Wang, J., M.A. Lee Bravatti, E.J. Johnson, G. Raman, 2020. Daily almond consumption in cardiovascular disease prevention via LDL-C change in the U.S. population: a cost effectiveness analysis. BMC Public Health. 20:558 https://doi.org/10.1186/s12889-020-08642-4
Background: Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 oz (42.5 g) of nut intake may reduce the risk of cardiovascular disease. Previous studies have focused on the cost-effectiveness of other foods or dietary factors on primary cardiovascular disease prevention, yet not in almond consumption. This study aimed to examine the cost effectiveness of almond consumption in cardiovascular disease primary prevention. Perspective & Setting: This study assessed the cost-effectiveness of consuming 42.5 g of almond from the U.S. healthcare sector perspective.
Methods: A decision model was developed for 42.5 g of almond per day versus no almond consumption and cardiovascular disease in the U.S. population. Parameters in the model were derived from the literature, which included the probabilities of increasing low-density lipoprotein cholesterol, developing acute myocardial infarction and stroke, treating acute myocardial infarction, dying from the disease and surgery, as well as the costs of the disease and procedures in the U.S. population, and the quality-adjusted life years. The cost of almonds was based
on the current price in the U.S. market. Sensitivity analyses were conducted for different levels of willingness-to-pay, the probabilistic sensitivity analysis, ten-year risk prevention, different costs of procedures and almond prices, and patients with or without cardiovascular disease.
Results: The almond strategy had $363 lower cost and 0.02 higher quality-adjusted life years gain compared to the non-almond strategy in the base-case model. The annual net monetary benefit of almond consumption was $1421 higher per person than no almond consumption, when the willingness to pay threshold was set at $50,000 for annual health care expenditure. Almond was more cost-effective than non-almond in cardiovascular disease prevention in all the sensitivity analyses. Conclusion: Consuming 42.5 g of almonds per day is a cost-effective approach to prevent cardiovascular disease in the short term and potentially in the long term.
Freitas-Simoes, T.M., M. Wagner, C. Samieri, A. Sala-Vila, F. Grodstein, 2020. Consumption of Nuts at Midlife and Healthy Aging in Women. J Aging Res. https://doi.org/10.1155/2020/5651737.
Background: Nut consumption may reduce age-related diseases and lead to better health and well-being in aging. Many conditions of aging develop over decades, and thus earlier lifestyle factors may particularly influence later health. Methods: In 1998 and 2002, we administered food frequency questionnaires to assess nut consumption (peanuts, walnuts, and other nuts and peanut butter) in women in the Nurses’ Health Study in their 50 s/early 60 s. In 2012, those who survived beyond 65 years with no chronic diseases, no reported memory impairment, no physical disabilities, and intact mental health were considered “healthy agers.” We used multivariable logistic regression to estimate odds ratios for healthy versus usual aging, controlled for sociodemographic, behavioral, dietary, and other potential confounding factors. Results: Of 33,931 participants at midlife, 16% became “healthy agers.” After age adjustment, we observed a significant association between total nut consumption at midlife and higher odds of healthy aging, with strongest associations observed excluding peanut butter (odds ratio (OR) = 1.46, 95% confidence interval (CI) 1.32–1.62, ≥3 servings/week versus none). Findings were attenuated after further control for covariates, including overall diet quality (OR = 1.14, 95% CI 1.02–1.28, P trend = 0.05). For nut types, we found statistically significantly higher odds of healthy aging across peanuts, walnuts, and other nuts after age adjustment. After full control for confounders, only walnut consumption remained associated with healthy aging (P trend = 0.0001); for example, the OR was 1.20 (95% CI 1.00–1.44) for ≥2 servings/week versus none. Conclusions: Women consuming nuts at midlife have a greater likelihood of overall health and well-being at older ages. Nut consumption may represent a simple intervention to explore and promote healthy aging.
Altamimi, M., S. Zidan, M. Badrasawi, 2020. Effect of tree nuts consumption on serum lipid profile in hyperlipidemic individuals: A systematic review. Nutrition and Metabolic Insights. 13: 1–10.
