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Pecans and its polyphenols prevent obesity, hepatic steatosis and diabetes by reducing dysbiosis, inflammation, and increasing energy expenditure in mice fed a high-fat diet.

Delgadillo-Puga, C., I. Torre-Villalvazo, L.G. Noriega, L.A. Rodríguez-López, G. Alemán, E.A. Torre-Anaya, Y.Y. Cariño-Cervantes, B. Palacios-Gonzalez, J. Furuzawa-Carballeda, A.R. Tovar, L. Cisneros-Zevallos, 2023. Pecans and its polyphenols prevent obesity, hepatic steatosis and diabetes by reducing dysbiosis, inflammation, and increasing energy expenditure in mice fed a high-fat diet. Nutrients. 15(11):2591. https://doi.org/10.3390/nu15112591

Pecans (Carya illinoinensis) are considered a functional food due to the high content of polyunsaturated fatty acids, dietary fiber and polyphenols. To determine the effect of whole pecans (WP) or a pecan polyphenol (PP) extract on the development of metabolic abnormalities in mice fed a high-fat (HF) diet, we fed C57BL/6 mice with a Control diet (7% fat), HF diet (23% fat), HF containing 30% WP or an HF diet supplemented with 3.6 or 6 mg/g of PP for 18 weeks. Supplementation of an HF diet with WP or PP reduced fat mass, serum cholesterol, insulin and HOMA-IR by 44, 40, 74 and 91%, respectively, compared to the HF diet. They also enhanced glucose tolerance by 37%, prevented pancreatic islet hypertrophy, and increased oxygen consumption by 27% compared to the HF diet. These beneficial effects were associated with increased thermogenic activity in brown adipose tissue, mitochondrial activity and AMPK activation in skeletal muscle, reduced hypertrophy and macrophage infiltration of subcutaneous and visceral adipocytes, reduced hepatic lipid content and enhanced metabolic signaling. Moreover, the microbial diversity of mice fed WP or PP was higher than those fed HF, and associated with lower circulating lipopolysaccharides (~83-95%). Additionally, a 4-week intervention study with the HF 6PP diet reduced the metabolic abnormalities of obese mice. The present study demonstrates that WP or a PP extract prevented obesity, liver steatosis and diabetes by reducing dysbiosis, inflammation, and increasing mitochondrial content and energy expenditure. Pecan polyphenols were mainly condensed tannin and ellagic acid derivatives including ellagitannins as determined by LC-MS. Herein we also propose a model for the progression of the HF diet-mediated metabolic disorder based on early and late events, and the possible molecular targets of WP and PP extract in preventive and intervention strategies. The body surface area normalization equation gave a conversion equivalent to a daily human intake dose of 2101-3502 mg phenolics that can be obtained from 110-183 g pecan kernels/day (22-38 whole pecans) or 21.6-36 g defatted pecan flour/day for an average person of 60 kg. This work lays the groundwork for future clinical studies.

Long-term consumption of nuts (including peanuts, peanut butter, walnuts, and other nuts) in relation to risk of frailty in older women: evidence from a cohort study.

Wang, R., M.T. Hannan, M. Wang, A.W. Schwartz, E. Lopez-Garcia, F. Grodstein, 2023. Long-term consumption of nuts (including peanuts, peanut butter, walnuts, and other nuts) in relation to risk of frailty in older women: evidence from a cohort study. J Nutr. 153(3):820-7. https://doi.org/10.1016/j.tjnut.2023.01.003

Background: Adherence to a healthy diet is inversely associated with frailty. However, the relationship between nuts, a key food group of Mediterranean diet, and frailty is unclear. Objectives: This study aimed to evaluate the association between nut consumption and frailty in an aging female population. Methods: This population-based observational study included nonfrail women (60 y old) in the NHS from 11 states of the United States. Outcome was incident frailty, defined as having 3 of the FRAIL components (fatigue, lower strength, reduced aerobic capacity, multiple chronic conditions, and significant weight loss) and assessed every 4 y from 1992 to 2016. From 1990 to 2014, FFQs were used to assess the intakes of peanuts, peanut butter, walnuts (added in 1998), and other nuts at 4-y intervals. Exposure was total nut consumption, calculated as the sum of intakes of peanuts, peanut butter, walnuts, and other nuts and categorized into <1 serving/mo, 1-3 servings/mo, 1 serving/wk, 2-4 servings/wk, and ≥ 5 servings/wk. The relations of intakes of peanuts, peanut butter, and walnuts with frailty were also investigated separately. Cox proportional hazards models were used to assess the associations between nut consumption and frailty after adjusting for age, smoking, BMI, EI, diet quality, and medication use. Results: Among 71,704 participants, 14,195 incident frailty cases occurred over 1,165,290 person-years. The adjusted HR (95% CI) for consuming ≥ 5 servings/wk of nuts was 0.80 (0.73, 0.87), as compared with <1 serving/mo. Higher intakes of peanuts and walnuts, but not peanut butter, were also inversely associated with frailty. Conclusions: This large prospective cohort study showed a strong and consistent inverse association between regular nut consumption and incident frailty. This suggests that nut consumption should be further tested as a convenient public health intervention for the preservation of health and well-being in older adults.

