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Research Nut: Almonds

Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial

Fitó, M., M. Guxens, D. Corella, G. Sáez, R. Estruch, R. de la Torre, F. Francés, C. Cabezas, M. del C. López-Sabaterl, J. Marrugat, A. García-Arellano, F. Arós, V. Ruiz-Gutierrez, E. Ros, J. Salas-Salvadó, M. Fiol, R. Solá, M.I. Covas; for the PREDIMED Study, 2007. Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial. Arch Intern Med. 167:1195-203.

Background: Despite the richness in antioxidants of the Mediterranean diet, to our knowledge, no randomized controlled trials have assessed its effect on in vivo lipoprotein oxidation. Methods: A total of 372 subjects at high cardiovascular risk (210 women and 162 men; age range, 55-80 years), who were recruited into a large, multicenter, randomized, controlled, parallel-group clinical trial (the Prevencio’n con Dieta Mediterra’nea [PREDIMED] Study) directed at testing the efficacy of the traditional Mediterranean diet (TMD) on the primary prevention of coronary heart disease, were assigned to a low-fat diet (n=121) or one of 2 TMDs (TMD + virgin olive oil or TMD + nuts). The TMD participants received nutritional education and either free virgin olive oil for all the family (1 L/wk) or free nuts (30 g/d). Diets were ad libitum. Changes in oxidative stress markers were evaluated at 3 months. Results: After the 3-month interventions, mean (95% confidence intervals) oxidized low-density lipoprotein (LDL) levels decreased in the TMD + virgin olive oil (−10.6 U/L [−14.2 to −6.1]) and TMD + nuts (−7.3 U/L [−11.2 to −3.3]) groups, without changes in the low-fat diet group (−2.9 U/L [−7.3 to 1.5]). Change in oxidized LDL levels in the TMD + virgin olive oil group reached significance vs that of the low-fat group (P=.02). Malondialdehyde changes in mononuclear cells paralleled those of oxidized LDL. No changes in serum glutathione peroxidase activity were observed. Conclusions: Individuals at high cardiovascular risk who improved their diet toward a TMD pattern showed significant reductions in cellular lipid levels and LDL oxidation. Results provide further evidence to recommend the TMD as a useful tool against risk factors for CHD.

Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals

Jenkins J. D. A., C. W. C. Kendall, A. R. Josse, S. Salvatore,  F. Brighenti, L.  S. A. Augustin, P. R. Ellis, E. Vidgen, and A. V. Rao. 2006.  Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr. 136:1-6.

Strategies that decrease postprandial glucose excursions, including digestive enzyme inhibition, and low glycemic index diets result in lower diabetes incidence and coronary heart disease (CHD) risk, possibly through lower postprandial oxidative damage to lipids and proteins. We therefore assessed the effect of decreasing postprandial glucose excursions on measures of oxidative damage. Fifteen healthy subjects ate 2 bread control meals and 3 test meals: almonds and bread; parboiled rice; and instant mashed potatoes, balanced in carbohydrate, fat, and protein, using butter and cheese. We obtained blood samples at baseline and for 4 h postprandially. Glycemic indices for the rice (38 ± 6) and almond meals (55 ± 7) were less than for the potato meal (94 ± 11) (P < 0.003), as were the postprandial areas under the insulin concentration time curve (P < 0.001). No postmeal treatment differences were seen in total antioxidant capacity. However, the serum protein thiol concentration increased following the almond meal (15±14 mmol/L), indicating less oxidative protein damage, and decreased after the control bread, rice, and potato meals (-10 ± 8 mmol/L), when data from these 3 meals were pooled (P = 0.021). The change in protein thiols was also negatively related to the postprandial incremental peak glucose (r = -0.29, n = 60 observations, P = 0.026) and peak insulin responses (r = -0.26, n = 60 observations, P = 0.046). Therefore, lowering postprandial glucose excursions may decrease the risk of oxidative damage to proteins. Almonds are likely to lower this risk by decreasing the glycemic excursion and by providing antioxidants. These actions may relate to mechanisms by which nuts are associated with a decreased risk of CHD.