Many epidemiological studies have regularly connected nuts intake with decreased risk for coronary heart disease. The primary mechanism by which nuts protect against cardiovascular disease is through the improvement of lipid and apolipoprotein profile. Therefore, numerous dietary intervention studies investigated the impact of nut consumption on blood lipid levels. Many studies have shown that nut intake can enhance the lipid profile in a dose-response way among individuals with increased serum lipids. This systematic review examines the effectiveness of nuts on the lipid profile among patients with dyslipidemia from different age groups. A total of 29 interventional studies from 5 databases met the inclusion criteria. In all, 20 studies were randomized controlled clinical trials, whereas 9 were crossover-controlled clinical trials. Participants included in the studies were different in terms of age, sex and, serum lipid profile. The studies were inconsistent in the type of tree nuts, duration, dose, and the nut forms. All studies indicated changes in the lipid profile after the intervention particularly on the total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol/high-density lipoprotein. Interventional periods ranged from 3 weeks up to 12 months with doses ranged from 15 to 126gm. In conclusion, this review provides an evidence of favorable effect of nuts consumption of serum lipid profile.
Esquius, L., R. Segura, G.R. Oviedo, M. Massip-Salcedo, C. Javierre, 2020. Effect of almond supplementation on non-esterified fatty acid values and exercise performance. Nutrients. 12, 635; doi:10.3390/nu12030635
Several studies have investigated the effects of fat intake before exercise on subsequent substrate oxidation and exercise performance. While some studies have reported that unsaturated fatty acid supplementation slightly increases fat oxidation, the changes have not been reflected in the maximum oxygen uptake or in other performance and physiological parameters. We selected almonds as a fatty acid (FA) source for acute supplementation and investigated their effect on non-esterified fatty acid (NEFA) values and exercise performance. Five physically active male subjects (age 32.9 ± 12.7 years, height 178.5 ± 3.3 cm, and weight 81.3 ± 9.7 kg) were randomly assigned to take an almond or placebo supplement 2 h before participating in two cycling resistance training sessions separated by an interval of 7–10 days. Their performance was evaluated with a maximal incremental test until exhaustion. Blood samples collected before, during, and after testing were biochemically analysed. The results indicated a NEFA value average increase of 0.09 mg·dL−1 (95% CI: 0.05–0.14; p < 0.001) after active supplement intake and enhanced performance (5389 ± 1795 W vs. placebo 4470 ± 2053 W, p = 0.043) after almond supplementation compared to the placebo. The almond supplementation did not cause gastrointestinal disturbances. Our study suggests that acute almond supplementation 2 h before exercise can improve performance in endurance exercise in trained subjects.
Li, Z., A.S. Bhagavathula, M. Batavia, C. Clark, H.M. Abdulazeem, J. Rahmani, F. Yin, 2020. The effect of almonds consumption on blood pressure: A systematic review and dose-response meta-analysis of randomized control trials. 32(2):1757-1763.
Almond is rich in antioxidants and phytochemicals such as methylquercetin, protocatechuic acid, catechin, flavonoids, p-hydroxybenzoic acid, resveratrol, vanillic acid, and kaempferol. The aim of the present study was to systematically review and dose-response meta-analyses the effects of almond consumption on systolic and diastolic blood pressure (SBP/DBP), respectively, in Randomized Controlled Trials (RCTs). A systematic search was performed in PubMed/MEDLINE, web of sciences and SCOPUS by 2 researchers, independently to identify randomised controlled trials up to July 2019. There were no time or language restrictions. PRISMA guidelines were followed in conducting this meta-analysis. Fifteen studies with 21 arms, containing 853 participants, reported SBP as an outcome measure. Pooled results showed significant reduction in SBP (WMD: -0.90 mmHg, 95% CI: -1.74, -0.06, Pheterogeneity = 0.94) by almond intervention. There is no significant effect from almond consumption on DBP (WMD: 0.67 mmHg, 95% CI: -1.93, 0.60, Pheterogeneity = 0.001). Meta-regression analysis showed dose of used almond (g/d) as source of heterogeneity between results of DBP. In conclusion results of this meta-analysis showed reduce effect of almonds on systolic blood pressure.