Long-term consumption of nuts (including peanuts, peanut butter, walnuts, and other nuts) in relation to risk of frailty in older women: evidence from a cohort study.

Wang, R., M.T. Hannan, M. Wang, A.W. Schwartz, E. Lopez-Garcia, F. Grodstein, 2023. Long-term consumption of nuts (including peanuts, peanut butter, walnuts, and other nuts) in relation to risk of frailty in older women: evidence from a cohort study. J Nutr. 153(3):820-7. https://doi.org/10.1016/j.tjnut.2023.01.003

Background: Adherence to a healthy diet is inversely associated with frailty. However, the relationship between nuts, a key food group of Mediterranean diet, and frailty is unclear. Objectives: This study aimed to evaluate the association between nut consumption and frailty in an aging female population. Methods: This population-based observational study included nonfrail women (60 y old) in the NHS from 11 states of the United States. Outcome was incident frailty, defined as having 3 of the FRAIL components (fatigue, lower strength, reduced aerobic capacity, multiple chronic conditions, and significant weight loss) and assessed every 4 y from 1992 to 2016. From 1990 to 2014, FFQs were used to assess the intakes of peanuts, peanut butter, walnuts (added in 1998), and other nuts at 4-y intervals. Exposure was total nut consumption, calculated as the sum of intakes of peanuts, peanut butter, walnuts, and other nuts and categorized into <1 serving/mo, 1–3 servings/mo, 1 serving/wk, 2 4 servings/wk, and  5 servings/wk. The relations of intakes of peanuts, peanut butter, and walnuts with frailty were also investigated separately. Cox proportional hazards models were used to assess the associations between nut consumption and frailty after adjusting for age, smoking, BMI, EI, diet quality, and medication use. Results: Among 71,704 participants, 14,195 incident frailty cases occurred over 1,165,290 person-years. The adjusted HR (95% CI) for consuming 5 servings/wk of nuts was 0.80 (0.73, 0.87), as compared with <1 serving/mo. Higher intakes of peanuts and walnuts, but not peanut butter, were also inversely associated with frailty. Conclusions: This large prospective cohort study showed a strong and consistent inverse association between regular nut consumption and incident frailty. This suggests that nut consumption should be further tested as a convenient public health intervention for the preservation of health and well-being in older adults.

Key Area: Body Weight and Composition

Almonds vs. carbohydrate snacks in an energy-restricted diet: Weight and cardiometabolic outcomes from a randomized trial.

Carter, S., A.M. Hill, L.C. Mead, H.Y. Wong, C. Yandell, J.D. Buckley, S.Y. Tan, G.B. Rogers, F. Fraysse, A.M. Coates, 2023. Almonds vs. carbohydrate snacks in an energy-restricted diet: Weight and cardiometabolic outcomes from a randomized trial. Obesity (Silver Spring). 31(10):2467-2481. https://doi.org/10.1002/oby.23860

