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Research Nut: Mixed Nuts

Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance).

Fadelu, T., S. Zhang, D. Niedzwiecki, X. Ye, L.B. Saltz, R.J. Mayer, R.B. Mowat, R. Whittom, A. Hantel, A.B. Benson, D.M. Atienza, M. Messino, H.L. Kindler, A. Venook, S. Ogino, K. Ng, K. Wu, W. Willett, E. Giovannucci, J. Meyerhardt, Y. Bao, C.S. Fuchs, 2018. Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance). J Clin Oncol. 36(11):1112-1120.

Purpose: Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia, including type 2 diabetes, obesity, sedentary lifestyle, and high glycemic load diet. Nut intake has been associated with a lower risk of type 2 diabetes, metabolic syndrome, and insulin resistance. However, the effect of nut intake on colon cancer recurrence and survival is not known. Patients and Methods: We conducted a prospective, observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency questionnaires while enrolled onto a randomized adjuvant chemotherapy trial. Using Cox proportional hazards regression, we assessed associations of nut intake with cancer recurrence and mortality. Results: After a median follow-up of 6.5 years, compared with patients who abstained from nuts, individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio (HR) for disease-free survival of 0.58 (95% CI, 0.37 to 0.92; Ptrend = .03) and an HR for overall survival of 0.43 (95% CI, 0.25 to 0.74; Ptrend = .01). In subgroup analysis, the apparent benefit was confined to tree nut intake (HR for disease-free survival, 0.54; 95% CI, 0.34 to 0.85; Ptrend = .04; and HR for overall survival, 0.47; 95% CI, 0.27 to 0.82; Ptrend = .04). The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality. Conclusion: Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer.

Tree nut allergens.

Geiselhart, S., K. Hoffmann-Sommergruber, M. Bublin, 2018. Tree nut allergens. Mol Immunol. 100:71-81.

Tree nuts are considered as part of a healthy diet due to their high nutritional quality. However, they are also a potent source of allergenic proteins inducing IgE mediated hypersensitivity often causing serious, life-threatening reactions. The reported prevalence of tree nut allergy is up to 4.9% worldwide. The general term “tree nuts” comprises a number of nuts, seeds, and drupes, derived from trees from different botanical families. For hazelnut and walnut several allergens have been identified which are already partly applied in component resolved diagnosis, while for other tree nuts such as macadamia, coconut, and Brazil nut only individual allergens were identified and data on additional allergenic proteins are missing. This review summarizes the current knowledge on tree nut allergens and describes their physicochemical and immunological characterization and clinical relevance.

Effect of nut consumption on semen quality and functionality in healthy men consuming a Western-style diet: a randomized controlled trial.

Salas-Huetos, A., R. Moraleda, S. Giardina, E. Anton, J. Blanco, J. Salas-Salvadó, M. Bulló, 2018. Effect of nut consumption on semen quality and functionality in healthy men consuming a Western-style diet: a randomized controlled trial. Am J Clin Nutr. 108:953–962.

Background: Human semen quality has declined in industrialized countries. Pollution, smoking, and the consumption of a Western style diet are all hypothesized as potential causes. Objective: We evaluated the effect of chronic consumption of nuts on changes in conventional semen parameters and the potential mechanisms implicated. Design: The FERTINUTS study was a 14-wk randomized, controlled, parallel trial. A total of 119 healthy men, aged 18–35 y, were allocated to 1 of 2 intervention groups: one group was fed the usual Western-style diet enriched with 60 g of a mixture of nuts/d (nut group), and the other was fed the usual Western-style diet avoiding nuts (control group). Semen and blood samples were collected at baseline and at the end of the intervention. Dietary information was recorded throughout the trial. Changes in conventional semen parameters (pH, volume, sperm count and concentration, motility, and morphology) were determined as primary outcomes. The effect of nut consumption on sperm DNA fragmentation (SDF), reactive oxygen species (ROS) production, chromosome anomalies (X, Y, and 18), total DNA methylation, and microRNA expression were measured in sperm samples as potential causes of the changes in the seminogram. Results: Compared with the control group, improvements in total sperm count (P = 0.002) and vitality (P = 0.003), total motility (P = 0.006), progressive motility (P = 0.036), and morphology of sperm (P = 0.008) were observed in the nut group. Participants in the nut group showed an increase in the consumption of total fat, monounsaturated fatty acids, polyunsaturated fatty acids, magnesium, vitamin E, α-linolenic acid, total omega-3 (n–3) and ω-3: ω-6 ratio intake during the intervention. Participants in the nut group showed a significant reduction in SDF (P < 0.001) and in the expression of hsa-miR-34b-3p (P = 0.036). No significant changes in ROS, sperm chromosome anomalies, or DNA methylation were observed between groups. Conclusions: The inclusion of nuts in a Western-style diet significantly improves the total sperm count and the vitality, motility, and morphology of the sperm. These findings could be partly explained by a reduction in the sperm DNA fragmentation. This trial was registered at ISRCTN as ISRCTN12857940.