Ren, M., H. Zhang, J. Qi, A. Hu, Q. Jiang, Y. Hou, Q. Feng, O. Ojo, X. Wang, 2020. An almond-based low carbohydrate diet improves depression and glycometabolism in patients with Type 2 diabetes through modulating gut microbiota and GLP-1: A randomized controlled trial. Nutrients. 12(10):3036. doi: 10.3390/nu12103036.
Background: A low carbohydrate diet (LCD) is more beneficial for the glycometabolism in type 2 diabetes (T2DM) and may be effective in reducing depression. Almond, which is a common nut, has been shown to effectively improve hyperglycemia and depression symptoms. This study aimed to determine the effect of an almond-based LCD (a-LCD) on depression and glycometabolism, as well as gut microbiota and fasting glucagon-like peptide 1 (GLP-1) in patients with T2DM. Methods: This was a randomized controlled trial which compared an a-LCD with a low-fat diet (LFD). Forty-five participants with T2DM at a diabetes club and the Endocrine Division of the First and Second Affiliated Hospital of Soochow University between December 2018 to December 2019 completed each dietary intervention for 3 months, including 22 in the a-LCD group and 23 in the LFD group. The indicators for depression and biochemical indicators including glycosylated hemoglobin (HbA1c), gut microbiota, and GLP-1 concentration were assessed at the baseline and third month and compared between the two groups. Results: A-LCD significantly improved depression and HbA1c (p <0.01). Meanwhile, a-LCD significantly increased the short chain fatty acid (SCFAs)-producing bacteria Roseburia, Ruminococcus and Eubacterium. The GLP-1 concentration in the a-LCD group was higher than that in the LFD group (p <0.05). Conclusions: A-LCD could exert a beneficial effect on depression and glycometabolism in patients with T2DM. We speculate that the role of a-LCD in improving depression in patients with T2DM may be associated with it stimulating the growth of SCFAs-producing bacteria, increasing SCFAs production and GPR43 activation, and further maintaining GLP-1 secretion. In future studies, the SCFAs and GPR43 activation should be further examined.
Trombetta, D., A. Smeriglio, M. Denaro, R. Zagami, M. Tomassetti, R. Pilolli, E. De Angelis, L. Monaci, G. Mandalari, 2020. Understanding the fate of almond (Prunus dulcis (Mill.) D.A. Webb) oleosomes during simulated digestion. Nutrients. 12, 3397; doi:10.3390/nu12113397.
Background: Almond kernels contain phytochemicals with positive health effects in relation to heart disease, diabetes and obesity. Several studies have previously highlighted that almond cell wall encapsulation during digestion and particle size are factors associated with these benefits. In the present study, we have characterized almond oleosomes, natural oil droplets abundant in plants, and we have investigated their integrity during simulated gastrointestinal digestion. Methods: Oleosomes were visualized on the almond seed surface by imaging mass spectrometry analysis, and then characterized in terms of droplet size distribution by dynamic light scattering and protein profile by liquid chromatography high-resolution tandem mass spectrometry analysis. Results: The almond oleosomes’ distribution remained monomodal after in vitro mastication, whereas gastric and duodenal digestion led to a bimodal distribution, albeit characterized mainly by a prevalent population with a droplet size decrease related to a rearrangement of the protein profile. Oleosins, structural proteins found in plant oil bodies, persisted unchanged during simulated mastication, with the appearance of new prunin isoforms after gastric and duodenal digestion. Conclusions: The rearrangement of the protein profile could limit lipid bioaccessibility. The data improve our understanding of the behavior of almond lipids during gastrointestinal digestion, and may have implications for energy intake and satiety imparted by almonds.
G. Mandalari, 2020. Symposium ‘understanding and managing satiety: processes and opportunities.’ J Nutr Sci. 9:e42. doi: 10.1017/jns.2020.32.
