title: Walnut-enriched diet increases the association of LDL from hypercholesterolemic men with human HepG2 cells. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers. Diets Containing Pistachios Reduce Systolic Blood Pressure and Peripheral Vascular Responses to Stress in Adults With Dyslipidemia Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts. A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feeding trial. Dietary alpha-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. Substituting Walnuts for Monounsaturated Fat Improves the Serum Lipid Profile of Hypercholesterolemic Men and Women A Walnut Diet Improves Endothelial Function in Hypercholesterolemic Subjects: A Randomized Crossover Trial The effect of walnut intake on factors related to prostate and vascular health in older men Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. Chronic and acute effects of walnuts on antioxidant capacity and nutritional status in humans: a randomized, cross-over pilot study A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity1234 Cocoa, Hazelnuts, Sterols and Soluble Fiber Cream Reduces Lipids and Inflammation Biomarkers in Hypertensive Patients: A Randomized Controlled Trial Pistachio Nut Consumption and Serum Lipid Levels Effect of moderate walnut consumption on lipid profile, arterial stiffness, and platelet activation in humans Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: a prospective study. Pecans lower low-density lipoprotein cholesterol in people with normal lipid levels. Effects of almond dietary supplementation on coronary heart disease lipid risk factors and serum lipid oxidation parameters in men with mild hyperlipidemia. A Pilot Study on the Effects of Almond Consumption on DNA Damage and Oxidative Stress in Smokers Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. Serum lipid profiles in Japanese women and men during consumption of walnuts Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. A diet rich in walnuts favourably influences plasma fatty acid profile in moderately hyperlipidaemic subjects Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. SERUM LIPID EFFECTS OF A MONOUNSATURATED (PALMITOLEIC) FATTY ACID‐RICH DIET BASED ON MACADAMIA NUTS IN HEALTHY, YOUNG JAPANESE WOMEN Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction Almonds in the diet simultaneously improve plasma alpha-tocopherol concentrations and reduce plasma lipids. Pistachio Nuts Reduce Triglycerides and Body Weight by Comparison to Refined Carbohydrate Snack in Obese Subjects on a 12-Week Weight Loss Program Effects of Plant-Based Diets High in Raw or Roasted Almonds, or Roasted Almond Butter on Serum Lipoproteins in Humans Effects of walnuts on serum lipid levels and blood pressure in normal men. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes Walnut Consumption in Hyperlipidemic Patients Effect of Walnut-Enriched Restructured Meat in the Antioxidant Status of Overweight/Obese Senior Subjects with at Least One Extra CHD-Risk Factor Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Cholesterol lowering effects of nuts compared with a Canola oil enriched cereal of similar fat composition. Major lipids, apolipoproteins, and risk of vascular disease. Effects of different forms of hazelnuts on blood lipids and α-tocopherol concentrations in mildly hypercholesterolemic individuals
abstract: In a r and omized , cross-over feeding trial involving 10 men with polygenic hypercholesterolemia , a control , Mediterranean-type cholesterol-lowering diet , and a diet of similar composition in which walnuts replaced approximately 35 % of energy from unsaturated fat , were given for 6 weeks each . Compared with the control diet , the walnut diet reduced serum total and LDL cholesterol by 4.2 % ( P = 0.176 ) , and 6.0 % ( P = 0.087 ) , respectively . No changes were observed in HDL cholesterol , triglycerides , and apolipoprotein A-I levels or in the relative proportion of protein , triglycerides , phospholipids , and cholesteryl esters in LDL particles . The apolipoprotein B level declined in parallel with LDL cholesterol ( 6.0 % reduction ) . Whole LDL , particularly the triglyceride fraction , was enriched in polyunsaturated fatty acids from walnuts ( linoleic and alpha-linolenic acids ) . In comparison with LDL obtained during the control diet , LDL obtained during the walnut diet showed a 50 % increase in association rates to the LDL receptor in human hepatoma HepG2 cells . LDL uptake by HepG2 cells was correlated with alpha-linolenic acid content of the triglyceride plus cholesteryl ester fractions of LDL particles ( r(2 ) = 0.42 , P < 0.05 ) . Changes in the quantity and quality of LDL lipid fatty acids after a walnut-enriched diet facilitate receptor-mediated LDL clearance and may contribute to the cholesterol-lowering effect of walnut consumption BACKGROUND Elevated serum cholesterol levels play an important role in the development of coronary artery disease . Previous studies have suggested that nut consumption benefits lipid profile .  