Abstract
BackgroundThere is convincing evidence that daily whole almond consumption lowers blood LDL cholesterol concentrations, but effects on other cardiometabolic risk factors such as endothelial function and liver fat are still to be determined.ObjectivesWe aimed to investigate whether isoenergetic substitution of whole almonds for control snacks with the macronutrient profile of average snack intakes, had any impact on markers of cardiometabolic health in adults aged 30–70 y at above-average risk of cardiovascular disease (CVD).MethodsThe study was a 6-wk randomized controlled, parallel-arm trial. Following a 2-wk run-in period consuming control snacks (mini-muffins), participants consumed either whole roasted almonds (n = 51) or control snacks (n = 56), providing 20% of daily estimated energy requirements. Endothelial function (flow-mediated dilation), liver fat (MRI/magnetic resonance spectroscopy), and secondary outcomes as markers of cardiometabolic disease risk were assessed at baseline and end point.ResultsAlmonds, compared with control, increased endothelium-dependent vasodilation (mean difference 4.1%-units of measurement; 95% CI: 2.2, 5.9), but there were no differences in liver fat between groups. Plasma LDL cholesterol concentrations decreased in the almond group relative to control (mean difference −0.25 mmol/L; 95% CI: −0.45, −0.04), but there were no group differences in triglycerides, HDL cholesterol, glucose, insulin, insulin resistance, leptin, adiponectin, resistin, liver function enzymes, fetuin-A, body composition, pancreatic fat, intramyocellular lipids, fecal SCFAs, blood pressure, or 24-h heart rate variability. However, the long-phase heart rate variability parameter, very-low-frequency power, was increased during nighttime following the almond treatment compared with control (mean difference 337 ms2; 95% CI: 12, 661), indicating greater parasympathetic regulation.ConclusionsWhole almonds consumed as snacks markedly improve endothelial function, in addition to lowering LDL cholesterol, in adults with above-average risk of CVD.This trial was registered at clinicaltrials.gov as NCT02907684.
Highlights
Cardiovascular disease (CVD) continues to be the leading cause of global mortality
The development of cardiovascular disease (CVD) is preceded by cumulative interrelated hemodynamic and metabolic disturbances that develop over the life course and feature in the pathophysiological progression to type 2 diabetes (T2D) [1]
Fasting plasma non-HDL and LDL cholesterol concentrations were significantly reduced by almond snacks relative to control by −0.22 mmol/L and −0.25 mmol/L, respectively (Table 5), but there were no significant treatment effects on HDL cholesterol, triacylglycerol, glucose, insulin, HOMA-IR, adipokines, and markers of fatty liver
Summary
Cardiovascular disease (CVD) continues to be the leading cause of global mortality. The development of CVD is preceded by cumulative interrelated hemodynamic and metabolic disturbances that develop over the life course and feature in the pathophysiological progression to type 2 diabetes (T2D) [1]. Data derived from respondents to the UK National Diet and Nutrition Survey 2008–2012 revealed that the average snack nutrient profile had 14% of energy as saturated fats and 23% of energy as sugars. There is convincing evidence that daily whole almond consumption lowers blood LDL cholesterol concentrations, but effects on other cardiometabolic risk factors such as endothelial function and liver fat are still to be determined. Conclusions: Whole almonds consumed as snacks markedly improve endothelial function, in addition to lowering LDL cholesterol, in adults with above-average risk of CVD. This trial was registered at clinicaltrials.gov as NCT02907684.
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