Brown, R. C., L. Ware, A.R. Gray, S.L. Tey, A. Chisholm, 2023. Comparing the effects of consuming almonds or biscuits on body weight in habitual snackers: a 1-year randomized controlled trial. Amer. J. Clin. Nutr. 118(1):228–240. https://doi.org/10.1016/j.ajcnut.2023.05.015
Background: Almonds are nutrient rich, providing a healthier alternative to many snacks. Studies report health benefits with regular almond consumption without adverse weight gain. However, most interventions have been relatively short or have included additional dietary advice. Objectives: Taking a pragmatic approach, we compared consumption of almonds compared with biscuits on body weight and other health outcomes in a population of regular snackers of discretionary foods, hypothesizing the almonds will displace some of the less-healthful snacks in their current diets. Methods: We randomly assigned 136 nonobese habitual discretionary snackers to receive almonds or biscuits daily for 1 y. These isocaloric snacks provided either 10% of participants’ total energy (TE) requirements or 1030 kJ (equivalent to 42.5 g almonds), whichever was greater. Anthropometry, blood biomarkers, diet, appetite, sleep, and physical activity were assessed at baseline, 3, 6, and 12 mo, and body composition and RMR at baseline and 12 mo. Results: The difference in changes for body weight from baseline to 12 mo was not statistically significant (geometric means: 67.1 and 69.5 kg for almonds and 66.3 and 66.3 kg for biscuits, P = 0.275). There were no statistically significant differences in changes for body composition or other nondietary outcomes (all P ≥ 0.112). Absolute intakes of protein; total, polyunsaturated, and monosaturated fat; fiber; vitamin E; calcium; copper; magnesium; phosphorous; and zinc, and % TE from total monounsaturated, and polyunsaturated fat statistically significantly increased from baseline (all P ≤ 0.033), whereas % TE from carbohydrate and sugar statistically significantly (both P ≤ 0.014) decreased from baseline, in the almond compared with the biscuit group. Conclusions: Almonds can be incorporated into the diets of habitual snackers to improve diet quality, without evidence for changes in body weight, compared with a popular discretionary snack food.