A Moderate‐Fat Diet with Pistachios Lowers Small‐Dense LDL and Improves Markers of Insulin Sensitivity in Subjects with Moderately‐Elevated Cholesterol Levels

Abstract

We evaluated the dose‐response effects of pistachios over 4 weeks, on markers of insulin sensitivity in individuals (N=28) with moderately elevated LDL‐C (>; 110 mg/dl). Three test diets (SFA ≈ 8%; cholesterol < 300 mg/dl) were fed in this crossover study: control (25% total fat); 10% of energy from pistachios (1PD; 32–63 g; 30% total fat); or 20% of energy from pistachios (2PD; 63–126 g; 34% total fat). A Western run‐in diet (35% total fat, 11% SFA) was fed for 2 weeks; subjects had a mean BMI of 26.8 ± 0.7 kg/m2 and were weight stable while on the study. There was a significant diet effect on small‐dense LDL (sdLDL) levels (P = 0.001); sdLDL decreased on the 2PD versus the 1PD (P = 0.03) and the 2PD versus control (P = 0.001). There also was a significant diet effect for the TG/HDL‐C ratio (P = 0.041), with a significant reduction on the 2PD versus control (P = 0.036). Reductions in sdLDL levels were significantly correlated with reductions in TG levels (r = 0.424; P = 0.025); changes were calculated as the difference between baseline and post 2PD treatment. There were no significant diet effects for HDL‐C levels when comparing the pistachio diets to control, but there were trends for diet effects on increasing levels of functional α‐1 (P = 0.073) and α‐2 (P = 0.056) HDL particles. Pistachio inclusion in a moderate‐fat diet (≈ 35%) favorably affects insulin sensitivity and contributes to a beneficial cardio‐metabolic profile.Grant Funding Source: American Pistachio Growers