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Higher visceral adiposity is associated with an enhanced early thermogenic response to carbohydrate-rich food.

Gepner, Y., N. Bril, I. Shelef, D. Schwarzfuchs, D. Serfaty, M. Rein, N. Cohen, E. Shemesh, O. Tangi-Rosental, B. Sarusi, E. Goshen, S. Kenigsbuch, Y. Chassidim, R. Golan, S. Witkow, Y. Henkin, MJ. Stampfer, A. Rudich, I. Shai, 2015. Higher visceral adiposity is associated with an enhanced early thermogenic response to carbohydrate-rich food. Clin Nutr. 35(2):422-7.

Background: Studies examining the dynamics of the thermic effect of feeding (TEF) of specific food items and the relationship of TEF to visceral adiposity are limited. Methods: We measured resting energy expenditure (REE) and early-TEF (40-min postprandial, e-TEF) after 8-h fast by indirect calorimetry in 40 obese men, and imaged abdominal fat tissues by magnetic resonance imaging. Each participant was examined on two occasions, 3-weeks apart. At each examination we measured fasting REE and then postprandial REE following the isocaloric [∼380 kcal] consumption of either 56 gr walnuts [(8% carbohydrates; 84% fat, of which 72% polyunsaturated fat)], or 5-slices (150gr) of whole-grain bread (48% carbohydrates; 32% fat). e-TEF was calculated as the area under the curve between the fasting and postprandial tests. Results: Participants had a mean age of 45 ± 8 years, body-mass-index (BMI) = 31.1 ± 3.8 kg/m2, total abdominal fat area = 901.4 ± 240 cm2, visceral fat area (VAT) = 260 ± 102.9 cm2, fasting REE = 1854 ± 205 kcal, REE/kg = 19.39 ± 1.73 kcal/kg, and respiratory quotient (RQ, CO2 eliminated/O2 consumed) = 0.82 ± 0.04. Individuals who exhibited increased e-TEF (top ΔAUC median) to bread had higher VAT (299 cm2 vs. 223 cm2; p = 0.024) and higher BMI (32.4 kg/m2 vs. 30.0 kg/m2; p = 0.013), compared to their peers with the lower e-TEF response (ΔAUC below median). As expected, postprandial e-TEF was higher after whole-grain bread consumption [ΔAUC = +14 kcal/40min] compared to walnuts [ΔAUC = -2 kcal/40 min; p < 0.001]. Conclusions: Higher early thermic effect of high-carbohydrate food, likely reflecting digestion, early absorption and/or sympathetic tone (rather than metabolic utilization (oxidation)), associates with visceral adiposity. Future studies are required to determine if this association represents an added causality between early carbohydrate processing and visceral fat accumulation.

Weight loss with a modified Mediterranean-type diet using fat modification: a randomized controlled trial.

Austel, A., C. Ranke, N. Wagner, J. Görge, T. Ellrott, 2015. Weight loss with a modified Mediterranean-type diet using fat modification: a randomized controlled trial. Eur J Clin Nutr. 69(8):878-84

Background/Objective: There is evidence that Mediterranean diets with a high proportion of olive oil and nuts can be effective for weight management and prevention of cardiovascular disease. It might be difficult for populations with other eating habits to follow such diets. Therefore, a modified Mediterranean-type diet using fat modification through neutral and butter-flavored canola oil, walnuts and walnut oil with two portion-controlled sweet daily snacks was tested in Germany. Subjects/Methods: Randomized waiting-list control study with overweight/grade 1 obese subjects: 12-week self-help modified Mediterranean-type diet, 6 weeks of diet plans and 6 weeks of weight loss maintenance training. Trial duration was 12 months. Intervention group (IG) included 100 participants (average age of 52.4 years, weight 85.1 kg and body mass index (BMI) 30.1 kg/m2), waiting-list control group (CG) included 112 participants (52.6 years, 84.1 kg and 30.1 kg/m2). Results: Per-protocol weight loss after 12 weeks was 5.2 kg in IG vs 0.4 kg in CG (P⩽0.0001), BMI -1.8 vs -0.1 kg/m2 (P⩽0.0001), waist circumference -4.7 vs -0.9 cm (P⩽0.0001). Triglycerides, total cholesterol and LDL cholesterol improved significantly in IG but not in CG. One-year dropouts: 44% in IG and 53% in CG. Weight loss after 12 months: 4.2 kg (pooled data). Conclusions: A five-meal modified Mediterranean-type diet with two daily portion-controlled sweet snacks was effective for weight management in a self-help setting for overweight and grade 1 obese subjects. Fat modification through canola oil, walnuts and walnut oil improved blood lipids even at 12 months. 

Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005–2010.

O’Neil, C.E., V.L. Fulgoni, T.A. Nicklas, 2015. Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005–2010. Nutrition Journal. 14:64. DOI 10.1186/s12937-015-0052-x

Introduction: Previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS). Objective: To determine the association of tree nut consumption with risk factors for CVD and for MetS in adults. Methods: NHANES 2005–2010 data were used to examine the associations of tree nut consumption with health risks in adults 19+ years (n = 14,386; 51 % males). Tree nuts were: almonds, Brazil nuts, cashews, filberts [hazelnuts], macadamias, pecans, pine nuts, pistachios, and walnuts. Group definitions were non-consumers < ¼ ounce/day and consumers of ≥ ¼ ounce/day tree nuts using data from 24-h dietary recalls. Means and ANOVA (covariate adjusted) were determined using appropriate sample weights. Using logistic regression, odds ratios of being overweight (OW)/obese (OB) (body mass index [BMI] >25/<30 and ≥30, respectively) and having CVRF or MetS, were determined. Results: Tree nut consumption was associated with lower BMI (p = 0.004), waist circumference (WC) (p = 0.008), systolic blood pressure (BP) (p = 0.001), Homeostatic Model Assessment—Insulin Resistance (p = 0.043), and higher high density lipoprotein-cholesterol (p = 0.022), compared with no consumption, and a lower likelihood of OB (−25 %), OW/OB (−23 %), and elevated WC (−21 %). Conclusions: Tree nut consumption was associated with better weight status and some CVRF and MetS components.

Nut consumption and risk of colorectal cancer in women.

Yang, M., F.B. Hu, E.L. Giovannucci, M.J. Stampfer, W.C. Willett, C.S. Fuchs, K. Wu, Y. Bao, 2015. Nut consumption and risk of colorectal cancer in women. European Journal of Clinical Nutrition doi:10.1038/ejcn.2015.66.

Background/Objectives: Increasing nut consumption has been associated with reduced risk of obesity and type II diabetes, the risk factors for colorectal cancer. However, the association between nut consumption and colorectal cancer risk is unclear. We aimed to examine the association of long-term nut consumption with risk of colorectal cancer. Subjects/Methods: We prospectively followed 75 680 women who were free of cancer at baseline in the Nurses’ Health Study, and examined the association between nut consumption and colorectal cancer risk. Nut consumption was assessed at baseline and updated every 2–4 years. Relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards models. Results: During 2 103 037 person-years of follow-up, we identified 1503 colorectal cancer cases. After adjustment for other known or suspected risk factors, women who consumed nuts 2 or more times per week (that is,  56 g per week) had a 13% lower risk of colorectal cancer compared with those who rarely consumed nuts, but the association was not statistically significant (RR: 0.87; 95%CI: 0.72–1.05; P-trend: 0.06). No association was observed for peanut butter. Conclusions: In this large prospective cohort of women, frequent nut consumption was not significantly associated with colorectal cancer risk after adjusting for other risk factors.

The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials.

Mohammadifard, N., A. Salehi-Abargouei, J. Salas-Salvadó, M. Guasch-Ferré, K. Humphries,  N. Sarrafzadegan, 2015. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr. 101:966–82.

Background: Although several studies have assessed the effects of nut consumption (tree nuts, peanuts, and soy nuts) on blood pressure (BP), the results are conflicting. Objective: The aim was to conduct a systematic review and meta-analysis of published randomized controlled trials (RCTs) to estimate the effect of nut consumption on BP. Design: The databases MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched for RCTs carried out between 1958 and October 2013 that reported the effect of consuming single or mixed nuts (including walnuts, almonds, pistachios, cashews, hazelnuts, macadamia nuts, pecans, peanuts, and soy nuts) on systolic BP (SBP) or diastolic BP (DBP) as primary or secondary outcomes in adult populations aged $18 y. Relevant articles were identified by screening the abstracts and titles and the full text. Studies that evaluated the effects for, 2 wk or in which the control group ingested different healthy oils were excluded. Mean 6 SD changes in SBP and DBP in each treatment group were recorded for meta-analysis. Results: Twenty-one RCTs met the inclusion criteria. Our findings suggest that nut consumption leads to a significant reduction in SBP in participants without type 2 diabetes [mean difference (MD): 21.29; 95% CI: 22.35, 20.22; P = 0.02] but not in the total population. Subgroup analyses of different nut types suggest that pistachios, but not other nuts, significantly reduce SBP (MD: 21.82; 95% CI: 22.97, 20.67; P = 0.002). Our study suggests that pistachios (MD: 20.80; 95% CI: 21.43, 20.17; P = 0.01) and mixed nuts (MD: 21.19; 95% CI: 22.35, 20.03; P = 0.04) have a significant reducing effect on DBP. We found no significant changes in DBP after the consumption of other nuts. Conclusions: Total nut consumption lowered SBP in participants without type 2 diabetes. Pistachios seemed to have the strongest effect on reducing SBP and DBP. Mixed nuts also reduced DBP.