Assessment of the longer-term effects of a portfolio of cholesterol-lowering foods in hypercholesterolemia

Jenkins, D.J.A, C.W.C. Kendall, D.A. Faulkner, T. Nguyen, T. Kemp, A. Marchie, J. M. W. Wong, R. de Souza, A. Emam, E. Vidgen, E. A. Trautwein, K. G. Lapsley, C. Holmes, R. G. Josse, L. A. Leiter, P. W. Connelly, and W. Singer, 2006. Assessment of the longer-term effects of a portfolio of cholesterol-lowering foods in hypercholesterolemia. Am J Clin Nutr. 83:582-91.

Background: Cholesterol-lowering foods may be more effective when consumed as combinations rather than as single foods. Objectives: Our aims were to determine the effectiveness of consuming a combination of cholesterol-lowering foods (dietary portfolio) under real-world conditions and to compare these results with published data from the same participants who had undergone 4-wk metabolic studies to compare the same dietary portfolio with the effects of a statin. Design: For 12 mo, 66 hyperlipidemic participants were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000 kcal), and almonds (23 g/1000 kcal). Fifty-five participants completed the 1-y study. The 1-y data were also compared with published results on 29 of the participants who had also undergone separate 1-mo metabolic trials of a diet and a statin. Results: At 3 mo and 1 y, mean (±SE) LDL-cholesterol reductions appeared stable at 14.0 ± 1.6% (P < 0.001) and 12.8 ± 2.0% (P <0.001), respectively (n = 66). These reductions were less than those observed after the 1-mo metabolic diet and statin trials. Nevertheless, 31.8% of the participants (n = 21 of 66) had LDL-cholesterol reductions of >20% at 1 y (x ± SE: -29.7 ± 1.6%). The LDL cholesterol reductions in this group were not significantly different from those seen after their respective metabolically controlled portfolio or statin treatments. A correlation was found between total dietary adherence and LDL-cholesterol change (r =-0.42, P<0.001). Only 2 of the 26 participants with <55% compliance achieved LDL-cholesterol reductions >20% at 1 y. Conclusions: More than 30% of motivated participants who ate the dietary portfolio of cholesterol-lowering foods under real-world conditions were able to lower LDL-cholesterol concentrations >20%, which was not significantly different from their response to a first-generation statin taken under metabolically controlled conditions.

A nutrition and health perspective on almonds

Chen, C.-Y., K. Lapsley and J.B. Blumberg, 2006. A nutrition and health perspective on almonds. J Sci Food Agric. 86:2245-2250.

Almonds provide a nutrient-dense source of vitamin E, manganese, magnesium, copper, phosphorus. Fiber, riboflavin, monounsaturated fatty acids and protein. Habitual almond consumption does not lead to weight gain, and their inclusion in low-calorie diets appears to promote more weight loss than a comparable carbohydrate-based low-calorie diet. Also, almonds have a low glycemic index and do not adversely impact insulin sensitivity. Almonds are an excellent source of bioavailable alpha-tocopherol, and increasing their intake enhances the resistance of LDL against oxidation. In addition, the polyphenolic constituents of almonds have been characterized recently and found to possess antioxidant actions. Further research is required to achieve a better understanding of the role that the bioavailability and bioaccessibility of almond constituents and the synergy between them play in their associated health outcomes.

Concentrations of anthocyanins in common foods in the United States and estimation of normal consumption

Wu, X., Beecher, G.R., Holden, J.M., Haytowitz, D.B., Gebhardt, S.E., R.L. Prior, 2006.  Concentrations of anthocyanins in common foods in the United States and estimation of normal consumption. J. Agric. Food Chem. 54:4069-75.

