Casas-Agustench, P., P. Lopez-Uriarte, M. Bullo’, E. Ros, J.J. Cabre’-Vila, J. Salas-Salvado’, 2009. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutrition, Metabolism & Cardiovascular Diseases. doi:10.1016/j.numecd.2009.08.005.
Background and aims: Knowledge of the effect of nut consumption on metabolic syndrome (MetS) components is limited. We assessed the effects of nut intake on adiposity, serum lipids, insulin resistance, and inflammatory biomarkers in patients with MetS. Methods and results: In a randomized, parallel-group, 12-week feeding trial, 50 patients with MetS were given recommendations for a healthy diet with or without supplementation with 30 g/day of raw nuts (15 g walnuts, 7.5 g almonds and 7.5 g hazelnuts) (Nut and Control diet groups, respectively). Adiposity measures, serum lipids, insulin, Homeostasis Model Assessment (HOMA), interleukin-6 (IL-6) and other inflammatory biomarkers, and 48-h fecal fat were determined basally and at study’s completion. Moderate weight loss, decreased adiposity, and lower blood pressure occurred similarly after both diets. The Control, but not the Nut diet, was associated with significant (P < 0.05) reduction of LDL-cholesterol, with mean changes of -0.36 versus -0.13 mmol/L, respectively (between-group differences, P=0.154). The Nut diet reduced fasting insulin by 2.60 µU/mL (95% CI, -4.62 to -0.59) and HOMA-insulin resistance by 0.72 (-1.28 to -0.16) (P < 0.05 versus Control diet; both). Among inflammatory markers, the Nut diet resulted in changes of median plasma IL-6 of -1.1 ng/L (-2.7 to -0.1; P=0.035 versus Control diet), but adjustment for weight loss attenuated the significance of the association. Stool fat decreased with the Control diet and slightly increased with the Nut diet (P < 0.05 for between-group differences). Conclusion: Patients with MetS show decreased lipid responsiveness but improved insulin sensitivity after daily intake of 30 g of mixed nuts.
Bes-Rastrollo, M., N.M. Wedick, M.A. Martinez-Gonzalez, T.Y. Li, L. Sampson, F.B. Hu, 2009. Prospective study of nut consumption, long-term weight change, and obesity risk in women. Am J Clin Nutr 89:1-7.
Background: Data concerning the long-term association between nut consumption and weight change in a free-living population are sparse. Objective: The objective was to determine the relation between nut consumption and long-term weight change. Design: The participants were 51,188 women in the Nurses’ Health Study II aged 20-45 y, who had no cardiovascular disease, diabetes, or cancer. We prospectively evaluated the dietary intake of nuts and subsequent weight changes from 1991 to 1999. Results: Women who reported eating nuts _2 times/wk had a slightly less mean (6 SE) weight gain (5.04 6 0.12 kg) than did women who rarely ate nuts (5.55 6 0.04 kg) (P for trend , 0.001). For the same comparison, when total nut consumption was subdivided into peanuts and tree nuts, the results were similar (i.e., less weight gain in women eating either peanuts or tree nuts _2 times/wk). The results were similar in normal-weight, overweight, and obese participants. In multivariate analyses in which lifestyle and other dietary factors were controlled for, we found that greater nut consumption (_2 times/wk compared with never/almost never) was associated with a slightly lower risk of obesity (hazard ratio: 0.77; 95% CI: 0.57, 1.02; P for trend ¼ 0.003). Conclusions: Higher nut consumption was not associated with greater body weight gain during 8 y of follow-up in healthy middle aged women. Instead, it was associated with a slightly lower risk of weight gain and obesity. The results of this study suggest that incorporating nuts into diets does not lead to greater weight gain and may help weight control.
Alasalvar, C., F. Shahidi, 2009. Natural antioxidants in tree nuts. Eur. J. Lipid Sci. Technol. 111:1056-1062
The levels of natural antioxidants and phytochemicals present in tree nuts are reported. Where possible, the health claims by Food and Drug Administration and European Food Safety Authority and health effects of tree nuts are provided. The content and recommended dietary allowances of nutrient antioxidants (such as vitamins A, C, E, and the mineral selenium) present in various tree nuts are compared. Antioxidant activity and phytochemicals present among tree nuts have been thoroughly reviewed. Research findings from over 65 references, many of which have been published within the last 10 years, have been compiled and reported.
Sabate’, J., Y. Ang, 2009. Nuts and health outcomes: new epidemiologic evidence. Am J Clin Nutr89(suppl):1643S-8S.
