are not explored for their possible medicinal value. Thus, clinical studies, exploration of the therapeutic potential and the molecular mechanisms of all the compounds, and development of convenient dosage forms either for therapeutic or functional food purposes are warranted.

Tree nut allergy: a systematic review

PURPOSE OF REVIEW

Systematic scoping review, focusing on randomized clinical trials of recent research addressing tree nut allergy.

RECENT FINDINGS

This review addresses published, unpublished, and re-analyzed studies on tree nut allergy definition, epidemiology, etiology, diagnosis, prognosis, and therapy.

SUMMARY

The importance of tree nut allergy spans nations, economies, and cultures. While broad themes in epidemiology, etiology, diagnosis, prognosis, and therapy are emerging, the next major advance in tree nut allergy will require large, robust studies to deliver results important to patients and families.

Valorization of Local Legumes and Nuts as Key Components of the Mediterranean Diet

Legumes and nuts are components of high importance in the diet of many countries, mainly those in the Mediterranean region. They are also very versatile and culturally diverse foods found all over the world, acting as a basic protein source in certain countries. Their genetic diversity is needed to sustain the food supply and security for humans and livestock, especially because of the current loss of habitats, species, and genetic diversity worldwide, but also because of the ever present need to feed the increasing human population. Even though both legumes and nuts are considered as high-protein food and environmentally friendly crops, developed countries have lower consumption rates when compared to Asia or Africa. With a view to increasing the consumption of legumes and nuts, the objective of this review is to present the advantages on the use of autochthonous varieties from different countries around the world, thus providing a boost to the local market in the area. The consumption of these varieties could be helped by their use in ready-to-eat foods (RTE), which are now on the rise thanks to today's fast-paced lifestyles and the search for more nutritious and sustainable foods. The versatility of legumes and nuts covers a wide range of possibilities through their use in plant-based dairy analogues, providing alternative-protein and maximal amounts of nutrients and bioactive compounds, potential plant-based flours for bakery and pasta, and added-value traditional RTE meals. For this reason, information about legume and nut nutrition could possibly increase its acceptance with consumers.

Nuts as a Dietary Enrichment with Selected Minerals-Content Assessment Supported by Chemometric Analysis

Nuts used as a snack and meal accompaniment supply plant protein and fatty acids that are beneficial for human health; however, they can also provide minerals. The aim of this study was to determine the content of selected elements that are often deficient in the diet (calcium, potassium, magnesium, selenium, and zinc) in nuts and determine whether they can be used to supplement deficiencies in the diet. In this study, we analyzed 10 types of nuts (n = 120 samples) that are consumed and available for sale in Poland. The content of calcium, magnesium, selenium, and zinc was determined by the atomic absorption spectrometry method, and flame atomic emission spectrometry was used for determination of potassium contents. The highest median calcium content was found in almonds (2825.8 mg/kg), the highest potassium content in pistachio nuts (15,730.5 mg/kg), the highest magnesium and selenium contents in Brazil nuts (10,509.2 mg/kg and 4348.7 μg/kg, respectively), and the highest zinc content in pine nuts (72.4 mg/kg). All the tested nuts are a source of magnesium, eight types of tested nuts are a source of potassium, six nut types are a source of zinc, and four nut types are a source of selenium; however, among the tested nuts, only almonds can be considered a source of calcium. Moreover, we found that selected chemometric methods can be useful in the classification of nuts. The studied nuts are valuable products that can be used to supplement the diet with selected minerals and can therefore be labelled as functional products crucial for disease prevention.

The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial

Objectives

Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics.

Methods

The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed.

Results

The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial.

Conclusion

In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

The effect of walnut consumption on cardiometabolic profiles of individuals with abnormal glucose homoeostasis: a systematic review and meta-analysis of clinical trials

Findings on the effect of walnut consumption on cardiometabolic profiles in individuals with abnormal glucose homoeostasis are conflicting. We summarised earlier data in this regard. A systematic literature search of relevant reports published in Medline/PubMed, ISI web of Science, EMBASE, SCOPUS and Google Scholar up to October 2020 was conducted. Randomised trials that enrolled individuals with abnormal glucose homoeostasis in which the main intervention was walnut consumption were included. Abnormal glucose homoeostasis was defined as a spectrum of impaired glucose tolerance or pre-diabetic status that is associated with insulin resistance. Twelve studies were included in systematic review and eight in meta-analysis. No significant effect of walnut consumption on anthropometric measures, including weighted mean difference (WMD: -0·13; 95 % CI -0·64, 0·39 kg), BMI (-0·08; 95 % CI -0·47, 0·32 kg/m²) and waist circumference (0·01; 95 % CI -0·50, 0·52 cm) was observed. Although walnut intake did not influence on lipid profiles (including TAG, total- and HDL-cholesterol levels), individuals in the intervention group tended to have lower levels of LDL-cholesterol than those in the control group (-0·10; 95 % CI -0·20, 0·01 mmol/l; P = 0·06). Other cardiometabolic factors including markers of glycaemic control (fasting blood glucose and HbA1C levels), blood pressure and stimulus-adjusted response measure (a parameter of endothelial function) were not significantly affected. However, walnut consumption resulted in a significant increase in flow-mediated dilation (FMD) (0·93 %; 95 % CI 0·16, 1·71 %). Summarising earlier evidence, we found that walnut consumption might influence FMD and LDL-cholesterol levels in individuals with abnormal glucose homoeostasis. It did not affect other cardiometabolic profiles in these individuals.

