Al Wattar, B.H., J. Dodds, A. Placzek, E. Spyreli, A. Moore, R. Hooper, L. Beresford, T.J. Roseboom, M. Bes-Rastrollo, G. Hitman, K.S. Khan, S. Thangaratinam; ESTEEM study group, 2016. Effect of simple, targeted diet in pregnant women with metabolic risk factors on maternal and fetal outcomes (ESTEEM): study protocol for a pragmatic multicentre randomised trial. BMJ Open. 2016;6:e013495. doi:10.1136/bmjopen-2016013495.
Introduction: Women with metabolic risk factors are at higher risk of adverse pregnancy outcomes. Mediterranean-based dietary interventions have the potential to minimise these risks. We aim to evaluate the effectiveness of a simple, targeted intervention modelled on Mediterranean diet in preventing maternal and fetal complications in pregnant women with metabolic risk factors. Methods and Analysis: Pregnant women with a singleton pregnancy <18 weeks gestation, and without pre-existing diabetes, chronic renal disease and autoimmune diseases will be recruited. Women with metabolic risk factors will be randomised to receive a dietary intervention based on a Mediterranean pattern, supplemented with extra virgin olive oil and mixed nuts until delivery. The intervention will be delivered through a series of one to one and group sessions. The primary outcome is a composite maternal outcome of pre-eclampsia or gestational diabetes and a composite fetal outcome of stillbirth, small for gestational age fetus or admission to the neonatal intensive care unit. Secondary outcomes include maternal, fetal, dietary and laboratory outcomes. We aim to randomise 1230 eligible women with metabolic risk factors. We will also compare the outcomes in women with and without these risk factors. The sample size will provide us with 80% power at 5% significance, assuming a 20% loss to follow-up to detect a 30% reduction in maternal and fetal complications. Ethics and Dissemination: The ESTEEM trial is designed to provide a definitive estimate of the effects of Mediterranean dietary pattern in pregnancy on maternal and fetal outcomes. The pragmatic nature of ESTEEM ensures the applicability of its findings into clinical practice. The findings of the study will be published in peer-reviewed journals and presented at national and international scientific meetings and congresses.
Robbins, W.A., L. Xun, L.Z. FitzGerald, S. Esguerra, S.M. Henning, C.L. Carpenter, 2012. Walnuts improve semen quality in men consuming a western-style diet: randomized control dietary intervention trial. Biol Reprod. doi:10.1095/biolreprod.112.101634
Purpose: We tested the hypothesis that 75 gm of whole-shelled walnuts/day added to a Westernstyle diet of healthy young men would beneficially affect semen quality. Methods: A randomized, parallel two-group, dietary intervention trial with single-blind masking of outcome assessors, was conducted with 117 healthy men, age 21 – 35 years, who routinely consumed a Western-style diet. Primary outcome evaluated was improvement from baseline to 12 weeks in conventional semen parameters and sperm aneuploidy. Secondary endpoints included blood serum and sperm fatty acid (FA) profiles, sex hormones, and serum folate. Conclusions: The group consuming walnuts (n=59) experienced improvement in sperm vitality, motility, and morphology and the group continuing their usual diet but avoiding tree nuts (n=58) saw no change. Comparing differences from baseline between the groups, significance was found for vitality p=0.003, motility p=0.009, and morphology (normal forms) p=0.04. Serum FA profiles improved in the walnut group with increases in omega-6 (p=0.0004) and omega-3 p=0.0007) but not the control group. Only the plant source of omega-3, α-linolenic acid (ALA), increased (p=0.0001). Sperm aneuploidy was inversely correlated with sperm ALA, particularly sex chromosome nullisomy (-0.41, p=0.002). Findings demonstrated that walnuts added to a Western-style diet improved sperm vitality, motility and morphology.
Maslova, E., C. Granstrőm, S. Hansen, S.B. Petersen, M. Strøm, W.C. Willett, S.F. Olsen, 2012. Peanut and tree nut consumption during pregnancy and allergic disease in children—should mothers decrease their intake? Longitudinal evidence from the Danish National Birth Cohort. J Allergy Clin Immunol. 130:724-32.