Pistachio nuts are widely available , inexpensive and frequently consumed by the general population . OBJECTIVE To determine whether substituting 20 % of the daily caloric intake in the form of pistachio nuts will improve the lipid profiles of humans with primary , moderate hypercholesterolemia . DESIGN Controlled , r and omized crossover design . SETTING Outpatient dietary modification , counseling and blood analysis . PATIENTS Ten patients with moderate hypercholesterolemia . INTERVENTION Three weeks of dietary modification with 20 % caloric intake from pistachio nuts . MEASUREMENTS Body weight , blood pressure , total cholesterol , LDL , HDL , and triglycerides were monitored . Lipid profiles were analyzed prior to , during and after dietary modification . RESULTS After three weeks , there was a decrease in total cholesterol ( p<0.04 ) , an increase in HDL ( p<0.09 ) , a decrease in the total cholesterol/HDL ratio ( p<0.01 ) and a decrease in the LDL/HDL ratio ( p<0.02 ) . Triglycerides and LDL levels decreased , but not significantly . Body weight and blood pressure remained constant throughout the study . CONCLUSIONS Results suggest that eating pistachio nuts instead of other dietary fat calories can improve lipid profiles , thereby decreasing coronary risk . Further studies will be required to confirm these results and to determine the mechanism of this effect BACKGROUND AND AIMS Virgin olive oil ( VOO ) and nuts are basic components of the Mediterranean diet , a heart-healthy dietary pattern . Nuts have well known cholesterol lowering effects , while evidence is unclear for VOO . We design ed a study in hypercholesterolemic patients to assess the effects on serum lipids and other intermediate markers of cardiovascular risk of replacing 40 % of the fat in the background diet with VOO , walnuts or almonds . METHODS AND RESULTS After a 4 week run-in period with a healthy diet , eligible c and i date s were r and omized into three diet sequences in a crossover design , with a common background diet enriched with VOO , walnuts or almonds , lasting 4 weeks each . Outcomes were changes of serum lipids and oxidation and inflammation markers , measured by st and ard methods . Plasma fatty acids were determined by gas chromatography to assess compliance . In 18 participants completing the study ( 9 women , mean age 56 y , BMI 25.7 kg/m(2 ) ) , LDL-cholesterol was reduced from baseline by 7.3 % , 10.8 % and 13.4 % after the VOO , walnut and almond diets , respectively ( P = 0.001 , Friedman test ) . Total cholesterol and LDL/HDL ratios decreased in parallel . LDL-cholesterol decreases were greater than predicted from dietary fatty acid and cholesterol exchanges among diets . No changes of other lipid fractions , oxidation analytes or inflammatory biomarkers were observed . Plasma fatty acid changes after each diet sequence supported good compliance . CONCLUSION The results confirm the cholesterol lowering properties of nut-enriched diets . They also suggest that phenolic-rich VOO has a cholesterol lowering effect independently of its fatty acid content , which clearly deserves further study Nut consumption reduces cardiovascular risk , and reductions in blood pressure and peripheral vascular resistance may be important mediators of this relationship . We evaluated effects of pistachios on flow-mediated dilation and blood pressure response to acute stress . Twenty-eight adults with dyslipidemia completed a r and omized , crossover , controlled-feeding study . All of the meals were provided and calories were controlled . After 2 weeks on a typical Western diet ( 35 % total fat and 11 % saturated fat ) , test diets were presented in counterbalanced order for 4 weeks each , a low-fat control diet ( 25 % total fat and 8 % saturated fat ) , a diet containing 10 % of energy from pistachios ( on average , 1 serving per day ; 30 % total fat and 8 % saturated fat ) , and a diet containing 20 % of energy from pistachios ( on average , 2 servings per day , 34 % total fat and 8 % saturated fat ) . None of the resting hemodynamic measures significantly differed from pretreatment values . When resting and stress levels were included in the repeated- measures analysis , average reductions in systolic blood pressure were greater after the diet containing 1 serving per day versus 2 servings per day of pistachios ( mean change in systolic blood pressure , −4.8 vs −2.4 mm Hg , respectively ; P<0.05 ) . After the higher dose , there were significant reductions in peripheral resistance ( −62.1 dyne·s × cm−5 ) and heart rate ( −3 bpm ) versus the control diet ( P<0.0001 ) . These changes were partially offset by increases in cardiac output . There was no effect of diet on fasting flow-mediated dilation . Reductions in peripheral vascular constriction and the result ing decrease in hemodynamic load may be important contributors to lower risk in nut consumers BACKGROUND Dietary guidelines recommend interchanging protein foods ( e.g. , chicken for red meat ) , but they may be exchanged for carbohydrate-rich foods varying in quality [ glycemic load ( GL ) ] . Whether such exchanges occur and how they influence long-term weight gain are not established . OBJECTIVE Our objective was to determine how changes in intake of protein foods , GL , and their interrelationship influence long-term weight gain . DESIGN We investigated the association between 