This article reviews recent epidemiologic evidence on nut intake and health outcomes. It focuses on studies in which nut consumption is directly assessed or when nuts are included in a dietary score or pattern. Epidemiologic studies have been remarkably consistent in showing an association between nut consumption and a reduced risk of coronary heart disease (CHD). Some evidence has emerged recently to suggest health-protective benefits of nuts other than CHD. Frequent nut intake probably reduces risk of diabetes mellitus among women, but its effects on men are unknown. Evidence on the anticarcinogenic effects of nuts is somewhat limited because studies in the past 2 decades have examined only 3 tumor sites, and the benefits appear to be manifested only in women. However, the protective benefits of frequent nut consumption on gallstone diseases are observed in both sexes. Long-term nut consumption is linked with lower body weight and lower risk of obesity and weight gain. A dietary pattern or score that includes nuts is consistently related with beneficial health outcomes, and this provides an indirect evidence of the salutary benefits of nut consumption. More longitudinal studies are needed to clarify the possible effects of nuts on diseases other than CHD.
Raw, D., B. Lockwood, 2009. The health benefits of nuts. NUTRAfoods. 8(3)7-14.
Overall, nuts can belp reduce the certain risk factors associated with CVD and other chronic diseases, helping to prevent disease and promote health.
Li, T.Y., A.M. Brennan, N.M. Wedick, C. Mantzoros, N. Rifai, F.B. Hu, 2009. Regular Consumption of Nuts Is Associated with a Lower Risk of Cardiovascular Disease in Women with Type 2 Diabetes. J. Nutr.139:1333-1338.
Higher nut consumption has been associated with lower risk of coronary heart disease (CHD) events in several epidemiologic studies. The study examined the association between intake of nuts and incident cardiovascular disease (CVD) in a cohort of women with type 2 diabetes. For the primary analysis, there were 6309 women with type 2 diabetes who completed a validated FFQ every 2-4 y between 1980 and 2002 and were without CVD or cancer at study entry. Major CVD events included incident myocardial infarction (MI), revascularization, and stroke. During 54,656 person-years of follow-up, there were 452 CHD events (including MI and revascularization) and 182 incident stroke cases. Frequent nut and peanut butter consumption was inversely associated with total CVD risk in age-adjusted analyses. After adjustment for conventional CVD risk factors, consumption of at least 5 servings/wk of nuts or peanut butter [serving size, 28 g (1 ounce) for nuts and 16 g (1 tablespoon) for peanut butter] was significantly associated with a lower risk of CVD (relative risk = 0.56; 95% CI: 0.36-0.89). Furthermore, when we evaluated plasma lipid and inflammatory biomarkers, we observed that increasing nut consumption was significantly associated with a more favorable plasma lipid profile, including lower LDL cholesterol, non-HDL cholesterol, total cholesterol, and apolipoprotein-B-100 concentrations. However, we did not observe significant associations for HDL cholesterol or inflammatory markers. These data suggest that frequent nut and peanut butter consumption is associated with a significantly lower CVD risk in women with type 2 diabetes.
Ros, E., 2009. Nuts and novel biomarkers of cardiovascular disease. Am J Clin Nutr. 89(suppl):1649S-56S.
Nuts are energy-dense foods, rich in total fat and unsaturated fatty acids. The favorable fatty acid profile probably contributes to the beneficial effects of nut consumption observed in epidemiologic studies (prevention of coronary heart disease and diabetes) and feeding trials (cholesterol lowering). Besides fat, the complex matrices of nuts contain many bioactive compounds: vegetable protein, fiber, minerals, tocopherols, and phenolic compounds. By virtue of their unique composition, nuts are likely to benefit newer cardiovascular risk biomarkers, such as LDL oxidizability, soluble inflammatory molecules, and endothelial dysfunction. Protection of LDL oxidation by nut intake has been documented in some, but not all, clinical studies. In one study, feeding one daily serving of mixed nuts was associated with lower oxidized LDL concentrations. Regarding inflammation, cross-sectional studies have shown that nut consumption is associated with lower concentrations of circulating inflammatory molecules and higher plasma adiponectin, a potent anti-inflammatory adipokine. Clinical studies with nuts have documented reduced inflammatory cytokine concentrations but no consistent changes of C-reactive protein. Only walnuts have been formally tested for effects on endothelial function. After both walnut diets and single walnut meals, favorable vasoreactivity changes have been observed. Walnut consumption also reduced expression of endothelin 1, a potent endothelial activator, in an animal model of accelerated atherosclerosis. Beneficial effects on vascular reactivity may be ascribed to several constituents of walnuts: L-arginine, the precursor of nitricoxide, a-linolenic acid, and phenolic antioxidants. Although more studies are warranted, the emerging picture is that nut consumption beneficially influences cardiovascular risk beyond cholesterol lowering.