Effect of nut consumption on vascular endothelial function: A systematic review and meta-analysis of randomized controlled trials.

Xiao, Y., W. Huang, C. Peng, J. Zhang, C. Wong, J.H. Kim, E.-K. Yeoh, 2017. Effect of nut consumption on vascular endothelial function: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition. http://dx.doi.org/10.1016/j.clnu.2017.04.011

Objective: Nut consumption has consistently been found to be associated with a reduced risk of cardiovascular diseases (CVD) and mortality in prospective studies. However, its effect on endothelial function, a prognostic marker of CVD, is still controversial in clinical trials. This meta-analysis of randomized controlled trials (RCTs) aimed to quantitatively assess the effect of nuts on vascular endothelial function. Methods: Major electronic databases were searched for published RCTs that reported the effect of nuts on flow mediated dilation (FMD) as a measurement of endothelial function in the adult population (age eighteen years or over). We calculated the pooled estimates of weighted mean differences (WMDs) and their 95% confidence intervals (CIs) by using random-effects models. Results: A total of nine papers (10 trials) involving 374 participants were included. The pooled estimates found that nut consumption significantly improved FMD (WMD: 0.41%; 95% CI: 0.18%, 0.63%; P = 0.001). Moderate and marginally significant heterogeneity was observed among the studies (I2 = 39.5%, P = 0.094). Subgroup analyses indicated that walnuts significantly improved FMD (WMD: 0.39%; 95% CI: 0.16%, 0.63%; P = 0.001). In addition, nut consumption had a significant effect on FMD in the trials with study duration <18 weeks, nut dose <67 g/d, or subjects with baseline FMD ≥8.6%. Conclusions: Nut consumption significantly improved endothelial function. However, the beneficial effect was limited to walnuts. More studies examining the effect of other nuts on endothelial function are needed in the future.

Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study.

Rehm, C.D., A. Drewnowski. 2017. Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study. Nutr. J. doi:10.1186/s12937017-0238-5.

Background: Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015–2020 Dietary Guidelines for Americans (DGAs). Objective: To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. Methods: Food pattern modeling was implemented in the nationally representative 2009–2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. Results: Compared to observed diets, modeled food patterns were significantly lower in empty calories (−20.1% and −18.7% in Model 1 and Model 2, respectively), added sugars (−17.8% and −16.9%), solid fats (−21.0% and −19.3%), saturated fat (−6.6% and −7.1%)., and sodium (−12.3% and −11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed. Conclusion: Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.

 

Determination of myo-inositol phosphates in tree nuts and grain fractions by HPLC–ESI–MS.

Duong, Q.H., K.D. Clark, K.G. Lapsley, R.B. Pegg. 2017. Determination of myo-inositol phosphates in tree nuts and grain fractions by HPLC–ESI–MS. J. Food Comp. Anal. 59:74-82.

High-performance liquid chromatography coupled with electrospray ionization mass spectrometry (HPLC–ESI–MS) was utilized for the rapid, on-line detection of all six forms of inositol phosphate (InsP) in seven major tree nuts (i.e., cashews, Brazil nuts, macadamias, walnuts, pecans, pistachios, hazelnuts) and three grain components that are allegedly rich in phosphorus (wheat aleurone, rice bran, corn germ). The total InsP levels ranged from 3 to 20 μmol/g in the tree nuts and from 10 to 97 μmol/g in the grain components. While inositol hexakisphosphate was the predominant form in all samples, at least 20% of the InsP molar concentration comprised lower forms of InsPs. In tree nuts, InsPs accounted for 18–59% of the organic phosphorus content and 12–46% of the total phosphorus content. For grain samples, these values ranged from 66–97% and 58–80%, respectively. Significant differences in InsP levels among tree nuts underline the need for further investigation of InsPs in this food group, particularly with regard to different cultivars, growing conditions, and processing conditions. HPLC–ESI–MS offered a sensitive and time-efficient detection approach for InsPs in various complex nut and grain matrices, highlighting its potential application for many other sample types.

 

An umbrella review of nuts intake and risk of cardiovascular disease.

Schwingshackl, L., G. Hoffmann, B. Missbach, M. Stelmach-Mardas, H. Boeing, 2017. An umbrella review of nuts intake and risk of cardiovascular disease. Current Pharmaceutical Design. 23:1016-1027.