4-y changes in consumption of protein foods , GL , and their interaction with 4-y weight change over a 16- to 24-y follow-up , adjusted for other lifestyle changes ( smoking , physical activity , television watching , sleep duration ) , body mass index , and all dietary factors simultaneously in 3 prospect i ve US cohorts ( Nurses ' Health Study , Nurses ' Health Study II , and Health Professionals Follow-Up Study ) comprising 120,784 men and women free of chronic disease or obesity at baseline . RESULTS Protein foods were not interchanged with each other ( intercorrelations typically < |0.05| ) but with carbohydrate ( negative correlation as low as -0.39 ) . Protein foods had different relations with long-term weight gain , with positive associations for meats , chicken with skin , and regular cheese ( per increased serving/d , 0.13 - 1.17 kg ; P = 0.02 to P < 0.001 ) ; no association for milk , legumes , peanuts , or eggs ( P > 0.40 for each ) ; and relative weight loss for yogurt , peanut butter , walnuts , other nuts , chicken without skin , low-fat cheese , and seafood ( -0.14 to -0.71 kg ; P = 0.01 to P < 0.001 ) . Increases in GL were independently associated with a 0.42-kg greater weight gain per 50-unit increase ( P < 0.001 ) . Significant interactions ( P-interaction < 0.05 ) between changes in protein foods and GL were identified ; for example , increased cheese intake was associated with weight gain when GL increased , with weight stability when GL did not change , and with weight loss when exchanged for GL ( i.e. , decrease in GL ) . CONCLUSION Protein foods were commonly interchanged with carbohydrate , and changes in protein foods and GL interacted to influence long-term weight gain Frequent consumption of nuts is associated with decreased risk of cardiovascular disease . We investigated the effect of pecans rich in monounsaturated fat as an alternative to the Step 1 diet in modifying serum lipids and lipoproteins in men and women with normal to moderately high serum cholesterol . In a single-blind , r and omized , controlled , crossover feeding study , we assigned 23 subjects ( mean age : 38 y ; 9 women , 14 men ) to follow two diets , each for 4 wk : a Step I diet and a pecan-enriched diet ( accomplished by proportionately reducing all food items in a Step I diet by one fifth for a 20 % isoenergetic replacement with pecans ) . The percentage of energy from fat in the two diets was 28.3 and 39.6 % , respectively . Both diets improved the lipid profile ; however , the pecan-enriched diet decreased both serum total and LDL cholesterol by 0.32 mmol/L ( 6.7 and 10.4 % , respectively ) and triglyceride by 0.14 mmol/L ( 11.1 % ) beyond the Step I diet , while increasing HDL cholesterol by 0.06 mmol/L ( 2.5 mg/dL ) . Serum apolipoprotein B and lipoprotein(a ) decreased by 11.6 and 11.1 % , respectively , and apolipoprotein A1 increased by 2.2 % when subjects consumed the pecan compared with the Step I diet . These differences were all significant ( P < 0.05 ) . A 20 % isoenergetic replacement of a Step I diet with pecans favorably altered the serum lipid profile beyond the Step I diet , without increasing body weight .  Nuts such as pecans that are rich in monounsaturated fat may therefore be recommended as part of prescribed cholesterol-lowering diet of patients or habitual diet of healthy individuals BACKGROUND Frequent consumption of nuts may lower the risk of cardiovascular disease by favorably altering serum lipid and lipoprotein concentrations . OBJECTIVE We compared the effects of 2 amounts of almond intake with those of a National Cholesterol Education Program Step I diet on serum lipids , lipoproteins , apolipoproteins , and glucose in healthy and mildly hypercholesterolemic adults . DESIGN In a r and omized crossover design , 25 healthy subjects ( 14 men , 11 women ) with a mean ( + /- SD ) age of 41 + /- 13 y were fed 3 isoenergetic diets for 4 wk each after being fed a 2-wk run-in diet ( containing 34 % of energy from fat ) . The experimental diets included a Step I diet , a low-almond diet , and a high-almond diet , in which almonds contributed 0 % , 10 % , and 20 % of total energy , respectively . RESULTS Inverse relations were observed between the percentage of energy in the diet from almonds and the subject 's total cholesterol ( P value for trend < 0.001 ) , LDL-cholesterol ( P < 0.001 ) , and apolipoprotein B ( P < 0.001 ) concentrations and the ratios of LDL to HDL cholesterol ( P < 0.001 ) and of apolipoprotein B to apolipoprotein A ( P < 0.001 ) . Compared with the Step I diet , the high-almond diet reduced total cholesterol ( 0.24 mmol/L or 4.4 % ; P = 0.001 ) , LDL cholesterol ( 0.26 mmol/L or 7.0 % ; P < 0.001 ) , and apolipoprotein B ( 6.6 mg/dL or 6.6 % ; P < 0.001 ) ; increased HDL cholesterol ( 0.02 mmol/L or 1.7 % ; P = 0.08 ) ; and decreased the ratio of LDL to HDL cholesterol ( 8.8 % ; P < 0.001 ) . CONCLUSIONS Isoenergetic incorporation of approximately 68 g of almonds ( 20 % of energy ) into an 8368-kJ ( 2000-kcal ) Step I diet markedly improved the serum lipid profile  of healthy and mildly hypercholesterolemic adults .  