Abstract
This comprehensive narrative review of 64 randomized controlled trials (RCTs) and 14 systematic reviews and/or meta-analyses provides an in-depth analysis of the effect of almonds on weight measures, metabolic health biomarkers and outcomes, and the colonic microbiota, with extensive use of figures and tables. Almonds are a higher energy-dense (ED) food that acts like a lower ED food when consumed. Recent systematic reviews and meta-analyses of nut RCTs showed that almonds were the only nut that had a small but significant decrease in both mean body mass and fat mass, compared to control diets. The biological mechanisms for almond weight control include enhanced displacement of other foods, decreased macronutrient bioavailability for a lower net metabolizable energy (ME), upregulation of acute signals for reduced hunger, and elevated satiety and increased resting energy expenditure. The intake of 42.5 g/day of almonds significantly lowered low-density lipoprotein cholesterol (LDL-C), 10-year Framingham estimated coronary heart disease (CHD) risk and associated cardiovascular disease (CVD) medical expenditures. Diastolic blood pressure (BP) was modestly but significantly lowered when almonds were consumed at >42.5 g/day or for >6 weeks. Recent RCTs suggest possible emerging health benefits for almonds such as enhanced cognitive performance, improved heart rate variability under mental stress, and reduced rate of facial skin aging from exposure to ultraviolet (UV) B radiation. Eight RCTs show that almonds can support colonic microbiota health by promoting microflora richness and diversity, increasing the ratio of symbiotic to pathogenic microflora, and concentrations of health-promoting colonic bioactives. Almonds are a premier healthy snack for precision nutrition diet plans.
Highlights
Compared to other nuts, a serving of almonds provides the highest or among the highest amounts of fiber, protein, monounsaturated and polyunsaturated fats, magnesium, calcium, iron, folate, riboflavin, niacin, vitamin E, phytosterols, flavonoids, and phenolic acids, and are among the lowest in calories, available carbohydrates, and saturated fat [1,2]
Six systematic reviews and meta-analyses published since 2018 have evaluated total and/or specific nut-enriched diets compared to control diets for their effects on body mass, fat mass or %, body mass index (BMI), and waist circumference (WC) [23,24,25,26,27,28]. These analyses showed that only almonds had a small but significant mean decrease in body and fat mass compared to control diets to help reduce the risk of being overweight or obese, especially at doses >42.5 g/day and for >6 weeks duration [24,25,26,27,28]
Guarneiri et al [23], in a 2021 systematic review and meta-analysis of 55 randomized controlled trials (RCTs) of all commonly consumed nuts, found that there was no significant overall mean change in body mass, BMI, and WC in diets with 10–100 g nuts/day consumed over 3 to 52 weeks, regardless of the level of dietary substitution guidance provided. nut diets with dietary substitution guidance significantly reduced overall mean % body fat (BF%) compared to nut diets without dietary substitution guidance (Table 1)
Summary
A serving of almonds provides the highest or among the highest amounts of fiber, protein, monounsaturated and polyunsaturated fats, magnesium, calcium, iron, folate, riboflavin, niacin, vitamin E, phytosterols, flavonoids, and phenolic acids, and are among the lowest in calories, available carbohydrates, and saturated fat [1,2]. There are a number of possible emerging almond health outcomes on improved cognitive performance, variable heart rate when under mental stress, and protection against adverse ultraviolet (UV) B radiation on facial aging The objective of this narrative review is to provide a comprehensive overview of data from all almond RCTs on body weight and composition measures, metabolic health biomarkers and outcomes, and the colonic microbiota, with numerous figures and tables to highlight important RCT design variations and result attributes that are not typically presented with detail in systematic reviews and meta-analyses, which are designed to focus on, for example, the quality of the RCTs analyzed, overall mean, coefficient intervals, dose–response effects, effect sizes, or level of heterogeneity
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