Background: The relation between maternal peanut intake during pregnancy and allergic disease development in children has been controversial. Objective: We used data from the Danish National Birth Cohort to examine associations between maternal peanut and tree nut intake during pregnancy and allergic outcomes in children at 18 months and 7 years of age. Methods: We estimated maternal peanut and tree nut intake (n 5 61,908) using a validated midpregnancy food frequency questionnaire. At 18 months, we used parental report of childhood asthma diagnosis, wheeze symptoms, and recurrent wheeze (>3 episodes). We defined current asthma at 7 years as doctor-diagnosed asthma plus wheeze in the past 12 months and allergic rhinitis as a self-reported doctor’s diagnosis. We also used alternative classifications based on registry-based International Classification of Diseases, Tenth Revision, codes and drug dispensary data. We report here odds ratios (ORs) comparing intake of 1 or more times per week versus no intake. Results: We found that maternal intake of peanuts (OR, 0.79; 95% CI, 0.65-0.97) and tree nuts (OR, 0.75; 95% CI, 0.67-0.84) was inversely associated with asthma in children at 18 months of age. Compared with mothers consuming no peanuts, children whose mothers reported eating peanuts 1 or more times per week were 0.66 (95% CI, 0.44-0.98) and 0.83 (95% CI, 0.70-1.00) times as likely to have a registry-based and medication related asthma diagnosis, respectively. Higher tree nut intake was inversely associated with a medication-related asthma diagnosis (OR, 0.81; 95% CI, 0.73-0.90) and self-reported allergic rhinitis (OR, 0.80; 95% CI, 0.64-1.01). Conclusions: Our results do not suggest that women should decrease peanut and tree nut intake during pregnancy; instead, consumption of peanuts and tree nuts during pregnancy might even decrease the risk of allergic disease development in children.
Kalgaonkar, S., R.U. Almario, D. Gurusinghe, E.M. Garamendi, W. Buchan, K. Kim, S.E. Karakas, 2011. Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. European Journal of Clinical Nutrition. 65:386–393.
Background/Objectives: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance, dyslipidemia and increased inflammation, which all benefit from dietary intake of monounsaturated and n-3 polyunsaturated fatty acids (MUFA and n-3 PUFA). Our goal was to compare the effects of MUFA-rich almonds vs n-3/n-6 PUFA-rich walnuts on metabolic and endocrine parameters in PCOS. Subjects/Methods: Thirty-one PCOS patients randomly received either walnuts or almonds containing 31 g of total fat per day for 6 weeks. At the beginning and at the end, anthropometric parameters, fasting lipids, phospholipid-fatty acids, inflammatory markers, androgens, oral glucose tolerance tests (OGTT) and frequently sampled intravenous-GTT were obtained. Results: Weight remained stable. Within group, walnuts increased the n-3/n-6 essential PUFA in the diet and plasma phospholipids. Walnuts decreased low-density lipoprotein-cholesterol by 6% from 3.76±0.27 to 3.38±0.22 mmol/l (P=0.05) and apoprotein B by 11% from 0.72±0.04 to 0.64±0.05 g/l (P<0.03). Although almonds also reduced low-density lipoprotein-cholesterol by 10% and apoprotein B by 9%, these were not significant. Walnuts increased insulin response during OGTT by 26% (P<0.02). Both walnuts and almonds increased adiponectin (walnuts from 9.5±1.6 to 11.3±1.8 mg per 100 ml, P=0.0241; almonds from 10.1±1.5 to 12.2±1.4 mg/dl, P=0.0262). Walnuts decreased HgBA1 from 5.7±0.1 to 5.5±0.1% (P=0.0006) with significant intergroup difference from almonds (P=0.0470). Walnuts increased sex hormone-binding globulin from 38.3±4.1 to 43.1±4.3 nmol/l (P=0.0038) and almonds reduced free androgen index from 2.6±0.4 to 1.8±0.3 (P=0.0470). Conclusion: Nut intake exerted beneficial effects on plasma lipids and androgens in PCOS.
Aldemir M., E. Okulu, S. Neşelioğlu, O. Erel, O. Kayıgil, 2011. Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res. 23(1):32-8.