Total and LDL-cholesterol concentrations declined with progressively higher intakes of almonds , which suggests a dose-response relation BACKGROUND Atherosclerosis is a chronic inflammatory disease . We previously reported that a diet high in alpha-linolenic acid ( ALA ) reduces lipid and inflammatory cardiovascular disease risk factors in hypercholesterolemic subjects . OBJECTIVE The objective was to evaluate the effects of a diet high in ALA on serum proinflammatory cytokine concentrations and cytokine production by cultured peripheral blood mononuclear cells ( P BMC s ) from subjects fed the experimental diets . DESIGN A r and omized , controlled , 3-diet , 3-period crossover study design was used . Hypercholesterolemic subjects ( n = 23 ) were assigned to 3 experimental diets : a diet high in ALA ( ALA diet ; 6.5 % of energy ) , a diet high in linoleic acid ( LA diet ; 12.6 % of energy ) , and an average American diet ( AAD ) for 6 wk . Serum interleukin (IL)-6 , IL-1beta , and tumor necrosis factor-alpha ( TNF-alpha ) concentrations and the production of IL-6 , IL-1beta , and TNF-alpha by P BMC s were measured . RESULTS IL-6 , IL-1beta , and TNF-alpha production by P BMC s and serum TNF-alpha concentrations were lower ( P < 0.05 and P < 0.08 , respectively ) with the ALA diet than with the LA diet or AAD .  P BMC production of TNF-alpha was inversely correlated with ALA ( r = -0.402 , P = 0.07 ) and with eicosapentaenoic acid ( r = -0.476 , P = 0.03 ) concentrations in P BMC lipids with the ALA diet . Changes in serum ALA were inversely correlated with changes in TNF-alpha produced by P BMC s ( r = -0.423 , P < 0.05 ) . CONCLUSIONS Increased intakes of dietary ALA elicit antiinflammatory effects by inhibiting IL-6 , IL-1beta , and TNF-alpha production in cultured P BMC s. Changes in P BMC ALA and eicosapentaenoic acid ( derived from dietary ALA ) are associated with beneficial changes in TNF-alpha release . Thus , the cardioprotective effects of ALA are mediated in part by a reduction in the production of inflammatory cytokines This study was conducted to assess the cholesterol-lowering potential of macadamia nuts .  Seventeen hypercholesterolemic men ( mean age 54 y ) were given macadamia nuts ( 40 - 90 g/d ) , equivalent to 15 % energy intake , for 4 wk . Plasma total cholesterol , LDL cholesterol , HDL cholesterol , triglycerides and homocysteine concentrations and the fatty acid composition of plasma lipids were determined before and after treatment . Plasma MUFA 16:1(n-7 ) , 18:1(n-7 ) and 20:1(n-9 ) were elevated after intervention with macadamia nuts .  Plasma ( n-6 ) and ( n-3 ) PUFA concentrations were unaffected by macadamia nut consumption . Plasma total cholesterol and LDL cholesterol concentrations decreased by 3.0 and 5.3 % , respectively , and HDL cholesterol levels increased by 7.9 % in hypercholesterolemic men after macadamia nut consumption . Plasma triglyceride and homocysteine concentrations were not affected by treatment . Macadamia nut consumption was associated with a significant increase in the relative intake of MUFA and a reduced relative intake of saturated fatty acids and PUFA . This study demonstrates that macadamia nut consumption as part of a healthy diet favorably modifies the plasma lipid profile in hypercholesterolemic men despite their diet being high in fat BACKGROUND Nuts appear to have cardiovascular benefits but their effect in diabetic patients is unclear . OBJECTIVE The objective was to assess effects of almond-enriched diets on insulin sensitivity and lipids in patients with normoglycemia or type 2 diabetes . DESIGN Study 1 assessed the effect of almonds on insulin sensitivity in 20 free-living healthy volunteers who received 100 g almonds/d for 4 wk . Study 2 was a r and omized crossover study that compared 4 diets in 30 volunteers with type 2 diabetes : 1 ) high-fat , high-almond ( HFA ; 37 % total fat , 10 % from almonds ) ; 2 ) low-fat , high-almond ( LFA ; 25 % total fat , 10 % from almonds ) ; 3 ) high-fat control ( HFC ; 37 % total fat , 10 % from olive or canola oil ) ; and 4 ) low-fat control ( LFC ; 25 % total fat , 10 % from olive or canola oil ) . After each 4-wk diet , serum lipids and oral glucose tolerance were measured . RESULTS In study 1 , almond consumption did not change insulin sensitivity significantly , although body weight increased and total and LDL cholesterol decreased by 21 % and 29 % , respectively ( P < 0.05 ) . In study 2 , total cholesterol was lowest with the HFA diet ( 4.46 + /- 0.14 , 4.52 + /- 0.14 , 4.63 + /- 0.14 , and 4.63 + /- 0.14 mmol/L with the HFA , HFC , LFA , and LFC diets , respectively ; P = 0.0004 for fat level ) . HDL cholesterol was significantly lower with the almond diets ( P = 0.002 ) ; however , no significant effect of fat source on LDL : HDL was observed . Glycemia was unaffected . CONCLUSIONS Almond-enriched diets do not alter insulin sensitivity in healthy adults or glycemia in patients with diabetes . Almonds had beneficial effects on serum lipids in healthy adults and produced changes similar to high monounsaturated fat oils in diabetic patients Epidemiologic and clinical studies have shown that nut consumption is associated with favorable plasma lipid profiles and reduced cardiovascular risk . These effects