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Research Area: Consumption

Diet quality improves for parents and children when almonds are incorporated into their daily diet: a randomized, crossover study.

Burns, A.M., M.A. Zitt, C.C. Rowe, B. Langkamp-Henken, V. Mai, C. Nieves, Jr., M. Ukhanova, M.C. Christman, W.J. Dahl, 2016. Diet quality improves for parents and children when almonds are incorporated into their daily diet: a randomized, crossover study. Nutr. Res. 36:80-89.

The health benefits of nuts may, in part, be due to the fiber that provides substrate for the maintenance of a healthy and diverse microbiota. We hypothesized that consuming almonds would benefit immune status through improving diet quality and modulation of microbiota composition in parents and their children, while improving gastrointestinal function. In a crossover trial, 29 parents (35 ± 0.6 years) and their children (n = 29; 4 ± 0.2 years; pairs) consumed 1.5 and 0.5 oz, respectively, of almonds and/or almond butter or control (no almonds) for 3 weeks followed by 4-week washouts. Parents completed daily questionnaires of stool frequency and compliance with nut intake. The Gastrointestinal Symptom Response Scale was administered weekly. Participants provided stools for microbiota analysis and saliva for secretory immunoglobulin A. Serum antioxidant/proinflammatory balance was determined in parents. From weekly dietary recalls (Automated Self-Administered 24-Hour Dietary Recall), nutrient and energy intake were assessed and Healthy Eating Index-2010 scores were calculated. Consuming almonds increased total Healthy Eating Index score from 53.7 ± 1.8 to 61.4 ± 1.4 (parents) and 53.7 ± 2.6 to 61.4 ± 2.2 (children; P < .001). Minimal changes in gastrointestinal symptoms and no change in stool frequency were noted with the almond intervention. Microbiota was stable at the phylum and family level, but genus-level changes occurred with nut intake, especially in children. No differences were observed for immune markers. Although higher intakes of almonds or longer interventions may be needed to demonstrate effects on immune status, a moderate intake of almonds improves diet quality in adults and their young children and modulates microbiota composition.

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 (n = 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 (p < 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 (p < 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 (p < 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.

Impact of typical rather than nutrient-dense food choices in the US department of agriculture food patterns.

Britten, P., L.E. Cleveland, K.L. Koegel, K.J. Kuczynski, S.M. Nickols-Richardson, 2012. Impact of typical rather than nutrient-dense food choices in the US department of agriculture food patterns. J Acad Nutr Diet. 112:1560-1569.

Background: The US Department of Agriculture (USDA) Food Patterns, released as part of the 2010 Dietary Guidelines for Americans, are designed to meet nutrient needs without exceeding energy requirements. They identify amounts to consume from each food group and recommend that nutrient-dense forms—lean or low-fat, without added sugars or salt—be consumed. Americans fall short of most food group intake targets and do not consume foods in nutrient-dense forms. Intake of calories from solid fats and added sugars exceed maximum limits by large margins. Objective: Our aim was to determine the potential effect on meeting USDA Food Pattern nutrient adequacy and moderation goals if Americans consumed the recommended quantities from each food group, but did not implement the advice to select nutrient dense forms of food and instead made more typical food choices. Design Food-pattern modeling analysis using the USDA Food Patterns, which are structured to allow modifications in one or more aspects of the patterns, was used. Nutrient profiles for each food group were modified by replacing each nutrient-dense representative food with a similar but typical choice. Typical nutrient profiles were used to determine the energy and nutrient content of the food patterns. Results: Moderation goals are not met when amounts of food in the USDA Food Patterns are followed and typical rather than nutrient-dense food choices are made. Energy, total fat, saturated fat, and sodium exceed limits in all patterns, often by substantial margins. With typical choices, calories were 15% to 30% (ie, 350 to 450 kcal) above the target calorie level for each pattern. Adequacy goals were not substantially affected by the use of typical food choices. Conclusions: If consumers consume the recommended quantities from each food group and subgroup, but fail to choose foods in low-fat, no-added-sugars, and low-sodium forms, they will not meet the USDA Food Patterns moderation goals or the 2010 Dietary Guidelines for Americans.