Why Should Pistachio Be a Regular Food in Our Diet?

The pistachio is regarded as a relevant source of biologically active components that, compared to other nuts, possess a healthier nutritional profile with low-fat content composed mainly of monounsaturated fatty acids, a high source of vegetable protein and dietary fibre, remarkable content of minerals, especially potassium, and an excellent source of vitamins, such as vitamins C and E. A rich composition in terms of phytochemicals, such as tocopherols, carotenoids, and, importantly, phenolic compounds, makes pistachio a powerful food to explore its involvement in the prevention of prevalent pathologies. Although pistachio has been less explored than other nuts (walnut, almonds, hazelnut, etc.), many studies provide evidence of its beneficial effects on CVD risk factors beyond the lipid-lowering effect. The present review gathers recent data regarding the most beneficial effects of pistachio on lipid and glucose homeostasis, endothelial function, oxidative stress, and inflammation that essentially convey a protective/preventive effect on the onset of pathological conditions, such as obesity, type 2 diabetes, CVD, and cancer. Likewise, the influence of pistachio consumption on gut microbiota is reviewed with promising results. However, population nut consumption does not meet current intake recommendations due to the extended belief that they are fattening products, their high cost, or teething problems, among the most critical barriers, which would be solved with more research and information.

Walnut Intake Interventions Targeting Biomarkers of Metabolic Syndrome and Inflammation in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Biomarkers of metabolic syndrome and inflammation are pathophysiological predictors and factors of senescence and age-related diseases. Recent evidence showed that particular diet components, such as walnuts rich in antioxidant bioactive compounds and with a balanced lipid profile, could have positive outcomes on human health. A systematic search in PubMed, EMBASE, Cochrane Library, Scopus, and ClinicalTrials.gov databases was performed to retrieve randomized controlled trials published from the beginning of each database through November 2021, reporting on the outcomes of walnut consumption over 22 metabolic syndrome and inflammatory markers in middle-aged and older adults. The search strategy rendered 17 studies in the final selection, including 11 crossover and 6 parallel trials. The study revealed that walnut-enriched diets had statistically significant decreasing effects for triglyceride, total cholesterol, and LDL cholesterol concentrations on some inflammatory markers and presented no consequences on anthropometric and glycemic parameters. Although further studies and better-designed ones are needed to strengthen these findings, the results emphasize the benefits of including walnuts in the dietary plans of this age group.

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study

Background and Aims

Adherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients.

Methods

In this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD.

Results

The participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat.

Conclusion

Higher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

The Role of Nut and Seed Consumption in Colorectal Cancer: A Narrative Review

Given the increased incidence of colorectal cancer worldwide, especially in developed and developing countries, is comes as no surprise that researchers are concentrating on methods to combat this public health issue, through investigating both lifestyle interventions and treatment options. Although treatment options are being constantly discovered and developed, researchers have also begun investigating the influence that nutrition and lifestyle have on CRC. Among the food categories, nuts and seeds boast numerous beneficial effects for cardiovascular health and metabolic balance and they contain a plethora of phytochemicals and antioxidants. The present narrative review aims to offer a broad perspective to date on the known effects of this consumption on colorectal cancer. For this purpose, articles were identified by conducting a search in the PubMed and Google Scholar databases, using search phrases such as ″nut intake and colorectal cancer″ and ″seed consumption and colorectal cancer”, narrowing the search pool to those articles published between 2019 and 2022. The search returned eight relevant papers, all of which were validated by a second author. While the existing research is divided between those studies which have found no significant link between nut consumption and colorectal cancer protection and those which have, there is a consensus regarding the necessity for further research on this subject, as well as the possible mechanisms which might be involved in the protective effect observed by some researchers.