Objective: This study evaluated weight and cardiometabolic outcomes after a 3-month energy-restricted diet (−30%) containing almonds (almond-enriched diet [AED]) or containing carbohydrate-rich snacks (nut-free control diet [NFD]) (Phase 1), followed by 6 months of weight maintenance (Phase 2). Methods: Participants (25–65 years old) with overweight or obesity (BMI 27.5–34.9 kg/m2) were randomly allocated to AED (n = 68) or NFD (n = 72). Results: Both groups lost weight during Phase 1 (p < 0.001) (mean [SE], −7.0 [0.5] kg AED vs. −7.0 [0.5] kg NFD, p = 0.858) and Phase 2 (p = 0.009) (−1.1 [0.5] kg AED vs. −1.3 [0.6] NFD, p = 0.756), with improvements in percentage lean mass after Phase 2 (4.8% [0.3%], p < 0.001). Reductions occurred in fasting glucose (−0.2 [0.07] mmol/L, p = 0.003), insulin (−8.1 [4.0] pmol/L, p = 0.036), blood pressure (−4.9 [0.8] mm Hg systolic, −5.0 [0.5] mm Hg diastolic, p < 0.001), total cholesterol (−0.3 [0.1] mmol/L), low-density lipoprotein (LDL) (−0.2 [0.1] mmol/L), very low density lipoprotein (−0.1 [0.03] mmol/L), and triglycerides (−0.3 [0.06] mmol/L) (all p < 0.001), and high-density lipoprotein increased (0.1 [0.02] mmol/L, p = 0.011) by the end of Phase 2 in both groups. There were group by time interactions for lipoprotein particle concentrations: very small triglyceride-rich (−31.0 [7.7] nmol/L AED vs. −4.8 [7.9] nmol/L NFD, p = 0.007), small LDL (−109.3 [40.5] nmol/L AED vs. −20.7 [41.6] nmol/L NFD, p = 0.017), and medium LDL (−24.4 [43.4] nmol/L AED vs. −130.5 [44.4] nmol/L NFD, p = 0.045). Conclusions: An energy-restricted AED resulted in weight loss and weight loss maintenance comparable to an energy-restricted NFD, and both diets supported cardiometabolic health. The AED resulted in greater improvements in some lipoprotein subfractions, which may enhance reductions in cardiovascular risk.

Nuts, Energy Balance and Body Weight.

Baer, D.J., M. Dalton, J. Blundell, G. Finlayson, F.B. Hu, 2023. Nuts, Energy Balance and Body Weight. Nutrients. 15(5):1162. doi: 10.3390/nu15051162.

Over several decades, the health benefits of consuming nuts have been investigated, resulting in a large body of evidence that nuts can reduce the risk of chronic diseases. The consumption of nuts, being a higher-fat plant food, is restricted by some in order to minimize weight gain. In this review, we discuss several factors related to energy intake from nuts, including food matrix and its impact on digestibility, and the role of nuts in regulating appetite. We review the data from randomized controlled trials and observational studies conducted to examine the relationship between nut intake and body weight or body mass index. Consistently, the evidence from RCTs and observational cohorts indicates that higher nut consumption does not cause greater weight gain; rather, nuts may be beneficial for weight control and prevention of long-term weight gain. Multiple mechanisms likely contribute to these findings, including aspects of nut composition which affect nutrient and energy availability as well as satiety signaling.

Mixed nuts as healthy snacks: effect on tryptophan metabolism and cardiovascular risk factors.

Yang, J., R. Lee, Z. Schulz, A. Hsu, J. Pai, S. Yang, S.M. Henning, J. Huang, J.P. Jacobs, D. Heber, Z. Li., 2023. Mixed nuts as healthy snacks: effect on tryptophan metabolism and cardiovascular risk factors. Nutrients. 15, 569; https://doi.org/10.3390/nu15030569.

We recently demonstrated that the consumption of mixed tree nuts (MTNs) during caloric restriction decreased cardiovascular risk factors and increased satiety. Tryptophan (Trp) metabolism has been indicated as a factor in cardiovascular disease. Here, we investigated the effect of MTNs on Trp metabolism and the link to cardiovascular risk markers. Plasma and stool were collected from 95 overweight individuals who consumed either MTNs (or pretzels) daily as part of a hypocaloric weight loss diet for 12 weeks followed by an isocaloric weight maintenance program for an additional 12 weeks. Plasma and fecal samples were evaluated for Trp metabolites by LC–MS and for gut microbiota by 16S rRNA sequencing. Trp–kynurenine metabolism was reduced only in the MTNs group during weight loss (baseline vs. week 12). Changes in Trp–serotonin (week 24) and Trp–indole (week 12) metabolism from baseline were increased in the MTNs group compared to the pretzel group. Intergroup analysis between MTN and pretzel groups does not identify significant microbial changes as indicated by alpha diversity and beta diversity. Changes in the relative abundance of genus Paludicola during intervention are statistically different between the MTNs and pretzel group with p < 0.001 (q = 0.07). Our findings suggest that consumption of MTNs affects Trp host and microbial metabolism in overweight and obese subjects.

The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial.