We investigated the effects of Antep pistachio on International Index of Erectile Function (IIEF) scores, penile color Doppler ultrasound (PCDU) parameters and serum lipid levels in patients with ED. A total of 17 married male patients with ED for at least 12 months were included in this prospective study. Patients were put on a 100 g pistachio nuts diet for 3 weeks. IIEF and PCDU were evaluated before and after the pistachio diet. In addition, plasma total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured before and after dietary modifications from all subjects. Mean IIEF-15 score was 36 ± 7.5 before the diet and 54.2 ± 4.9 after the diet (P=0.001). Similarly, an increase in all five domains of IIEF was observed after the diet (P<0.05). Mean peak systolic velocity values before and after the pistachio diet were 35.5 ± 15.2 and 43.3 ± 12.4 cm s(-1), respectively (P=0.018). After the pistachio diet, TC and LDL levels decreased significantly, whereas HDL level increased (P=0.008, 0.007 and 0.001, respectively). We demonstrated that a pistachio diet improved IIEF scores and PCDU parameters without any associated side effects in patients with ED. Furthermore, the lipid parameters showed statistically significant improvements after this diet.
Spaccarotella, K.J., Kris-Etherton P.M., Stone, W.L., Bagshaw, D.M., Fishell V.K., West S.G., Lawrence F.R., and Hartman T.J., 2008. The Effect of Walnut Intake on Factors Related to Prostate and Vascular Health in Older Men. Nutrition Journal. 7:13.
Background: Tocopherols may protect against prostate cancer and cardiovascular disease (CVD). Methods: We assessed the effect of walnuts, which are rich in tocopherols, on markers of prostate and vascular health in men at risk for prostate cancer. We conducted an 8-week walnut supplement study to examine effects of walnuts on serum tocopherols and prostate specific antigen (PSA). Subjects (n = 21) consumed (in random order) their usual diet +/- a walnut supplement (75 g/d) that was isocalorically incorporated in their habitual diets. Prior to the supplement study, 5 fasted subjects participated in an acute time course experiment and had blood taken at baseline and 1, 2, 4, and 8 h after consuming walnuts (75 g). Results: During the time course experiment, triglycerides peaked at 4 h, and gamma-tocopherol (γ-T) increased from 4 to 8 h. Triglyceride – normalized γ-T was two-fold higher (P = 0.01) after 8 versus 4 h. In the supplement study, change from baseline was +0.83 ± 0.52 μmol/L for γ-T, -2.65 ± 1.30 μmol/L for alpha-tocopherol (α-T) and -3.49 ± 1.99 for the tocopherol ratio (α-T: γ-T). A linear mixed model showed that, although PSA did not change, the ratio of free PSA:total PSA increased and approached significance (P = 0.07). The α-T: γ-T ratio decreased significantly (P = 0.01), partly reflecting an increase in serum γ-T, which approached significance (P = 0.08). Conclusion: The significant decrease in the α-T: γ-T ratio with an increase in serum γ-T and a trend towards an increase in the ratio of free PSA:total PSA following the 8-week supplement study suggest that walnuts may improve biomarkers of prostate and vascular statu
Simon J., J. Sabaté, J. Tanzman, 2007. Lack of effect of walnut on serum levels of prostate specific antigen: A brief report. AJCN. 26; 4; 317-320.
Objective: To examine whether the short-term consumption of walnuts, a food rich in α-linolenic acid, affects levels of serum prostate-specific antigen (PSA), a marker of prostate enlargement, inflammation, and cancer. Methods: Using data from a 12-month randomized crossover study examining the effect of walnut consumption on body composition, we examined whether increased walnut consumption (mean 35 grams daily, 12% total energy) affected serum PSA levels among 40 middle-aged men. Results: There was no significant difference between mean PSA level at the conclusion of the 6-month walnut-supplemented diet (1.05 μg/L, 95% CI [0.81, 1.37]) and the conclusion of the 6-month control diet (1.06 μg/L, 95% CI [0.81, 1.38]) (P = 0.86) (or a mean proportional decrease in PSA of -1%). Conclusions: Our results suggest that short-term consumption of walnuts is unlikely to affect PSA levels adversely among otherwise normal men.