The Content of Phenolic Compounds and Mineral Elements in Edible Nuts

Edible nuts are an important component of a healthy diet, and their frequent consumption has beneficial impact on human health, including reducing the risk of cardiovascular and neurodegenerative diseases. Moreover, various factors, including cultivar, climate, soil characteristic, storage and treatment have influence on the chemical composition of nuts. Therefore, nine tree nut types and peanuts commonly available on Polish market were evaluated for phenolic profile and mineral elements content. The concentration of individual phenolic compounds, including flavonoids, aromatic acids and caffeic acid phenethyl ester (CAPE) was determined by ultra-high pressure liquid chromatography, while the content of macro-elements and trace minerals was analyzed by atomic absorption spectrometry. The phenolic profile of analyzed nuts substantially varied depending on the type of nut. The highest total content of all analyzed flavonoids was determined in walnuts (114.861 µg/g), while the lowest in almonds (1.717 µg/g). In turn, the highest total content of all tested aromatic acid was determined in pecans (33.743 µg/g), and the lowest in almonds (0.096 µg/g). Epicatechin and cinnamic acid were detected in the highest concentration in tested nuts. Moreover, in examined nuts (except walnuts and Brazil nuts), the presence of CAPE was confirmed. The tested nuts were also characterized by wide variation in element concentrations. Almonds contained high concentration of macro-elements (13,111.60 µg/g), while high content of trace elements was determined in pine nuts (192.79 µg/g). The obtained results indicate that the tested nuts are characterized by a significant diversity in the content of both phenolic compounds and minerals. However, all types of nuts, apart from the well-known source of fatty acids, are a rich source of various components with beneficial effect on human health.

Evaluating the Nutritional Properties of Food: A Scoping Review

There are many methods or indicators used for evaluating the nutritional value of foods; however, it is difficult to accurately reflect the comprehensive nutritional value of a food with a single indicator, and a systematic evaluation system is lacking. In this article, we systematically summarize the common evaluation methods and indicators of the nutritional value of foods. The purpose of this review was to establish an evaluation procedure for nutritional properties of foodstuffs and to help scientists choose more direct and economical evaluation methods according to food types or relevant indicators. The procedure involves the selection of a three-level evaluation method that covers the whole spectrum of a food’s nutritional characteristics. It is applicable to scientific research in the fields of agricultural science, food science, nutrition, and so on.

Life style and Parkinson's disease

The question whether life style may impair the advent or course of the disease in patients with Parkinsonism is of great importance for patients and physicians alike. We present here comprehensive information on the influence of the environment, diet (especially caffeine, nicotine, alcohol, chocolate and dairy products), physical activity and sleep on risk and course of Parkinson’s disease.

Emulsion and Microemulsion Systems to Improve Functional Edible Oils Enriched with Walnut and Pistachio Phenolic Extracts

The purpose of this research was to improve the properties of functional edible oils with potential health promoting effects, enriched with phenolic-rich extracts obtained from pistachio and walnut (5.1 and 27.4% phenolic contents respectively), by means of emulsion and micro emulsion systems. Stable water-in-oil (W/O) emulsions were obtained employing polyglycerol polyrhizinoleate (PGPR) as emulsifier (0.5, 2% H₂O in oil), despite having a whitish and opaque appearance; transparent and stable microemulsions were prepared using proper proportion (e.g., 97:3) between the oily phase and the mixture of aqueous phase and emulsifiers (3:2 lecithin-distilled monoglycerides (DMG). Total polar phenolics contents ranging between 257 and 835 mg/kg were obtained in the novel functional edible oils' formulations, reaching higher content using walnut as compared to pistachio extracts. Antioxidant capacity determined by the 2,2-diphenyl-1-(2,4,6-trinitrophenyl)hydrazyl (DPPH) method increased approx. 7.5 and 1.5 times using walnut and pistachio extracts respectively. An emulsion using gallic acid and a microemulsion employing hydroxytyrosol, two well-known antioxidants, were also studied to compare antioxidant capacity of the proposed enriched oils. Furthermore, the oxidative stability of these products-very relevant to establish their commercial value-was measured under accelerated testing conditions employing the Rancimat equipment (100 °C) and performing an oven test (at 40 °C for walnut oils and 60 °C for pistachio and refined olive oils). Rancimat oxidative stability greatly increased and better results were obtained with walnut (2-3 times higher) as compared to pistachio extract enriched oils (1.5-2 times higher). On the contrary, under the oven test conditions, both the initial oxidation rate constant and the time required to reach a value of peroxide value equal to 15 (upper commercial category limit), indicated that under these assay conditions the protection against oxidation is higher using pistachio extract (2-4 times higher) than walnut's (1.5-2 times higher). Stable emulsions and transparent microemulsions phenolic-rich nut oils (250-800 mg/kg) were therefore developed, possessing a higher oxidative stability (1.5-4 times) and DPPH antioxidant capacity (1.5-7.5 times).

