Archive

Research Area: Cardiovascular Health

Nut consumption and risk of cardiovascular disease and ischemic heart disease mortality: The Adventist Health Study 2. 

Suprono, M.S., D.J. Shavlik, F.M. Butler, J. Sabaté, G.E. Fraser, M.J. Orlich, 2025. Nut consumption and risk of cardiovascular disease and ischemic heart disease mortality: The Adventist Health Study 2.  J Nutr. https://doi.org/10.1016/j.tjnut.2025.10.022

Background: Cardiovascular disease (CVD) and ischemic heart disease (IHD) are leading causes of mortality worldwide. Nut consumption has been associated with reduced risk. Objectives: To examine the associations between total nut and tree nut intake with CVD and IHD mortality, and to explore the potential benefits of substituting nuts for less heart-healthy foods. Methods: This prospective cohort study followed 80,529 Adventist participants for an average of 11.1 y. During this period, 4258 CVD deaths, including 1529 IHD deaths, were recorded. Dietary intake was assessed using a validated food frequency questionnaire. We examined total nut intake (combining tree nuts, peanuts, and peanut butter) as well as tree nut intake specifically (including almonds, cashews, walnuts, and mixed nuts). Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, dietary, and lifestyle factors. Results: Participants with higher nut intake tended to be older, more educated, and reported healthier lifestyle behaviors. After multivariable adjustment, higher total nut intake was significantly associated with lower CVD (HR: 0.86; 95% CI: 0.79, 0.94) and IHD mortality (HR: 0.81; 95% CI: 0.70, 0.94) when comparing the 90th with the 10th percentile of intake. Stronger inverse associations were observed with tree nut intake and CVD (HR: 0.83; 95% CI: 0.74, 0.92) and IHD mortality (HR: 0.73; 95% CI: 0.62, 0.87). Substitution analysis revealed that replacing unprocessed red meats and processed meats with total nuts and tree nuts was associated with lower risk of CVD and IHD mortality. Conclusions: Higher intakes of total nuts and tree nuts are associated with significantly lower risk of CVD and IHD mortality. These findings support dietary recommendations to increase nut consumption as part of a heart-healthy diet.

Effect of the Mediterranean diet supplemented with olive oil versus the Mediterranean diet supplemented with mixed nuts on blood pressure and serum lipid indexes among adults: a systematic review and meta-analysis of randomized controlled trials.

Pourrajab, B., A.M. Harijani, P. Asghari, F. Shidfar, 2025. Effect of the Mediterranean diet supplemented with olive oil versus the Mediterranean diet supplemented with mixed nuts on blood pressure and serum lipid indexes among adults: a systematic review and meta-analysis of randomized controlled trials. Systematic Reviews and Meta-analyses. 35(11). https://doi.org/10.1016/j.numecd.2025.104166

Background and aim: Hypertension and dyslipidemia are major risk factors for cardiovascular disease (CVD). This systematic review and meta-analysis compared the effects of two Mediterranean (MED) dietary patterns—one supplemented with olive oil and the other with mixed nuts—on blood pressure and lipid profile. Methods and results: Relevant studies published until April 24, 2024, were thoroughly searched in online databases, including PubMed/Medline, Scopus, Clarivate Analytics’ Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. The analysis included 21 trials with 25 effect sizes, calculated as standardized mean differences with 95 % confidence intervals (CI). The findings indicated that the MED diet supplemented with olive oil has no significant effect on lipid indices and diastolic blood pressure (DBP) when contrasted with the MED diet supplemented with mixed nuts. However, the olive oil group had slightly higher systolic blood pressure levels than the mixed nuts group, with a significant p-value of <0.001. Conclusions: Evidence indicates no significant difference in serum lipid profile and DBP between the MED diet supplemented with olive oil and that with mixed nuts in participants at risk of CVD. However, mixed nuts significantly reduce SBP compared to olive oil. More studies on diverse populations are needed.

Effects of almond consumption on selected markers of inflammation and oxidative stress: A systematic review and meta-analysis.