Nut consumption is associated with a healthy dietary pattern in military men.

Mullie, M., P. Clarys, 2012. Nut consumption is associated with a healthy dietary pattern in military men. Food and Nutrition Sciences. 3:1048-1054.

The objective of the research was to determine the relation between nut consumption and dietary patterns described by Healthy Eating Index, Mediterranean Diet Score and principal component analysis. In a cross-sectional study, 1852 military men were contacted by mail. Using food-frequency questionnaires, nut consumption was recorded and stratified in weekly versus less than weekly. Three dietary indices were calculated and stratified in quintiles. For principal component analysis, the healthiest dietary pattern rich in fruits and vegetables was selected as Healthy Dietary Pattern. The highest quintiles of Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern were systematically associated with the highest weekly consumption of nuts. The highest quintiles were also associated with the lowest intake of saturated fat, i.e. between 10 and 12 energy-percent compared with 17 to 19 energy-percent for the lowest quintiles. The mean daily nut consumption was less than 6 g a day, which is beneath the recommended quantity for cardiovascular protection. Nut consumption was associated with the healthiest dietary pattern, independently of the used method to determine the dietary pattern. Regular nut consumption seems to be a component of a cluster of several healthy behaviors.

Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999-2004.

O’Neil, C.E., D.R. Keast, T.A. Nicklas, V.L. Fulgoni, 2012. Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999-2004. Nutrition Research. 32:185-194.

The purpose of this study was to determine the association of out-of-hand nut (OOHN) consumption with nutrient intake, diet quality, and the prevalence of risk factors for cardiovascular disease and metabolic syndrome. Data from 24-hour recalls from individuals aged 2+ years (n = 24,385) participating in the 1999-2004 National Health and Nutrition Examination Survey were used. The population was divided into children aged 2 to 11, 12 to 18, and adults 19+ years, and each group was dichotomized into OOHN consumers and nonconsumers. Out-of-hand nut consumers were defined as those individuals consuming ¼ oz of nuts or more per d. Means, standard errors, and covariate-adjusted analyses of variance were determined using appropriate sample weights. Diet quality was determined using the Healthy Eating Index-2005. Significance was set at P < .05. The percent of OOHN consumers increased with age: 2.1% ± 0.3%, 2.6% ± 0.3%, 6.5% ± 0.5%, and 9.6% ± 0.5% those aged 2 to 11, 12 to 18, 19 to 50, and 51+ years, respectively. The 2 latter groups were combined into a single group of consumers aged 19+ years for subsequent analyses. Consumers of OOHN from all age groups had higher intakes of energy, monounsaturated and polyunsaturated fatty acids, dietary fiber, copper, and magnesium and lower intakes of carbohydrates, cholesterol, and sodium than did nonconsumers. Diet quality was higher in OOHN consumers of all age groups. In children aged 2 to 11 years, consumers had a higher prevalence of overweight/obesity. In those aged 12 to 18 years, weight and percent overweight were lower in consumers. Adult consumers had higher high-density lipoprotein cholesterol, red blood cell folate, and serum folate levels and lower insulin, glycohemoglobin, and C-reactive protein levels than did nonconsumers. Adult consumers also had a 19% decreased risk of hypertension and a 21% decreased risk of low high-density lipoprotein cholesterol levels. Data suggested that OOHN consumption was associated with improved nutrient intake, diet quality, and, in adults, a lower prevalence of 2 risk factors for metabolic syndrome. Consumption of OOHN, as part of a healthy diet, should be encouraged by health professionals.

Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in U.S. adults: NHANES 1999–2004.

O’Neil, C.E., D.R. Keast, T.A. Nicklas, V.L. Fulgoni, 2011. Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in U.S. adults: NHANES 1999–2004. Journal of the American College of Nutrition. 30(6):502–510.