Background: Nuts have been an indispensable component of the human diet for hundreds because of their unique nutrient composition and are thought to play a beneficial part in the prevention of cardiovascular diseases. Objective: To evaluate the extent, validity and presence of evidence for studies investigating the impact of nuts intake on biomarkers of cardiovascular disease and cardiovascular events, we performed an umbrella review of all published meta-analyses synthesizing data from both observational studies and randomized controlled trials. Method: PubMed (between 1966 and April 2016) was searched for systematic reviews and meta-analyses. Methodological quality was assessed by applying the AMSTAR score (0-11 points), and the meta-evidence by applying NutriGrade, our recently developed scoring system (0-10 points). Results: In total, 14 meta-analyses were included in the umbrella review. Only 4 out of 14 reported an AMSTAR score ≥8 (high methodological quality), whereas NutriGrade meta-evidence score varied between 2 (very low meta-evidence) and 7.9 (moderate meta-evidence). There is consistent evidence from intervention trials, reporting significant reductions for total cholesterol, and from observational studies that higher intakes of nuts were associated with reduced risk of cardiovascular disease and hypertension. On the other side no effect could be observed for stroke, HDL-cholesterol, and blood pressure in the normal range.  Conclusion: In summary, the present umbrella review showed that nuts intake was associated with reduced risk of cardiovascular disease and hypertension, and lower levels of total cholesterol. The observed evidence is limited by the moderate methodological quality and very low to moderate quality of evidence.

Associations between nut consumption and health vary between omnivores, vegetarians, and vegans.

Brown, R.C., A.R. Gray, S.L. Tey, A. Chisholm, V. Burley, D.C. Greenwood, J. Cade, 2017. Associations between nut consumption and health vary between omnivores, vegetarians, and vegans. Nutrients. 7, 9, 1219; doi:10.3390/nu9111219.

Regular nut consumption is associated with reduced risk factors for chronic disease; however, most population-based studies lack consideration of effect modification by dietary pattern. The UK Women’s Cohort Study (UKWCS) provides an ideal opportunity to examine relationships between nut consumption and chronic disease risk factors in a large sample with diverse dietary patterns. Nut and nutrient intake from 34,831 women was estimated using a food frequency questionnaire among self-identified omnivores, vegetarians and vegans. In this cross-sectional analysis, higher nut consumption was associated with lower body weight (difference between highest and lowest consumption categories from adjusted model: 6.1kg; 95% CI: 4.7,7.6) body mass index (BMI, 2.4 units difference; 95% CI:1.9,2.9), and waist circumference (2.6cm difference; 95% CI:1.4,3.8) (all ρ for linear trend<0.001). Higher nut consumption was also associated with reduced prevalence of high cholesterol and high blood pressure; having a history of heart attack, diabetes and gallstones; and markers of diet quality (all adjusted ρ for linear trend ≤ 0.011). Higher nut consumption appeared over all to be associated with greater benefits amongst omnivores compared to vegetarians and vegans. Findings support existing literature around beneficial effects of nut consumption and suggest that benefits may be larger among omnivores. Nut promotion strategies may have the highest population impact by specifically targeting this group.

Longitudinal analysis of nut-inclusive diets and body mass index among overweight and obese African American women living in rural Alabama and Mississippi, 2011–2013.

Sterling, S.R., B. Bertrand, S. Judd, T.L. Carson, P. Chandler-Laney, M.L. Baskin, 2017. Longitudinal analysis of nut-inclusive diets and body mass index among overweight and obese African American women living in rural Alabama and Mississippi, 2011–2013. Prev Chronic Dis 2017;14:160595. DOI: https://doi.org/10.5888/pcd14.160595.

Introduction: Nuts, when eaten alongside other nutritionally rich foods, may decrease obesity and related chronic disease risks, which are high among African American women in the rural South. We monitored changes in nut intake, other obesity-related foods (fruits, vegetables, red or processed meats, added sugars), and body mass index (BMI) over a 2-year weight loss intervention among 383 overweight and obese African American women in rural Alabama and Mississippi. Methods: Two dietary recalls were administered at 4 points over 24 months. Mann–Whitney tests compared differences in median food group intake between nut consumers and non-nut consumers, and t tests identified BMI differences between groups. Mixed linear models tested the relationship between nut intake and intake of the select food groups, and between nut intake and BMI over time. Results: Overall nut consumers ate more fruits and vegetables and less red meat than non-nut consumers. Nut consumers had lower BMI values than non-nut consumers. Weight loss by the end of the intervention was significant for nut consumers but not for non-nut consumers, even after accounting for kilocalorie consumption and physical activity engagement. Conclusion: Nut consumption is associated with consumption of other nutritionally rich foods and lower BMI among African American women in rural Alabama and Mississippi. Future interventions should target increasing daily nut intake, decreasing added sugar intake, and identifying strategies to encourage positive dietary changes to continue after an intervention.

Prebiotic nut compounds and human microbiota.

Lamuel-Raventos, R.M., M.-P. St. Onge, 2017. Prebiotic nut compounds and human microbiota. Critical Reviews in Food Science and Nutrition. 57(14): 3154–3163.

Nut consumption is clearly related to human health outcomes. Its beneficial effects have been mainly attributed to nut fatty acid profiles and content of vegetable protein, fiber, vitamins, minerals, phytosterols and phenolics. However, in this review we focus on the prebiotics properties in humans of the nonbioaccessible material of nuts (polymerized polyphenols and polysaccharides), which provides substrates for the human gut microbiota and on the formation of new bioactive metabolites and the absorption of that may partly explain the health benefits of nut consumption.