Eslami M, L. Khaghani, E.F. Moghadam, 2025. Effects of almond consumption on selected markers of inflammation and oxidative stress: A systematic review and meta-analysis. Clin Nutr Res. 14(1):78-89. https://doi.org/10.7762/cnr.2025.14.1.78

This systematic review and meta-analysis aimed to evaluate the effectiveness of almond consumption on serum C-reactive protein (CRP) and malondialdehyde (MDA) levels in individuals at risk of cardiovascular disease (CVD). An electronic database search was performed on PubMed, Web of Science, Scopus, and the Cochrane Library from inception through October 2024. Summary effect size measurements were calculated using random effects model estimation and were reported as weighted mean differences (WMDs) along with 95% confidence intervals (CIs). A total of 258 articles were identified, and 13 randomized controlled trials (RCTs) were included in the systematic review and meta-analysis. The meta-analysis of eleven RCTs, which involved a total of 544 participants, indicated that almonds significantly reduced levels of CRP (WMD, −0.28 mg/L; 95% CI, −0.52, −0.04; p = 0.02). However, we found no significant benefit of almond consumption in improving serum MDA levels, and due to the limited number of studies, the examination of MDA was conducted only qualitatively. This study supports the conclusion that almond consumption has favorable effects on CRP levels in individuals with CVD risk factors. More high-quality trials are needed to confirm these findings.

Effect of premeal pistachio supplementation on cardiometabolic risk factors among Asian Indian adults with prediabetes: A randomized controlled trial.

Ashwini, K., K. Abirami, R. Gayathri, S. Sasikala, V. Sudha, S. Shobana, R.G. Jeevan, K. Krishnaswamy, V. Deepika, M. Rajalakshmi, R.M.R. Bai, K. Parkavi, S. Padmavathi, R.M. Anjana, R. Unnikrishnan, F.B. Hu, W.C. Willett, J. Salas-Salvadó, S.N. Bhupathiraju, V. Mohan, 2025. Effect of premeal pistachio supplementation on cardiometabolic risk factors among Asian Indian adults with prediabetes: A randomized controlled trial. J Nutr. 155(3):899-909. https://doi.org/10.1016/j.tjnut.2024.12.005

Background: Asian Indians are susceptible to developing type 2 diabetes at a lower age and often consume diets that are high in glycemic load and low in healthy fats. Objectives: This study aimed to evaluate the effect of 30g prebreakfast and 30g predinner supplementation of pistachios for 12 wk on glycated hemoglobin (HbA1c), other glycemic markers, anthropometry, and lipid profile of Asian Indians with prediabetes. Methods: In a 12-wk parallel arm, randomized controlled trial, we recruited 120 participants with prediabetes based on American Diabetes Association criteria. The intervention group (n = 60) consumed 60g pistachios (30g prebreakfast and predinner) whereas the control group (n = 60) followed a routine diet that excluded nuts. At baseline and 12 wk, we collected blood samples for biochemical analysis, anthropometrics, and 24-h recalls. Participants wore a continuous glucose monitoring (CGM) sensor during the trial’s first and last 2 wk. Urinary N-methyl-trans-4-hydroxy-l-proline (MHP) was measured as a marker of pistachio consumption. Results: A total of 109 participants completed the study (follow-up rate = 90.8%). Compared with participants in the control group, those in the intervention group had significant reductions in HbA1c (mean between-group difference: −0.2; 95% confidence interval: −0.3, −0.1; P < 0.001] with no significant changes in fasting or 2-h post glucose load plasma glucose. Compared with the control group, the intervention group had significant reductions in serum triglyceride, waist circumference, lipid accumulation product, visceral adiposity index, and atherogenic index. Urinary MHP (mg/g creatinine) showed a 62% increase in the intervention compared with the control group (P < 0.05). CGM data revealed significant decreases in the incremental area under the curve, 2-h after breakfast (28%, p=0.01) and after dinner (17%, P = 0.002) in the intervention group compared to the control group. Conclusions: A 12-wk, premeal load of 60g pistachios lowers HbA1c and improves cardiometabolic profile among Asian Indians with prediabetes. This is among the first studies to investigate these effects in this ethnic group.