This brief report summarises a framework for understanding satiety presented at the 13th European Nutrition Conference, FENS 2019 – Malnutrition in an Obese World: European Perspectives. Aspects of satiety phenotyping and role of food hedonics in satiation are considered in the context of appetite control and obesity. Almonds are evaluated for their unique composition and structure which affect their behaviour in the human gastrointestinal tract. Their role in appetite control and management of satiety has been explored.
S. Carter, A.M. Hill, C. Yandell, J.D. Buckley, S.-Y. Tan, G.B. Rogers, J. Childs, M. Matheson, K. Lamb, S. Ward, T.R. Stanton, F. Fraysse, A.P. Hills, A.M. Coates, 2020. Study protocol for a 9-month randomised controlled trial assessing the effects of almonds versus carbohydrate-rich snack foods on weight loss and weight maintenance. BMJ Open. 10:e036542. doi:10.1136/ bmjopen-2019-036542.
Introduction: Epidemiological studies indicate an inverse association between nut consumption and body mass index (BMI). However, clinical trials evaluating the effects of nut consumption compared with a nut-free diet on adiposity have reported mixed findings with some studies reporting greater weight loss and others reporting no weight change. This paper describes the rationale and detailed protocol for a randomised controlled trial assessing whether the inclusion of almonds or carbohydrate-rich snacks in an otherwise nut-free energy-restricted diet will promote weight loss during 3 months of energy restriction and limit weight regain during 6 months of weight maintenance. Methods and analysis: One hundred and thirty-four adults aged 25-65 years with a BMI of 27.5-34.9 kg/m2 will be recruited and randomly allocated to either the almond-enriched diet (AED) (15% energy from almonds) or a nut-free control diet (NFD) (15% energy from carbohydrate-rich snack foods). Study snack foods will be provided. Weight loss will be achieved through a 30% energy restriction over 3 months, and weight maintenance will be encouraged for 6 months by increasing overall energy intake by ~120-180 kcal/day (~500-750kJ/day) as required. Food will be self-selected, based on recommendations from the study dietitian. Body composition, resting energy expenditure, total daily energy expenditure (via doubly labelled water), physical activity, appetite regulation, cardiometabolic health, gut microbiome, liver health, inflammatory factors, eating behaviours, mood and personality, functional mobility and pain, quality of life and sleep patterns will be measured throughout the 9-month trial. The effects of intervention on the outcome measures over time will be analysed using random effects mixed models, with treatment (AED or NFD) and time (baseline, 3 months and 9 months) being the between and within factors, respectively in the analysis.
Dikariyanto, V., L. Smith, P.J. Chowienczyk, S.E. Berry, W.L. Hall, 2020. Snacking on whole almonds for six weeks increases heart rate variability during mental stress in healthy adults: A randomized controlled trial. Nutrients. 12,1828; doi:10.3390/nu12061828.
Cardiac autonomic regulation can be indirectly measured by heart rate variability (HRV). Low HRV, which can be induced by mental stress, is a predictor of risk of sudden cardiac death. Few studies have investigated cause-and-effect relationships between diet and HRV. Nut consumption is associated with CVD risk reduction, but the impact on HRV, particularly in response to stress, is unclear. Men and women (30–70 y) with above average risk of developing CVD were randomly assigned in a 6-week randomized, controlled, parallel arm trial to consume either whole almond or isocaloric control snacks (20% of daily estimated energy requirement). Control snacks contained the average nutrient profile of UK snacks. Five-minute periods of supine heart rate (HR) and HRV were measured at resting and during mental stress (Stroop color-word test) at baseline and six weeks. High frequency (HF) power, which reflects parasympathetic regulation of HR, was increased following almonds during the mental stress task relative to control (mean difference between groups 124 ms2; 95% CI 11, 237; p = 0.031, n = 105), but other indices were unaffected. Snacking on whole almonds instead of typical snacks may reduce risk of CVD partly by ameliorating the suppression of HRV during periods of mental stress.