Tree nut consumption is associated with better nutrient adequacy and diet quality in adults: national health and nutrition examination survey 2005–2010.

O’Neil, C.E., T.A. Nicklas, V.L. Fulgoni III, 2015. Tree nut consumption is associated with better nutrient adequacy and diet quality in adults: national health and nutrition examination survey 2005–2010.  Nutrients. 7(1):595-607.

Nutrient adequacy of tree nut consumers has not been examined. The National Health and Nutrition Examination Survey 2005–2010 data were used to assess the association of tree nut consumption by adults 19+ years (= 14,386) with nutrient adequacy and diet quality. Covariate adjusted usual intake was determined using two 24-h dietary recalls and the National Cancer Institute method. Percentages of the consumption groups below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was determined using the Healthy Eating Index-2005 (HEI) score. Usual intake data showed consumers of tree nuts had a lower percentage (< 0.0001) of the population below the EAR for vitamins A (22 ± 5 vs. 49 ± 1), E (38 ± 4 vs. 94 ± 0.4) and C (17 ± 4 vs. 44 ± 1); folate (2.5 ± 1.5 vs. 12 ± 0.6); calcium (26 ± 3 vs. 44 ± 1); iron (3 ± 0.6 vs. 9 ± 0.4); magnesium (8 ± 1 vs. 60 ± 1); and zinc (1.5 ± 1 vs. 13 ± 1). Tree nut consumers had a higher percentage (< 0.0001) of the population above the AI for fiber (33 ± 3 vs. 4 ± 0.3) and potassium (12 ± 3 mg vs. 2 ± 0.2 mg). HEI-2005 total score was higher (< 0.0001) in tree nut consumers (61 ± 0.7 vs. 52 ± 0.3) than non-consumers. Health professionals should encourage the use of tree nuts as part of a dietary approach to healthy eating.

Mediterranean diet and cardiovascular health: teachings of the PREDIMED study.

Ros, E., M.A. Martínez-González, R. Estruch, J. Salas-Salvadó, M. Fitó, J.A. Martínez, D. Corella, 2014. Mediterranean diet and cardiovascular health: teachings of the PREDIMED study. Adv. Nutr. 5:330S–336S.

The PREDIMED (Prevención con Dieta Mediterránea) study was designed to assess the long-term effects of the Mediterranean diet (MeDiet) without any energy restriction on incident cardiovascular disease (CVD) as a multicenter, randomized, primary prevention trial in individuals at high risk. Participants were randomly assigned to 3 diet groups: 1) MeDiet supplemented with extra-virgin olive oil (EVOO); 2) MeDiet supplemented with nuts; and 3) control diet (advice on a low-fat diet). After 4.8 y, 288 major CVD events occurred in 7447 participants; crude hazard ratios were 0.70 (95% CI:0.53, 0.91) for the MeDiet + EVOO and 0.70 (95% CI: 0.53, 0.94) for the MeDiet + nuts compared with the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 participants without diabetes were 0.60 (95% CI: 0.43, 0.85) and 0.82 (95% CI: 0.61, 1.10) compared with the control group. After 1-y follow-up, participants in the MeDiet + nuts group showed a significant 13.7% reduction in prevalence of metabolic syndrome compared with reductions of 6.7% and 2.0% in the MeDiet + EVOO and control groups, respectively. Analyses of intermediate markers of cardiovascular risk demonstrated beneficial effects of the MeDiets on blood pressure, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis, as well as on the expression of proatherogenic genes involved in vascular events and thrombosis. Nutritional genomics studies demonstrated interactions between a MeDiet and cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), apolipoprotein A2 (APOA2), cholesteryl ester transfer protein plasma (CETP), and transcription factor 7-like 2 (TCF7L2) gene polymorphisms. The PREDIMED study results demonstrate that a high unsaturated fat and antioxidant-rich dietary pattern such as the MeDiet is a useful tool in the prevention of CVD.

Walnut polyphenol metabolites, urolithins A and B, inhibit the expression of the prostate-specific antigen and the androgen receptor in prostate cancer cells.

Sánchez-González, C., Ciudad, C.J., Noé, V., Izquierdo-Pulido, M., 2014. Walnut polyphenol metabolites, urolithins A and B, inhibit the expression of the prostate-specific antigen and the androgen receptor in prostate cancer cells. Food Funct. 5(11):2922-30.

