Dismore, M.L., D.B. Haytowitz, S.E. Gebhardt, J.W. Peterson, S.L. Booth, 2003. Vitamin K content of nuts and fruits in the US diet. J Am Diet Assoc. 103:1650-1652.
Assessment of vitamin K dietary intakes has been limited by incomplete vitamin K food composition data for the US food supply. The phylloquinone (vitamin K1) concentrations of nuts (n=76) and fruits (n=215) were determined by high-performance liquid chromatography. Each sample represented a composite of units obtained from 12 to 24 outlets, which provided geographic representation of the US food supply. With the exception of pine nuts and cashews, which contain 53.9 and 34.8 µg of phylloquinone per 100 g of nut, respectively, nuts are not important dietary sources of vitamin K. Similarly, most fruits are not important sources of vitamin K, with the exception of some berries, green fruits, and prunes. Menu planning for patients on warfarin can include a healthy diet including fruits and nuts without compromising the stability of their oral anticoagulation therapy.
Wood, R.A., 2003. The natural history of food allergy. Pediatrics. 111:1631–1637.
The natural history of food allergy refers to the development of food sensitivities as well as the possible loss of the same food sensitivities over time. Most food allergy is acquired in the first 1 to 2 years of life, whereas the loss of food allergy is a far more variable process, depending on both the individual child and the specific food allergy. For example, whereas most milk allergy is outgrown over time, most allergies to peanuts and tree nuts are never lost. In addition, whereas some children may lose their milk allergy in a matter of months, the process may take as long as 8 or 10 years in other children. This review provides an overview of the natural history of food allergy and provides specific information on the natural course of the most common childhood food allergies.
Roux, K.H., S.S. Teuber, S.K. Sathe, 2003. Tree nut allergens. Int Arch Allergy Immunol. 131:234–244.
Allergic reactions to tree nuts can be serious and life threatening. Considerable research has been conducted in recent years in an attempt to characterize those allergens that are most responsible for allergy sensitization and triggering. Both native and recombinant nut allergens have been identified and characterized and, for some, the IgE-reactive epitopes described. Some allergens, such as lipid transfer proteins, profilins, and members of the Bet v 1-related family, represent minor constituents in tree nuts. These allergens are frequently cross-reactive with other food and pollen homologues, and are considered panallergens. Others, such as legumins, vicilins, and 2S albumins, represent major seed storage protein constituents of the nuts. The allergenic tree nuts discussed in this review include those most commonly responsible for allergic reactions such as hazelnut, walnut, cashew, and almond as well as those less frequently associated with allergies including pecan, chestnut, Brazil nut, pine nut, macadamia nut, pistachio, coconut, Nangai nut, and acorn.
Teuber, S.S., S.S. Comstock, S.K. Sathe, K.H. Roux, 2003. Tree nut allergy. Current Allergy and Asthma Reports. 3:54–61.
Tree nuts are clinically associated with severe immunoglobulin E–mediated systemic allergic reactions independent of pollen allergy and with reactions that are usually confined to the oral mucosa in patients with immunoglobulin E directed toward cross-reacting pollen allergens. The latter reactions can progress to severe and life-threatening episodes in some patients. Many patients with severe tree nut allergy are co-sensitized to peanut. Clinical studies on cross-reactivity between the tree nuts are few in number, but based on reports to date, avoidance of the other tree nuts once sensitivity is diagnosed appears prudent unless specific challenges are performed to ensure clinical tolerance. Even then, great care must be taken to avoid cross-contamination. As with other severe food allergies, a recurrent problem in clinical management is the failure of physicians to prescribe self-injectable epinephrine to patients who are at risk of anaphylaxis.
Jenkins, D.J.A., C.W.C. Kendall, A. Marchie, D. Faulkner, J.M.W. Wong, R. de Souza, A. Emam, T.L. Parker, E. Vidgen, K.G. Lapsley, E.A. Trautwein, R.G. Josse, L.A. Leiter, P.W. Connelly, 2003. Effects of a dietary portfolio of cholesterol-lowering foods vs. lovastatin on serum lipids and c-reactive protein. JAMA.290:502-10.