may result from their high monounsaturated fat ( MUFA ) content but nuts contain constituents other than fatty acids that might be cardioprotective . We conducted a study to compare the effects of whole-almond vs. almond oil consumption on plasma lipids and LDL oxidation in healthy men and women . Using a r and omized crossover trial design , 22 normolipemic men and women replaced half of their habitual fat ( approximately 14 % of approximately 29 % energy ) with either whole almonds ( WA ) or almond oil ( AO ) for 6-wk periods . Compliance was ascertained by monitoring dietary intake via biweekly 5-d food records , return of empty almond product packages and weekly meetings with a registered dietitian . Fat replacement with either WA and AO result ed in a 54 % increase in percentage of energy as MUFA with declines in both saturated fat and cholesterol intake and no significant changes in total energy , total or polyunsaturated fat intake . The effects of  WA  and  AO  on plasma lipids did not differ compared with baseline ; plasma triglyceride , total and LDL cholesterol significantly decreased , 14 , 4 and 6 % respectively , whereas HDL cholesterol increased 6 % . Neither treatment affected in vitro LDL oxidizability . We conclude that WA and AO do not differ in their beneficial effects on the plasma lipid variables measured and that this suggests that the favorable effect of almonds is mediated by components in the oil fraction of these nuts Epidemiologic studies and clinical trials have demonstrated that the unique fatty acid profile of nuts beneficially affects serum lipids/lipoproteins , reducing cardiovascular disease ( CVD ) risk .  Nuts are low in SFA and high in PUFA and monounsaturated fatty acids ( MUFA ) . Macadamia nuts are a rich source of MUFA . A r and omized , crossover , controlled feeding study ( 5-wk diet periods ) compared a Macadamia nut-rich diet [ 42.5 g ( 1.5 ounces)/8.79 MJ ( 2100 kcal ) ] [ MAC ; 33 % total fat ( 7 % SFA , 18 % MUFA , 5 % PUFA ) ] vs. an average American diet [ AAD ; 33 % total fat ( 13 % SFA , 11 % MUFA , 5 % PUFA ) ] on the lipid/lipoprotein profile of mildly hypercholesterolemic ( n = 25 ; 15 female , 10 male ) subjects .  Serum concentrations of total cholesterol ( TC ) and LDL cholesterol ( LDL-C ) following the MAC ( 4.94 + /- 0.17 mmol/L , 3.14 + /- 0.14 mmol/L ) were lower than the AAD ( 5.45 + /- 0.17 mmol/L , 3.44 + /- 0.14 mmol/L ; P < 0.05 ) . The serum non-HDL cholesterol ( HDL-C ) concentration and the ratios of TC : HDL-C and LDL-C : HDL-C were reduced following consumption of the MAC diet ( 3.83 + /- 0.17 , 4.60 + /- 0.24 , and 2.91 + /- 0.17 , respectively ) compared with the AAD ( 4.26 + /- 0.17 , 4.89 + /- 0.24 , and 3.09 + /- 0.18 , respectively ; P < 0.05 ) . There was no change in serum triglyceride concentration . Thus , macadamia nuts can be included in a heart-healthy dietary pattern that reduces lipid/lipoprotein CVD risk factors . Nuts as an isocaloric substitute for high SFA foods increase the proportion of unsaturated fatty acids and decrease SFA , thereby lowering CVD risk BACKGROUND  Nut consumption lowers cardiovascular disease ( CVD ) risk . Studies are lacking about the effects of pistachios , a nutrient-dense nut , on CVD risk factors , dose-response relations , and lipid-lowering mechanisms . OBJECTIVE We evaluated the effects of 2 doses of pistachios , added to a lower-fat diet , on lipids and lipoproteins , apolipoprotein (apo)-defined lipoprotein subclasses , and plasma fatty acids . To investigate the mechanisms of action , we measured cholesteryl ester transfer protein and indexes of plasma stearoyl-CoA desaturase activity ( SCD ) . DESIGN In a r and omized crossover controlled-feeding study , 28 individuals with LDL cholesterol > or = 2.86 mmol/L consumed 3 isoenergetic diets for 4 wk each . Baseline measures were assessed after 2 wk of a typical Western diet . The experimental diets included a lower-fat control diet with no pistachios [ 25 % total fat ; 8 % saturated fatty acids ( SFAs ) , 9 % monounsaturated fatty acids ( MUFAs ) , and 5 % polyunsaturated fatty acids ( PUFAs ) ] , 1 serving/d of a pistachio diet ( 1 PD ; 10 % of energy from pistachios ; 30 % total fat ; 8 % SFAs , 12 % MUFAs , and 6 % PUFAs ) , and 2 servings/d of a pistachio diet ( 2 PD ; 20 % of energy from pistachios ; 34 % total fat ; 8 % SFAs , 15 % MUFAs , and 8 % PUFAs ) . RESULTS The 2 PD decreased ( P < 0.05 compared with the control diet ) total cholesterol ( -8 % ) , LDL cholesterol ( -11.6 % ) , non-HDL cholesterol ( -11 % ) , apo B ( -4 % ) , apo B/apo A-I ( -4 % ) , and plasma SCD activity ( -1 % ) . The 1 PD and 2 PD , respectively , elicited a dose-dependent lowering ( P < 0.05 ) of total cholesterol/HDL cholesterol ( -1 % and -8 % ) , LDL cholesterol/HDL cholesterol ( -3 % and -11 % ) , and non-HDL cholesterol/HDL cholesterol ( -2 % and -10 % ) . CONCLUSIONS Inclusion of pistachios in a healthy diet beneficially affects CVD risk factors in a dose-dependent manner , which may reflect effects on SCD Lifestyle modification is the cornerstone of population -based strategies for prevention of coronary heart disease and is the first line of therapy in patients with