Walnuts have been gathering attention for their health-promoting properties. They are rich in polyphenols, mainly ellagitannins (ETs) that after consumption are hydrolyzed to release ellagic acid (EA). EA is further metabolized by microbiota to form urolithins, such as A and B, which are absorbed. ETs, EA and urolithins have shown to slow the proliferation and growth of different types of cancer cells but the mechanisms remain unclear. We investigate the role of urolithins in the regulatory mechanisms in prostate cancer, specifically those related to the androgen receptor (AR), which have been linked to the development of this type of cancer. In our study, urolithins down-regulated the mRNA and protein levels of both prostate specific antigen (PSA) and AR in LNCaP cells. The luciferase assay performed with a construct containing three androgen response elements (AREs) showed that urolithins inhibit AR-mediated PSA expression at the transcriptional level. Electrophoretic mobility shift assays revealed that urolithins decreased AR binding to its consensus response element. Additionally, urolithins induced apoptosis in LNCaP cells, and this effect correlated with a decrease in Bcl-2 protein levels. In summary, urolithins attenuate the function of the AR by repressing its expression, causing a down-regulation of PSA levels and inducing apoptosis. Our results suggest that a diet rich in ET-containing foods, such as walnuts, could contribute to the prevention of prostate cancer.

Communicating clinical research to reduce cancer risk through diet: Walnuts as a case example.

Toner, C.D, 2014. Communicating clinical research to reduce cancer risk through diet: Walnuts as a case example. Nutr Res Pract. 8(4):347-5.

Inflammation is one mechanism through which cancer is initiated and progresses, and is implicated in the etiology of other conditions that affect cancer risk and prognosis, such as type 2 diabetes, cardiovascular disease, and visceral obesity. Emerging human evidence, primarily epidemiological, suggests that walnuts impact risk of these chronic diseases via inflammation. The published literature documents associations between walnut consumption and reduced risk of cancer, and mortality from cancer, diabetes, and cardiovascular disease, particularly within the context of the Mediterranean Diet. While encouraging, follow-up in human intervention trials is needed to better elucidate any potential cancer prevention effect of walnuts, per se. In humans, the far-reaching positive effects of a plant-based diet that includes walnuts may be the most critical message for the public. Indeed, appropriate translation of nutrition research is essential for facilitating healthful consumer dietary behavior. This paper will explore the translation and application of human evidence regarding connections with cancer and biomarkers of inflammation to the development of dietary guidance for the public and individualized dietary advice. Strategies for encouraging dietary patterns that may reduce cancer risk will be explored.

Dietary supplementation of walnuts improves memory deficits and learning skills in transgenic mouse model of Alzheimer’s Disease.

Muthaiyah, B., Essa, M.M., Lee, M., Chauhan, V., Kaur, K., Chauhan, A., 2014. Dietary supplementation of walnuts improves memory deficits and learning skills in transgenic mouse model of Alzheimer’s Disease. J Alzheimers Dis. 42(4):1397-405.

Previous in vitro studies have shown that walnut extract can inhibit amyloid-β (Aβ) fibrillization, can solubilize its fibrils, and has a protective effect against Aβ-induced oxidative stress and cellular death. In this study, we analyzed the effect of dietary supplementation with walnuts on learning skills, memory, anxiety, locomotor activity, and motor coordination in the Tg2576 transgenic (tg) mouse model of AD (AD-tg). From the age of 4 months, the experimental groups of AD-tg mice were fed custom-mixed diets containing 6% walnuts (T6) or 9% walnuts (T9), i.e., equivalent to 1 or 1.5 oz, respectively, of walnuts per day in humans. The control groups, i.e., AD-tg and wild-type mice, were fed a diet without walnuts (T0, Wt). These experimental and control mice were examined at the ages of 13-14 months by Morris water maze (for spatial memory and learning ability), T maze (for position discrimination learning ability), rotarod (for psychomotor coordination), and elevated plus maze (for anxiety-related behavior). AD-tg mice on the control diet (T0) showed memory deficit, anxiety-related behavior, and severe impairment in spatial learning ability, position discrimination learning ability, and motor coordination compared to the Wt mice on the same diet. The AD-tg mice receiving the diets with 6% or 9% walnuts (T6 and T9) showed a significant improvement in memory, learning ability, anxiety, and motor development compared to the AD-tg mice on the control diet (T0). There was no statistically significant difference in behavioral performance between the T6/T9 mice on walnuts-enriched diets and the Wt group on the control diet. These findings suggest that dietary supplementation with walnuts may have a beneficial effect in reducing the risk, delaying the onset, or slowing the progression of, or preventing AD.