Background: Few recent epidemiologic studies have assessed the effect that nut consumption (including tree nuts and peanuts) has on health risks, including metabolic syndrome (MetS). Objective: This study compared the health risk for cardiovascular disease, type 2 diabetes, and MetS of nut consumers with that of nonconsumers. Design: Adults 19+ years (n = 13,292) participating in the 1999–2004 National Health and Nutrition Examination Survey were used. Intake from 24-hour recalls was used to determine intake. Nut/tree nut consumers consumed ≥¼ ounce per day. Covariate-adjusted means, standard errors, and prevalence rates were determined for the nut consumption groups. Results: The prevalence of nut consumers was 18.6% ± 0.7% and 21.0% ± 0.9% in those 19–50 years and 51 years and older, respectively. Nut consumption was associated with a decreased body mass index (27.7 kg/m2 ± 0.2 vs 28.1 ± 0.1 kg/m2, p<0.05), waist circumference (95.6 ± 0.4 cm vs 96.4 ± 0.3 cm, p < 0.05), and systolic blood pressure (121.9 ± 0.4 mmHg vs 123.20 ± 0.3 mmHg, p < 0.01) compared with nonconsumers. Tree nut consumers also had a lower weight (78.8 ± 0.7 kg vs 80.7 ± 0.3 kg, p < 0.05). Nut consumers had a lower percentage of two risk factors for MetS: hypertension (31.5% ± 1.0% vs 34.2% ± 0.8%, p < 0.05) and low high density lipoprotein-cholesterol (HDL-C) (29.6% ± 1.0% vs 34.8% ± 0.8%, p < 0.01). Tree nut consumers had a lower prevalence of four risk factors for MetS: abdominal obesity (43.6% ± 1.6% vs 49.5% ± 0.8%, p < 0.05), hypertension (31.4% ± 1.2% vs 33.9% ± 0.8%, p < 0.05), low HDL-C (27.9% ± 1.7% vs 34.5% ± 0.8%, p < 0.01), high fasting glucose (11.4% ± 1.4% vs 15.0% ± 0.7%, p < 0.05), and a lower prevalence of MetS (21.2% ± 2.1% vs 26.6% ± 0.7%, p < 0.05). Conclusion: Nut/tree nut consumption was associated with a decreased prevalence of selected risk factors for cardiovascular disease, type 2 diabetes, and MetS.

Consumption of polyunsaturated fatty acids, fish, and nuts and risk of inflammatory disease mortality.

Gopinath, B., A.E. Buyken, V.M. Flood, M. Empson, E. Rochtchina, P. Mitchell, 2011. Consumption of polyunsaturated fatty acids, fish, and nuts and risk of inflammatory disease mortality. Am J Clin Nutr. 93:1073–9.

Background: n–3 (omega-3) Polyunsaturated fatty acids (PUFAs), fish, and nuts can regulate inflammatory processes and responses. Objective: We investigated whether dietary intakes of PUFAs [n-3, n–6 (omega-6), and α-linolenic acid], fish, and nuts were associated with 15-y mortality attributed to noncardiovascular, noncancer inflammatory diseases. Design: The analyses involved 2514 participants aged ≥49 y at baseline. Dietary data were collected by using a semiquantitative food-frequency questionnaire, and PUFA, fish, and nut intakes were calculated. Inflammatory disease mortality was confirmed from the Australian National Death Index. Results: Over 15 y, 214 subjects died of  inflammatory diseases. Women in the highest tertiles of total n-3 PUFA intake, compared with those in the lowest tertile of intake at baseline, had a 44% reduced risk of inflammatory disease mortality (P for trend = 0.03). This association was not observed in men. In both men and women, each 1-SD increase in energy-adjusted intake of α-linolenic acid was inversely associated with inflammatory mortality (hazard ratio: 0.83; 95% CI: 0.71, 0.98). Subjects in the second and third tertiles of nut consumption had a 51% and 32% reduced risk of inflammatory disease mortality, respectively, compared with those in the first tertile (reference). Dietary intakes of long-chain n-3 and n-6 PUFAs and fish were not associated with inflammatory disease mortality. Conclusions: We report on a novel link between dietary intake of total n-3 PUFA and risk of inflammatory disease mortality in older women. Furthermore, our data indicate a protective role of nuts, but not fish, against inflammatory disease mortality.

Mediterranean nuts: origins, ancient medicinal benefits and symbolism.