hypercholesterolemia . Diets low in saturated fatty acids and cholesterol have long been recommended to decrease low-density lipoprotein ( LDL ) cholesterol levels and reduce cardiovascular risk ( 1 ) . Ample evidence suggests that polyunsaturated fatty acids and monounsaturated fatty acids have a similar cholesterol-lowering effect when substituted for saturated fatty acids ( 2 - 4 ) . However , most studies of fatty acids and blood lipids have been done with fats and oils , rarely with whole fatty foods . Because people usually buy and consume whole food products , it is desirable to know the effects of specific foods on risk factors for coronary heart disease . Recent reports suggest that the regular consumption of nuts might reduce cardiovascular risk ( 5 ) . Walnuts are particularly rich in polyunsaturated fatty acids ( 6 ) , and epidemiologic evidence suggests that frequent walnut consumption protects against coronary heart disease ( 7 ) . In a controlled feeding trial by Sabat and colleagues ( 8) , a diet in which walnuts represented 55 % of the energy from fat reduced blood cholesterol levels in normal young men when compared with a st and ard low-fat diet . However , the results can not easily be extrapolated to the population at risk for coronary heart disease because women , older age groups , and hypercholesterolemic persons were not studied ( 8) . In addition , because meals were served at a metabolic kitchen , the study did not address the question of whether free-living persons would incorporate substantial quantities of walnuts into their diets . Because oxidized LDL plays a key role in atherogenesis ( 9 ) and oxidative damage involves peroxidation of polyunsaturated fatty acids in LDL lipids ( 10 ) , there is concern that walnut intake may promote LDL oxidation . Therefore , we design ed a dietary intervention study in free-living adult men and women with polygenic hypercholesterolemia to compare the effects of a walnut-rich diet with those of a cholesterol-lowering Mediterranean diet on serum lipid levels , lipoprotein levels , and LDL resistance to oxidation . Methods Patients Adult men and women with polygenic hypercholesterolemia attending the Lipid Clinic of the Hospital Clnic of Barcelona were eligible if they had serum LDL cholesterol concentrations greater than 3.36 mmol/L ( 130 mg/dL ) and triglyceride concentrations less than 2.82 mmol/L ( 250 mg/dL ) ; no evidence of alcohol , tobacco , or drug abuse ; absence of diabetes mellitus and liver , kidney , thyroid , or other endocrine diseases , as assessed by medical history , a complete physical examination , and laboratory tests ; no intake in the previous 8 weeks of medications known to affect lipid metabolism , including hypolipidemic agents and estrogen compounds in women ; infrequent consumption of nuts and no known history of allergy to them ; and no use of multivitamin or vitamin E supplements  . Because the target population had common ( polygenic ) hypercholesterolemia , we excluded persons whose elevated blood cholesterol levels had a strong genetic basis ( such as heterozygous familial hypercholesterolemia or familial combined hyperlipidemia ) , as established by st and ard criteria . On admission to the Lipid Clinic , all patients were advised to follow a  Mediterranean-type hypolipidemic diet ( 11 ) . For a crossover design , statistical power calculations indicated that to detect mean differences of 0.39 mmol/L ( 15 mg/dL ) , 34 patients would need to complete the two treatment periods ( statistic , 0.05 ; power>0.8 ) . From a computerized register of clinical records , 75 hypercholesterolemic patients ( 35 women and 40 men ) who initially met the eligibility criteria were selected for screening and were asked to participate in the study . They were offered free walnuts but no monetary compensation . Study Design A crossover design was used . Patients were r and omly assigned to the two diet sequences by using a computer-generated r and om-number table , with stratification by sex . Because patients followed each diet for 6 weeks and lipoprotein changes due to dietary intervention stabilize in less than 4 weeks ( 12 ) , we did not incorporate a washout period between diets . In their crossover feeding study with walnuts , Sabat and colleagues ( 8) did not observe a carryover effect . In the week before the trial began , patients received expert dietary counseling individually and in a group class . Twice during the pretrial week and on weeks 5 and 6 of each one of the two dietary periods , patients came to the clinic for a medical visit , an interview with the dietitian , anthropometric measurements , and blood extraction . The main outcomes of the study were changes in serum levels of total and LDL cholesterol from the control diet period to the walnut diet period . Secondary outcomes were changes in other lipid variables and oxidizability of LDL particles . The study protocol was approved by the institutional review board of the Hospital Clnic of Barcelona , and all patients gave informed consent . Diets The experimental diets were individually prescribed and were based on estimated energy requirements . Because participants ate on their own , detailed dietary information was provided to them and , if appropriate , to their partners .  