Context To enhance the effectiveness of diet in lowering cholesterol, recommendations of the Adult Treatment Panel III of the National Cholesterol Education Program emphasize diets low in saturated fat together with plant sterols and viscous fibers, and the American Heart Association supports the use of soy protein and nuts. Objective To determine whether a diet containing all of these recommended food components leads to cholesterol reduction comparable with that of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). Design Randomized controlled trial conducted between October and December 2002. Setting and Participants Forty-six healthy, hyperlipidemic adults (25 men and 21 postmenopausal women) with a mean (SE) age of 59 (1) years and body mass index of 27.6 (0.5), recruited from a Canadian hospital-affiliated nutrition research center and the community. Interventions Participants were randomly assigned to undergo 1 of 3 interventions on an outpatient basis for 1 month: a diet very low in saturated fat, based on milled whole-wheat cereals and low-fat dairy foods (n=16; control); the same diet plus lovastatin, 20 mg/d (n=14); or a diet high in plant sterols (1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers (9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (n=16; dietary portfolio). Main Outcome Measures Lipid and C-reactive protein levels, obtained from fasting blood samples; blood pressure; and body weight; measured at weeks 0, 2, and 4 and compared among the 3 treatment groups. Results The control, statin, and dietary portfolio groups had mean (SE) decreases in low-density lipoprotein cholesterol of 8.0% (2.1%) (P=.002), 30.9% (3.6%) (P<.001), and 28.6% (3.2%) (P<.001), respectively. Respective reductions in C-reactive protein were 10.0% (8.6%) (P=.27), 33.3% (8.3%) (P=.002), and 28.2% (10.8%) (P=.02). The significant reductions in the statin and dietary portfolio groups were all significantly different from changes in the control group. There were no significant differences in efficacy between the statin and dietary portfolio treatments. Conclusion In this study, diversifying cholesterol-lowering components in the same dietary portfolio increased the effectiveness of diet as a treatment of hypercholesterolemia.
Jenkins, D.J.A., C.W.C Kendall, A. Marchie, D. Faulkner, E. Vidgen, K.G. Lapsley, E.A. Trautwein, T.L. Parker, R.G. Josse, L.A. Leiter, P.W. Connelly, 2003. The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia. Metabolism. 52:11:1478-83.
Reductions in low-density lipoprotein-cholesterol (LDL-C) result from diets containing almonds, or diets that are either low in saturated fat or high in viscous fibers, soy proteins, or plant sterols. We have therefore combined all of these interventions in a single diet (portfolio diet) to determine whether cholesterol reductions could be achieved of similar magnitude to those reported in recent statin trials which reduced cardiovascular events. Twenty-five hyperlipidemic subjects consumed either a portfolio diet (n = 13), very low in saturated fat and high in plant sterols (1.2 g/l,000 kcal), soy protein (16.2 g/1,000 kcal), viscous fibers (8.3 g/1,000 kcal), and almonds (16.6 g/1,000 kcal), or a low-saturated fat diet (n=12) based on whole-wheat cereals and low-fat dairy foods. Fasting blood, blood pressure, and body weight were obtained at weeks 0, 2, and 4 of each phase. LDL-C was reduced by 12.1% ± 2.4% (P < .001) on the low-fat diet and by 35.0% ± 3.1% (P < .001) on the portfolio diet, which also reduced the ratio of LDL-C to high-density lipoprotein-cholesterol (HDL-C) significantly (30.0% ± 3.5%; P< .001). The reductions in LDL-C and the LDL:HDL-C ratio were both significantly lower on the portfolio diet than on the control diet (P < .001 and P < .001, respectively). Mean weight loss was similar on test and control diets (1.0 kg and 0.9 kg, respectively). No difference was seen in blood pressure, HDL-C, serum triglycerides, lipoprotein (a)[Lp(a)], or homocysteine concentrations between diets. Combining a number of foods and food components in a single dietary portfolio may lower LDL-C similarly to statins and so increase the potential effectiveness of dietary therapy.
Davis, P., C.K. Iwahashi, W. Yokoyama, 2003. Whole almonds activate gastrointestinal (GI) tract anti-proliferative signaling in APCmin (multiple intestinal neoplasia) mice. FASEB Journal. 17(5):A1153.
Most recently, researchers used a genetic mouse model and examined the effects of whole almonds versus almond-component-containing diets on the APC min mouse. Whole almonds activated GI tract anti-proliferative signaling, which might give a mechanistic explanation of almonds’ chemo-protective effect.
Sabaté, J., 2003. Nut consumption and body weight. Am J Clin Nutr. 78(suppl):647S-50S.