Nuts as a Part of Dietary Strategy to Improve Metabolic Biomarkers: A Narrative Review

Background

Nuts are in the spotlight because of their association with improved health outcomes. We aimed to summarize the findings of previous studies to evaluate the impact of nuts consumption on glycaemic and lipid profile, inflammation, and oxidative stress.

Methods

Electronic searches for observational and intervention studies were undertaken in PubMed, Embase, Web of Science, and Science Direct until 2022 for searching the studies aiming the application of different types of nuts and the beneficial effects of nuts in improving glycemia, dyslipidemia, inflammation, and oxidative stress.

Results

Results from 56 interventional, 9 narrative and 3 systematic reviews, and 12 meta-analysis studies, aiming at the evaluating beneficial effects of different types of nuts on metabolic markers, showed that nut consumption could improve metabolic markers, including glycaemic factors, lipid profile, and inflammatory and oxidative stress parameters in both healthy and individuals with metabolic disorders in a type-, dose- and duration-dependent manner. According to their unique nutrient components, nuts can be known as a part of a healthy diet, resulting in improved metabolic biomarkers.

Conclusion

Considering the efficacy of nuts in improving metabolic markers, incorporation of, incorporating nuts the effectiveness of nuts in improving metabolic markers, incorporating nuts in the diet may prevent the incidence or aggravation of chronic metabolic diseases. Considering the health benefits of the nuts' components, including essential micronutrients, if consumed in the appropriate dose and duration to provide the necessary amount of effective micronutrients to improve health, we will see an improvement in metabolic factors. At the same time, more research is required to determine the optimal type, dose, and duration of nut intervention with regards to metabolic control and reducing the risk of developing metabolic disorders.

Perspective: Is it Time to Expand Research on "Nuts" to Include "Seeds"? Justifications and Key Considerations

The health benefits of nuts reported throughout the literature are extensive and well established for reducing the risk of, and managing several chronic conditions such as cardiovascular disease, type 2 diabetes, nonalcoholic fatty liver disease, and cognition. Despite their comparable nutrient profile to nuts, seeds are often not assessed in clinical and epidemiological studies. Interestingly, dietary guidelines and recommendations often refer to "nuts and seeds" collectively, even though they are not consistently examined together in nutrition research when determining associated health benefits. The purpose of this review is to call for future nutrition research to consider combining nuts and seeds. This review provides justification for this proposal by summarizing current definitions for nuts and seeds and highlighting the similarities or dissimilarities in their nutrient compositions. Following this, we summarize current evidence on the health benefits of nuts and seeds, research gaps that should be addressed, and considerations for future research using both epidemiological and interventional study designs.

Associations of Nutritional Behavior and Gut Microbiota with the Risk of COVID-19 in Healthy Young Adults in Poland

The numerous consequences of the coronavirus disease 2019 (COVID-19) pandemic in healthy young people and the lack of clarity as to the long-term disease outcomes have spurred the search for risk factors for SARS-CoV-2 infection. We aimed to evaluate the associations of nutritional behaviors, gut microbiota, and physical activity with the risk of COVID-19 in healthy young nonobese people. Data on body composition, anthropometric measurements, physical activity, dietary intake, and gut microbiota were obtained from 95 adults (mean age, 34.66 ± 5.76 years). A balanced diet rich in vegetables and fruit, including nuts, wholegrain cereal products, and legumes, covers the need for vitamins and minerals. Such a diet can be an effective measure to reduce the risk of COVID-19 in nonobese healthy physically active young people with normal immune function. People with balanced diet and an average daily consumption of >500 g of vegetables and fruit and >10 g of nuts had an 86% lower risk of COVID-19 compared with those whose diet was not balanced and who consumed lower amounts of these products. It is well documented that proper nutrition, physical activity, and maintenance of normal weight facilitate good health by ensuring optimal immune function. The beneficial effects of these interventions should be strongly emphasized during the COVID-19 pandemic.

Comparison and recommendation of dietary patterns based on nutrients for Eastern and Western patients with inflammatory bowel disease

Inflammatory bowel disease (IBD), a non-specific chronic idiopathic inflammatory condition of the digestive system, requires lifelong treatment in which drugs are the mainstay, along with surgery when necessary. In adjuvant therapies, the diet is considered to be an essential, controllable, and economical component. However, the majority of recent nutrition research has focused on the general effects of nutrients on IBD, with little attention given to the advantages and negative aspects of individual foods and dietary combinations. To cover these shortcomings, we surveyed the benefits and drawbacks of typical foods and their chemical compositions on intestinal pathophysiology by comparing nutrients existing in the foods in Eastern and Western countries. Moreover, for Eastern and Western patients with IBD, we innovatively propose a 3-step dietary recommendation based on modified customary eating habits, including lowering the triggering foods, modifying dietary advice to control disease progression, and improving surgery prognosis.