Diets were calculated in increments of 200 kcal to cover the range from 1600 to 2200 kcal . The control diet was Mediterranean and was composed of natural foodstuffs . Red meat and eggs were limited , vegetable products and fish were emphasized , olive oil was indicated for culinary use , and no nuts were allowed . The walnut diet was similar to the control diet , but walnuts partially replaced olive oil and other fatty foods . Prepackaged daily allowances of raw , shelled walnuts were provided daily in amounts varying from 41 g to 56 g ( the equivalent of 8 to 11 walnuts ) , according to the participants ' total energy intake . Walnuts were consumed as snacks or with meals in desserts or salads . In the walnut diet , walnuts contributed approximately 18 % of the total energy and 35 % of the total fat . To improve compliance , each family unit was given 1000-g packs of walnuts at the beginning of the walnut diet period .  Adherence to the study diets was carefully monitored . Unannounced 24-hour diet recalls were performed weekly by telephone during the two dietary periods , for a total of 12 recalls per patient . This method allows reliable estimations of food intake ( 13 ) . The nutrient composition of the diets was calculated with Food Processor Plus software , version 5.0 ( ESHA Research , Salem , Oregon ) , which was adapted to nutrient data bases of specific Mediterranean foods when appropriate . We defined noncompliance as at least 20 % deviation from dietary instructions regarding walnut or nutrient intake . Compliance during the walnut diet was also assessed at each clinic visit by a count of the empty walnut packages . The fatty acid content of LDL lipids was analyzed as a biological measure of adherence to the prescribed diets . Laboratory Measurements Blood sample s were obtained after an overnight fast , and serum and EDTA plasma were collected and processed immediately . Serum lipid and apolipoprotein levels were determined as described elsewhere ( 11 ) . In brief , serum cholesterol and triglyceride levels were measured by using enzymatic reagents ( Trinder , Bayer Diagnostics , Tarrytown , New York ) adapted to a Cobas Mira automated analyzer ( Hoffmann-LaRoche , Basel , Switzerl and ) . High-density lipoprotein ( HDL ) cholesterol was quantified after precipitation with phosphotungstic acid and magnesium chloride . Levels of apolipoprotein A-I and apolipoprotein B were determined by an immunoturbidimetric method ( Unimate 3 , Roche Diagnostic Systems , Basel , Switzerl and ) . Measurements of the cholesterol content of very-low-density lipoprotein particles and LDL particles were based on preparative ultracentrifugation ( 11 ) . Lipoprotein(a ) levels were measured by using an immunoturbidimetric method ( Lipoprotein[a ] SPQ II Test Kit , DiaSorin , Stillwater , Minnesota ) . To obtain the LDL fraction for fatty acid and oxidizability studies , lipoproteins were fractionated by sequential centrifugation adjusting with NaBr to separate very-low-density lipoprotein particles ( d=1.006 g/mL ) and to obtain LDL particles ( d=1.063 g/mL ) , as described elsewhere ( 14 ) . Low-density lipoprotein fatty acids were measured by capillary gas chromatography in the cholesteryl ester , phospholipid , and triglyceride lipid fractions ( 14 ) . Low-density lipoprotein susceptibility to oxidation was determined by measuring the -tocopherol content of LDL particles and conjugated diene kinetics after incubation of 50 g of LDL protein with 5 mol of copper sulfate at 37 C ( 15 , 16 ) . Statistical Analysis The two measurements obtained at baseline and at the end of each dietary period were averaged . Means and SDs are presented for each measurement . With methods described by Fleiss ( 17 ) , two-tailed t-tests were used to compare changes in outcome variables in response to dietary treatment and diet period and carryover effects for the two-period crossover design . Differences between the walnut and control diets were also tested by analysis of covariance using general linear models ; baseline values or sex were used as covariates . Analyses were performed by using SAS software ( SAS , Inc. , Cary , North Carolina ) ( 18 ) . Role of the Funding Sources The California Walnut Commission provided funding and walnuts . Research grants were also obtained from national and local nonprofit agencies . The funding sources were not involved in the design of the study and had no role in the collection , analysis , or interpretation of the data or in the decision to su bmi t the manuscript for publication . None of the authors has any financial interest in the nut food industry . Results Patient Characteristics Of the 75 eligible patients , 20 left the study before r and omization for Background —Epidemiological studies suggest that nut intake decreases coronary artery disease ( CAD ) risk . Nuts have a cholesterol-lowering effect that partly explains this benefit . Endothelial dysfunction is associated with CAD and its risk factors and is reversed by antioxidants and marine n-3 fatty acids . Walnuts are a rich source of both antioxidants and & agr;-linolenic acid , a