Frequent nut consumption is associated with lower rates of coronary artery disease (CAD). Also, nut-rich diets improve the serum lipid profile of participants in dietary intervention trials. However, nuts are fatty foods, and in theory their regular consumption may lead to body weight gain. Because obesity is a major public health problem and a risk factor for CAD, clinicians and policy makers ponder several questions. Will hypercholesterolemic patients advised to consume nuts gain weightý Is recommending increased nut consumption to the general population for CAD prevention sound public health adviceý Epidemiologic studies indicate an inverse association between frequency of nut consumption and body mass index. In well-controlled nut feeding trials, no changes in body weight were observed. Some studies on free-living subjects in which no constraints on body weight are imposed show a non-significant tendency to lower weight while subjects are on the nut diets. In another line of evidence, preliminary data indicate that subjects on nut-rich diets excrete more fat in stools. Further research is needed to study the effects of nut consumption on energy balance and body weight. In the meantime, the available cumulative data do not indicate that free-living people on self-selected diets including nuts frequently have a higher body mass index or a tendency to gain weight.
García-Lorda, P. I. M. Rangil, J. Salas-Salvadó, 2003. Nut consumption, body weight and insulin resistance. Eur J Clin Nutr. 57(suppl 1):S8-S11.
The beneficial effects of nuts on cardiovascular health are well known. However, since nuts provide a high caloric and fat content, some concern exists regarding a potential detrimental effect on body weight and insulin resistance. The current data available did not support such a negative effect of nut consumption on the short term or when nuts are included on diets that meet energy needs. Furthermore, there is some intriguing evidence that nuts can help to regulate body weight and protect against type II diabetes. This, however, still has to be proved and more research is needed to address the specific effects of nuts on satiety, energy balance, body weight and insulin resistance.
Wien, M.A., J.M. Sabaté, D.N. Ikle, S.E. Cole, and F.R. Kandeel, 2003. Almonds vs. complex carbohydrates in a weight reduction program. Intl J Obesity. 27:1365-72.
OBJECTIVE: To evaluate the effect of an almond-enriched (high monounsaturated fat, MUFA) or complex carbohydrate-enriched (high carbohydrate) formula-based low-calorie diet (LCD) on anthropometric, body composition and metabolic parameters in a weight reduction program. DESIGN: A randomized, prospective 24-week trial in a free-living population evaluating two distinct macronutrient interventions on obesity and metabolic syndrome-related parameters during weight reduction. SUBJECTS: In total, 65 overweight and obese adults (age: 27–79 y, body mass index (BMI): 27–55 kg/m2). INTERVENTION: A formula-based LCD enriched with 84 g/day of almonds (almond-LCD; 39% total fat, 25% MUFA and 32% carbohydrate as percent of dietary energy) or self-selected complex carbohydrates (CHO-LCD; 18% total fat, 5% MUFA and 53% carbohydrate as percent of dietary energy) featuring equivalent calories and protein. MAIN OUTCOME MEASUREMENTS: Various anthropometric, body composition and metabolic parameters at baseline, during and after 24 weeks of dietary intervention. RESULTS: LCD supplementation with almonds, in contrast to complex carbohydrates, was associated with greater reductions in weight/BMI (-18 vs -11%), waist circumference (WC) (-14 vs -9%), fat mass (FM) (-30 vs -20%), total body water (-8 vs -1%) and systolic blood pressure (-11 vs 0%), P=0.0001–0.05. A 62% greater reduction in weight/BMI, 50% greater reduction in WC and 56% greater reduction in FM were observed in the almond-LCD as compared to the CHO-LCD intervention. Ketone levels increased only in the almond-LCD group (+260 vs 0%, P<0.02). High-density lipoprotein cholesterol (HDL-C) increased in the CHO-LCD group and decreased in the almond-LCD group (+15 vs -6%, P=0.05). Glucose, insulin, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and LDL-C to HDL-C ratio decreased significantly to a similar extent in both dietary interventions. Homeostasis model analysis of insulin resistance (HOMAIR) decreased in both study groups over time (almond-LCD: -66% and CHO-LCD: -35%, P<0.0001). Among subjects with type 1 diabetes, diabetes medication reductions were sustained or further reduced in a greater proportion of almond-LCD as compared to CHO-LCD subjects (96 vs 50%, respectively). CONCLUSION: Our findings suggest that an almond-enriched LCD improves a preponderance of the abnormalities associated with the metabolic syndrome. Both dietary interventions were effective in decreasing body weight beyond the weight loss observed during long-term pharmacological interventions; however, the almond-LCD group experienced a sustained and greater weight reduction for the duration of the 24-week intervention. Almond supplementation of a formula-based LCD is a novel alternative to self-selected complex carbohydrates and has a potential role in reducing the public health implications of obesity.