Casas-Agustench, P., A. Salas-Huetos, J. Salas-Salvado´, 2011. Mediterranean nuts: origins, ancient medicinal benefits and symbolism. Public Health Nutrition: 14(12A): 2296–2301.

Objective: To consider historical aspects of nuts in relation to origin and distribution, attributed medicinal benefits, symbolism, legends and superstitions. Design: Review of historical aspects of nuts. Setting: Mediterranean region. Subjects: The varieties reviewed include almonds, walnuts, hazelnuts, pine nuts and pistachios. Results and conclusions: Like other foods, nuts have a wide variety of cultural connections to the areas where they grow and to the people who live there or eat them. History, symbolism and legends reveal the ancient tradition of nuts and how they are related to the lives of our ancestors. Archaeological excavations in eastern Turkey have uncovered the existence of a non-migratory society whose economy centered on harvesting nuts. This shows that nuts have been a staple in the human diet since the beginnings of history. Moreover, since ancient times nuts have been used for their medicinal properties. They also play a role in many old legends and traditions.

Current guidelines for nut consumption are achievable and sustainable: a hazelnut intervention.

Tey, S.L., R. Brown, A. Chisholm, A. Gray, S. Williams, C. Delahunty, 2011. Current guidelines for nut consumption are achievable and sustainable: a hazelnut intervention. Br J Nutr. 105:1503–1511.

Nuts are known for their hypocholesterolaemic properties; however, to achieve optimal health benefits, nuts must be consumed regularly and in sufficient quantity. It is therefore important to assess the acceptability of regular consumption of nuts. The present study examined the long-term effects of hazelnut consumption in three different forms on ‘desire to consume’ and ‘overall liking’. A total of forty-eight participants took part in this randomised cross-over study with three dietary phases of 4 weeks: 30 g/d of whole, sliced and ground hazelnuts. ‘Overall liking’ was measured in a three-stage design: a pre- and post-exposure tasting session and daily evaluation over the exposure period. ‘Desire to consume’ hazelnuts was measured during the exposure period only. Ratings were measured on a 150 mm visual analogue scale. Mean ratings of ‘desire to consume’ were 92 (SD 35) mm for ground, 108 (SD 33) mm for sliced and 116 (SD 30) mm for whole hazelnuts. For ‘overall liking’, the mean ratings were 101 (SD 29) mm for ground, 110 (SD 32) mm for sliced and 118 (SD 30) mm for whole hazelnuts. Ground hazelnuts had significantly lower ratings than both sliced (P ≤ 0.034) and whole hazelnuts (P < 0.001), with no difference in ratings between sliced and whole hazelnuts (P ≥ 0.125). For each form of nut, ratings of ‘overall liking’ and ‘desire to consume’ were stable over the exposure period, indicating that not only did the participants like the nuts, but also they wished to continue eating them. Therefore, the guideline to consume nuts on a regular basis appears to be a sustainable behaviour to reduce CVD.

Cultural and historical aspects of Mediterranean nuts with emphasis on their attributed healthy and nutritional properties.

Salas-Salvadó J, Casas-Agustench P, Salas-Huetos A., 2011. Cultural and historical aspects of Mediterranean nuts with emphasis on their attributed healthy and nutritional properties. Nutr Metab Cardiovasc Dis. 21(Suppl 1):S1-6.

BACKGROUND AND AIMS: Nuts have been part of the human diet since prehistoric times. The aim of the present article is to describe the most important historical and cultural aspects of nut consumption throughout history. DATA SYNTHESIS: We discuss the following historical aspects of nuts originating in the Mediterranean: prehistory, the Egyptian civilization, their spread through the Mediterranean region by the Greek, Phoenician and Roman civilizations, and their reintroduction into Europe by means of the Al-Andalus culture. Particular emphasis is placed on the healthy and nutritional attributes that nuts have had throughout history. We also consider the role of the first globalization of food–the exchange of nuts between continents–and discuss the symbolism that nuts have had for humans throughout history in the context of cultural aspects of the Mediterranean region. CONCLUSIONS: Nuts and fruits are probably the earliest foods consumed by humans and are considered to be important because of their nutritional properties. Nuts have also been used in the past by different civilizations as drugs to prevent or treat several diseases.