Zelicha, H., N. Kloting, A. Kaplan, A. Yaskolka Meir, E. Rinott, G. Tsaban, Y. Chassidim,  M. Bluher, U. Ceglarek, B. Isermann, M. Stumvoll, R.N. Quayson, M. von Bergen, B. Engelmann, U.E. Rolle-Kampczyk, S.B. Haange, K.M. Tuohy, C. Diotallevi, I. Shelef, F.B. Hu, M.J. Stampfer, I. Shai, 2022. The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial. BMC Medicine. 20(1):327. https://doi.org/10.1186/s12916-022-02525-8

Background: Mediterranean (MED) diet is a rich source of polyphenols, which benefit adiposity by several mechanisms. We explored the effect of the green-MED diet, twice fortified in dietary polyphenols and lower in red/processed meat, on visceral adipose tissue (VAT). Methods: In the 18-month Dietary Intervention Randomized Controlled Trial PoLyphenols UnproceSsed (DIRECT-PLUS) weight-loss trial, 294 participants were randomized to (A) healthy dietary guidelines (HDG), (B) MED, or (C) green-MED diets, all combined with physical activity. Both isocaloric MED groups consumed 28 g/day of walnuts (+ 440 mg/day polyphenols). The green-MED group further consumed green tea (3–4 cups/day) and Wolffia globosa (duckweed strain) plant green shake (100 g frozen cubes/day) (+ 800mg/day polyphenols) and reduced red meat intake. We used magnetic resonance imaging (MRI) to quantify the abdominal adipose tissues. Results: Participants (age = 51 years; 88% men; body mass index = 31.2 kg/m2; 29% VAT) had an 89.8% retention rate and 79.3% completed eligible MRIs. While both MED diets reached similar moderate weight (MED: − 2.7%, green-MED: − 3.9%) and waist circumference (MED: − 4.7%, green-MED: − 5.7%) loss, the green-MED dieters doubled the VAT loss (HDG: − 4.2%, MED: − 6.0%, green-MED: − 14.1%; p < 0.05, independent of age, sex, waist circumference, or weight loss). Higher dietary consumption of green tea, walnuts, and Wolffia globosa; lower red meat intake; higher total plasma polyphenols (mainly hippuric acid), and elevated urine urolithin A polyphenol were significantly related to greater VAT loss (p < 0.05, multivariate models). Conclusions: A green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression.

Effect of walnut predinner snack on mealtime hunger and nutrient intake among university students. 

Wilson, T., L.S. DeVaan, M.E. LaCasse, E.M. Gile, M.J. Weis, M.D. Ahmann, G.I. Schnellman, M.T. Lenz, T.L. Hooks, 2022. Effect of walnut predinner snack on mealtime hunger and nutrient intake among university students. J Medicinal Food. 25(1):89–96. https://doi.org/10.1089/jmf.2021.0092

Freshman-15 is a phenomenon of first-year university students resulting in weight gain partly due to new cafeteria eating patterns and stress. This study determined if a premeal walnut snack alters planned eating behavior and mealtime nutrient intake during a subsequent buffet-model meal. Healthy university students (n = 36; 18.1 ± 0.5 years; body mass index: 23.6 ± 3.9) received three treatments (90 min premeal) in randomized order on 3 consecutive days: (1) snack of 190 Cal (1 oz) of walnuts (WS), (2) snack of 190 Cal of gummy candy (GS), or (3) no snack (NS; control) before a standard cafeteria dinner (1760 Cal). Visual analog scale (VAS) surveys were administered before and after dinner, and caloric intake was determined. Premeal VAS desire to eat was lower after WS and GS than NS, whereas the sense of hunger and sense of fullness were higher after WS and GS compared with NS. Postmeal VAS was not different between treatments. Mealtime calories, total fat, saturated fat, cholesterol, protein, sodium, fiber, and sugar consumed after WS were significantly less than NS. Total fat and sodium consumed after GS did not significantly differ from NS. Mealtime total fat, sodium, and fiber for WS were significantly less than GC, and a trend was observed for total calories. Differences in calorie intake were not observed between treatments when snack calories were included as part of the mealtime caloric intake. These findings could be helpful for promoting WS and to a lesser degree GS for increased satiety before meals possibly leading to reduced food intake during dinner by university students.

Diet-induced fasting ghrelin elevation reflects the recovery of insulin sensitivity and visceral adiposity regression.