Anthocyanins (ACNs) are water-soluble plant pigments that have important functions in plant physiology as well as possible health effects. Over 100 common foods were screened for ACNs, and 24 of them were found to contain ACNs. Concentrations of total ACNs varied considerably from 0.7 to 1480 mg/100 g of fresh weight in gooseberry (‘Careless’ variety) and chokeberry, respectively. Not only does the concentration vary, but the specific anthocyanins present in foods are also quite different. Only six common aglycones, delphinidin, cyanidin, petunidin, pelargonidin, peonidin, and malvidin, were found in all of these foods. However, their sugar moieties and acylation patterns varied from food to food. Results from this study will add to the available data for the USDA Nutrient Database of flavonoids. On the basis of the concentration data and updated food intake data from NHANES 2001-2002, the daily intake of ACNs is estimated to be 12.5 mg/day/person in the United States. Of the different aglycones, cyanidin, delphinidin, and malvidin were estimated to contribute 45, 21, and 15%, respectively, of the total ACN intake. Nonacylated contributed 77% compared to 23% from acylated ACNs.

Chemical composition of selected edible nut seeds

Venkatachalam, M., S.K. Sathe. 2006. Chemical composition of selected edible nut seeds. J Agric Food Chem. 54, 4705-4714.

Commercially important edible nut seeds were analyzed for chemical composition and moisture sorption. Moisture (1.47-9.51%), protein (7.50-21.56%), lipid (42.88-66.71%), ash (1.16-3.28%), total soluble sugars (0.55-3.96%), tannins (0.01-0.88%), and phytate (0.15-0.35%) contents varied considerably. Regardless of the seed type, lipids were mainly composed of mono- and polyunsaturated fatty acids (>75% of the total lipids). Fatty acid composition analysis indicated that oleic acid (C18:1) was the main constituent of monounsaturated lipids in all seed samples. With the exception of macadamia, linoleic acid (C18:2) was the major polyunsaturated fatty acid. In the case of walnuts, in addition to linoleic acid (59.79%) linolenic acid (C18:3) also significantly contributed toward the total polyunsaturated lipids. Amino acid composition analyses indicated lysine (Brazil nut, cashew nut, hazelnut, pine nut, and walnut), sulfur amino acids methionine and cysteine (almond), tryptophan (macadamia, pecan), and threonine (peanut) to be the first limiting amino acid as compared to human (2-5 year old) amino acid requirements. The amino acid composition of the seeds was characterized by the dominance of hydrophobic (range = 37.16-44.54%) and acidic (27.95-33.17%) amino acids followed by basic (16.16-21.17%) and hydrophilic (8.48-11.74%) amino acids. Trypsin inhibitory activity, hemagglutinating activity, and proteolytic activity were not detected in the nut seed samples analyzed. Sorption isotherms (Aw range = 0.08-0.97) indicated a narrow range for monolayer water content (11-29 mg/g of dry matter). No visible mold growth was evident on any of the samples stored at Aw < 0.53 and 25 °C for 6 months.

Other relevant components of nuts: phytosterols, folate and minerals

Segura, R., C. Javierre, M.A. Lizarraga, E. Ros, 2006. Other relevant components of nuts: phytosterols, folate and minerals. British Journal of Nutrition. 96, Suppl. 2, S36-S44.

Nuts contain significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. Nuts do not contain cholesterol, but they are rich in chemically related phytosterols, a class of compounds that interfere with intestinal cholesterol absorption and thus help lower blood cholesterol. Nuts also contain folate, a B-vitamin necessary for normal cellular function that plays an important role in detoxifying homocysteine, a sulphur-containing amino acid with atherothrombotic properties that accumulates in plasma when folate status is subnormal. Compared to other common foodstuffs, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium and potassium. Like that of most vegetables, the sodium content of nuts is very low. A high intake of calcium, magnesium and potassium, together with a low sodium intake, is associated with protection against bone demineralization, arterial hypertension, insulin resistance, and overall cardiovascular risk. Phytosterols might justify part of the cholesterol-lowering effect of nut intake beyond that attributable to fatty acid exchange, while the mineral richness of nuts probably contributes to the prevention of diabetes and coronary heart disease observed in epidemiological studies in association with frequent nut consumption.

Tocopherols and total phenolics in 10 different nut types

Kornsteiner, M., K.H. Wagner, I. Elmadfa, 2006. Tocopherols and total phenolics in 10 different nut types. Food Chemistry. 98:381-87.