Lopez-Uriarte. P., M. Bullo, P. Casas-Agustench, N. Babio, J. Salas-Salvado, 2009. Nuts and oxidation: a systematic review. Nutrition Reviews. 67(9):497-508.
In recent years, nuts have received special attention because of their potential role in preventing cardiovascular disease. Because nuts are very rich in total fat that can potentially be oxidized and their skins contain several antioxidants, studies have been conducted to evaluate the potential effect of nut consumption on oxidative stress. This review evaluates the in vitro and in vivo studies conducted in animals or humans to analyze the effect of nuts on oxidation.
Escurriol, V., Cofán, M., M. Serra, M. Bullo’, J. Basora, J. Salas-Salvado’, D. Corella, I. Zazpe, M.A. Martínez-González, V. Ruiz-Gutiérrez , R. Estruch, E. Ros, 2009. Serum sterol responses to increasing plant sterol intake from natural foods in the Mediterranean diet. Eur J Nutr. 48(6):373-382.
Background: Phytosterols in natural foods are thought to inhibit cholesterol absorption. The Mediterranean diet is rich in phytosterol-containing plant foods. Aim of the study: To assess whether increasing phytosterols intake from natural foods was associated with a cholesterol-lowering effect in a substudy of a randomized trial of nutritional intervention with Mediterranean diets for primary cardiovascular prevention (PREDIMED study). Methods: One hundred and six high cardiovascular risk subjects assigned to two Mediterranean diets supplemented with virgin olive oil (VOO) or nuts, which are phytosterols-rich foods, or advice on a low-fat diet. Outcomes were 1-year changes in nutrient intake and serum levels of lipids and non-cholesterol sterols. Results: Average phytosterol intake increased by 76, 158 and 15 mg/day in participants assigned VOO, nuts and low-fat diets, respectively. Compared to participants in the low-fat diet group, changes in outcome variables were observed only in those in the Mediterranean diet with nuts group, with increases in intake of fiber, polyunsaturated fatty acids and phytosterols (P<0.020, all) and significant (P<0.05) reductions of LDL-cholesterol (0.27 mmol/l or 8.3%) and the LDL/HDL-cholesterol ratio (0.29 mmol/l or 11.5%). Variations in saturated fat, cholesterol or fiber intake were unrelated to LDL-cholesterol changes. In the whole group, changes in serum sitosterol-to-cholesterol, which reflect those of dietary phytosterol intake and absorption, correlated inversely to LDL-cholesterol changes (r = -0.256; P = 0.008). In multivariate analyses, baseline LDL-cholesterol, increases in serum sitosterol ratios and statin use were independently associated with LDL-cholesterol reductions. Conclusions: Small amounts of phytosterols in natural foods appear to be bioactive in cholesterol lowering.
Torabian, S., E. Haddad, S. Rajaram, J. Banta, J. Sabate’, 2009. Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation. J Hum Nutr Diet. 22:64-71.
Background: Nuts have been shown to have beneficial effects on human health due to the healthy fat content; however, the effect of antioxidants (i.e. polyphenols) in nuts have not been fully investigated. The present study aimed to assess the immediate effect of a polyphenol-rich meal (75% of energy from nuts: walnuts or almonds) and a polyphenol-free meal on plasma polyphenol content, antioxidant capacity and lipid peroxidation in healthy volunteers. Methods: Thirteen subjects participated in a randomized, crossover, intervention study. After an overnight fast, walnuts, almonds or a control meal in the form of smoothies were consumed by study subjects. Each subject participated on three occasions, 1 week apart, consuming one of the smoothies each time. Blood samples were obtained at fasting and then at intervals up to 3.5 h after consumption of the smoothies. Results: There was a significant increase in plasma polyphenol concentration following both nut meals, with peak concentrations being achieved at 90 min, and with a walnut meal having a more sustained higher concentration than an almond meal. The plasma total antioxidant capacity reached its highest point at 150 min postconsumption of the nut meals, and was higher after the almond compared to walnut meal. A gradual significant (P < 0.05) reduction in the susceptibility of plasma to lipid peroxidation was observed 90 min after ingestion of the nut meals. No changes were observed following consumption of control meal. Conclusions: Consumption of both nuts increased plasma polyphenol concentrations, increased the total antioxidant capacity and reduced plasma lipid peroxidation.