Tsaban, G., A. Yaskolka Meir, H. Zelicha, E. Rinott, A. Kaplan, A. Shalev, A. Katz, D. Brikner, M. Blüher, U. Ceglarek, M. Stumvoll, M.J. Stampfer, I. Shai, 2022. Diet-induced fasting ghrelin elevation reflects the recovery of insulin sensitivity and visceral adiposity regression. JCEM. 107(2):336–345. https://doi.org/10.1210/clinem/dgab681

Aims: Lower fasting-ghrelin-levels (FGL) are associated with obesity and metabolic syndrome. We aimed to explore the dynamics of FGL during weight-loss and its metabolic and adiposity-related manifestations beyond weight-loss. Methods: A secondary analysis of a clinical trial where we randomized participants with abdominal-obesity/dyslipidemia to one of three diets: healthy-dietary-guidelines (HDG), Mediterranean diet (MED), or green-MED diet, all combined with physical activity (PA). Both MED diets were similarly hypocaloric and included 28g/day walnuts. The green-MED group further consumed green tea (3-4 cups/day) and a Wolffia-globosa (Mankai) plant green-shake. We measured FGL and quantified body fat depots by Magnetic-Resonance-Imaging at baseline and after 18-months. Results: Among 294 participants [body-mass-index=31.3kg/m 2;FGL=504±208pg/mL; retention rate=89.8%], lower FGL were associated with unfavorable cardiometabolic parameters as higher visceral-adipose-tissue (VAT), intra-hepatic fat, leptin, and blood pressure (p<0.05 for all; multivariate models). ΔFGL18-month differed between men (+7.3+26.6%) and women (-9.2+21.3%,p=0.001). After 18-months of moderate and similar weight loss among the MED-groups, FGL increased by 1.3%, 5.4%, and 10.5% in HDG, MED, and green-MED groups, respectively (p=0.03 for green-MED vs. HDG), sex-stratified analysis revealed similar changes in men only. Among men, FGL18-month elevation was associated with favorable changes in insulin resistance profile and VAT regression, after adjusting for relative weight-loss (HbA1c:r=-0.216; homeostatic-model-of insulin-resistance:r=-0.154; HDL-c:r=0.147;VAT:r=-0.221;p<0.05 for all). , Insulin resistance and VAT remained inversely related with FGL elevation, beyond which was explained by weight-loss (residual regression analyses;p<0.05). Conclusions: Diet-induced FGL elevation may reflect insulin sensitivity recovery and VAT regression beyond weight-loss, specifically among men. Green-MED diet is associated with greater FGL elevation.

Appetite responses to pecan-enriched diets.

Guarneiri, L.L., C.M. Paton, J.A. Cooper, 2022. Appetite responses to pecan-enriched diets. Appetite. 173:106003. https://doi.org/10.1016/j.appet.2022.106003

Research suggests that tree nuts improve satiety during an acute meal, but the effects of daily consumption are less clear. The purpose of this study was to examine the impact of daily pecan consumption on markers of appetite in adults at-risk for cardiovascular disease (CVD). This was an 8-week, randomized, controlled trial with three treatments: two pecan groups and a nut-free control group (n = 16). The ADD group (n = 15) consumed pecans (68 g) as part of a free-living diet, and the SUB group (n = 16) substituted the pecans (68 g) for isocaloric foods from their diet. At pre- and post-intervention, a high-fat meal was consumed with 3.5 h postprandial blood draws and visual appetite scales (VAS) to determine changes in cholecystokinin (CCK), peptide YY (PYY), ghrelin, and subjective appetite. Participants also completed VAS questionnaires once/h for the next 5 h and recorded dietary intake. Although no differences between groups (p > 0.05), there was an increase in postprandial CCK and PYY and suppression of postprandial ghrelin within ADD (p ≤ 0.05) from pre-to post-intervention. Across the entire day, the decreases in prospective consumption and desire to eat were greater in ADD vs SUB (-79 ± 41 vs 11 ± 26 mm/9 h; p = 0.05) and ADD vs control (-64 ± 39 vs 23 ± 29 mm/9 h; p = 0.05), respectively. There was also a non-significant tendency for a greater decrease in overall appetite in ADD vs control (-67 ± 46 vs 20 ± 27 mm/9 h; p = 0.06). Within ADD, overall appetite, prospective consumption, and desire to eat decreased, and fullness increased from pre-to post-intervention (p ≤ 0.05 for all). There were no changes in self-reported energy intake on test days or other changes within or between groups. In conclusion, adding pecans to the daily diet improves subjective and physiological markers of postprandial appetite in adults that are at-risk for CVD.