The study was conducted to assess the content of tocopherols (α-, β-, γ- and δ-) and carotenoids (α- and β-carotene, zeaxanthin, lutein, cryptoxanthin and lycopene) in the unsaponifiable matter as well as the amount of total phenols of 10 different types of nuts. Tocopherols and carotenoids were analyzed with HPLC, total phenols photometrically. The mean value of α-tocopherol equivalents ranged from non-detectable (macadamias) to 33.1 mg/100 g extracted oil (hazelnuts). Among all nuts, almonds and hazelnuts had the highest mean α-tocopherol content (24.2 and 31.4 mg/100 g extracted oil, respectively). β- and γ-tocopherols were prevalent in Brazil nuts, cashews, peanuts, pecans, pines, pistachios and walnuts. Mean values oscillated between 5.1 (cashews) and 29.3 (pistachios). Traces of δ-tocopherol (<4 mg/100 g extracted oil) were analyzed in cashews, hazelnuts, peanuts, pecans, pines, pistachios and walnuts. There were no carotenoids detected in the tested nuts with the exception of pistachios. The mean content of total phenolics varied between 32 mg gallic acid equivalents/100 g (pines) and 1625 mg (walnuts). The results show the eterogenic amounts of antioxidants in nuts, which emphasizes the recommendation of a mixed nuts intake.

Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries

Jenab, M., J. Sabate’, N. Slimani, P. Ferrari, M. Mazuir, C. Casagrande, G. Deharveng, A. Tjønneland, A. Olsen, K. Overvad, M.-C. Boutron-Ruault, F. Clavel-Chapelon, H. Boeing, C. Weikert, J. Linseisen, S. Rohrmann, A. Trichopoulou, A. Naska, D. Palli, C. Sacerdote, R. Tumino, A. Mattiello, V. Pala, H.B. Bueno-de-Mesquita, M.C. Ocke’, P.H. Peeters, D. Engeset, G. Skeie, P. Jakszyn, E. Ardanaz, J.R. Quiro’s, M.D. Chirlaque, C. Martinez, P. Amiano, G. Berglund, R. Palmqvist, B. van Guelpen, S. Bingham, T. Key, E. Riboli, 2006. Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries. British Journal of Nutrition. 96, Suppl. 2, S12-S23

Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyze the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as  whole, derived from hidden sources or from spreads. Data was obtained from standardized 24-hour dietary recalls collected from 36,994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts = 4.4%, peanuts = 2.3% and seeds = 1.3%. The data show a clear northern (Sweden: mean intake = 0.15 g/d, average portion size = 15.1 g/d) to southern (Spain: mean intake = 2.99 g/d, average portion size = 34.7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28.5 v. 23.1 g/d, P<0.01) and peanuts (46.1 v. 35.1 g/d, P<0.01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group.

Nuts, body weight and insulin resistance

Rajaram, S., J. Sabate’, 2006. Nuts, body weight and insulin resistance. British Journal of Nutrition. 96, Suppl. 2, S79-S86.

Traditionally, nuts have been considered a staple food, but because of their high energy and fat content are not considered good for body weight control or insulin sensitivity. Frequent consumption of nuts reduces the risk of coronary artery disease and type-2 diabetes and nut-enriched diets favorably alter blood lipids in normal and hypercholesterolemic individuals under controlled and free-living dietary conditions. However, whether or not frequent consumption of nuts can cause weight gain and impair insulin sensitivity is not fully understood. Review of the available data to date suggests that adding nuts to habitual diets of free-living individuals does not cause weight gain. In fact, nuts have a tendency to lower body weight and fat mass. In the context of calorie-restricted diets, adding nuts produces a more lasting and greater magnitude of weight loss among obese subjects while improving insulin sensitivity. Further studies are needed to clarify the effect of long-term ($ year) consumption of nuts on body weight and their role in altering insulin sensitivity both in normal and type-2 diabetics. In the meantime, there is sufficient evidence to promote the inclusion of nuts as part of healthy diets.