plant n-3 fatty acid . Methods and Results —To test the hypothesis that walnut intake will reverse endothelial dysfunction , we r and omized in a crossover design 21 hypercholesterolemic men and women to a cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content  in which walnuts replaced ≈32 % of the energy from monounsaturated fat . Participants followed each diet for 4 weeks . After each intervention , we obtained fasting blood and performed ultrasound measurements of brachial artery vasomotor function . Eighteen subjects completing the protocol had suitable ultrasound studies . Compared with the Mediterranean diet , the walnut diet improved endothelium-dependent vasodilation and reduced levels of vascular cell adhesion molecule-1 ( P < 0.05 for both ) . Endothelium-independent vasodilation and levels of intercellular adhesion molecule-1 , C-reactive protein , homocysteine , and oxidation biomarkers were similar after each diet . The walnut diet significantly reduced total cholesterol ( −4.4±7.4 % ) and LDL cholesterol ( −6.4±10.0 % ) ( P < 0.05 for both ) . Cholesterol reductions correlated with increases of both dietary & agr;-linolenic acid and LDL & ggr;-tocopherol content , and changes of endothelium-dependent vasodilation correlated with those of cholesterol-to-HDL ratios ( P < 0.05 for all ) . Conclusions —Substituting walnuts for monounsaturated fat in a Mediterranean diet improves endothelium-dependent vasodilation in hypercholesterolemic subjects . This finding might explain the cardioprotective effect of nut intake beyond cholesterol lowering 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 r and om 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 timecourse experiment and had  blood taken at baseline and 1 , 2 , 4 , and 8 h after consuming walnuts ( 75 g ) . Results During the timecourse 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 status Frequent consumption of nuts lowers the risk of CHD . While lowering blood lipids is one of the mechanisms for cardioprotection , the present study sought to determine whether monounsaturated fat-rich almonds also influence other CHD risk factors such as inflammation and haemostasis . This was a r and omised , controlled , crossover feeding study with twenty-five healthy adults ( eleven men ; fourteen women ) , age 22 - 53 years . Following a 2 week run-in phase ( 34 % energy from fat ) , subjects were assigned in r and om order to three diets for 4 weeks each : a heart-healthy control diet with no nuts ( < 30 % energy from fat ) , low-almond diet and high-almond diet ( 10 % or 20 % isoenergetic replacement of control diet with almonds , respectively ) . Serum E-selectin was significantly lower on the high-almond diet compared with the control diet . E-selectin decreased as the percentage of energy from almonds increased ( P < 0.0001 ) . C-reactive protein ( CRP ) was lower in both the almond diets compared with the control diet . A clear dose response was not observed for either E-selectin or CRP . There was no effect of diet on IL-6 or fibrinogen . Tissue plasminogen activator antigen was significantly lower on the control and high-almond diets compared with the low-almond diet , although the values were within normal range . In conclusion , consumption of almonds influenced a few but not all of the markers of inflammation and haemostasis . A clear dose response was not observed for any of the markers studied Background Compared with other common plant foods , walnuts ( Juglans regia ) are consistently ranked among the highest in antioxidant capacity . In vitro , walnut polyphenols inhibit plasma and LDL oxidation , while in animal models they lower biomarkers of oxidative stress and raise antioxidant capacity . A limited number of human feeding trials indicate that walnuts improve some measures of antioxidant status , but not others . Methods A 19 wk , r and omized crossover trial was conducted in 21 generally healthy men and postmenopausal women ≥50 y to study the dose-response effects of walnut intake on biomarkers of antioxidant activity , oxidative stress , and nutrient status . Subjects were r and omized to receive either 21 or 42 g raw walnuts/d during each 6 wk intervention phase with a 6 wk washout between phases . Subjects were instructed to consume their usual diet , but refrain from eating any other tree nuts , seeds , peanuts , or ellagitannin-rich foods during the entire study , and other polyphenol-rich foods for 2 d prior to each study visit . Results Compared to baseline levels , red blood cell ( RBC ) linoleic acid and plasma pyridoxal phosphate ( PLP ) were significantly higher after 6 wk with 42 g/d walnuts ( P < 0.05 for both ) . Overall , changes in plasma total thiols , and other antioxidant biomarkers , were not significant with either walnut dose . However , when compared to fasting levels , plasma total thiols were elevated within 1 h of walnut consumption with both doses during the baseline and end visits for each intervention phase ( P < 0.05 for all ) . Despite the observed increase in RBC linoleic and linolenic acids associated with walnut consumption , this substrate for lipid peroxidation only minimally affected malondialdehyde ( MDA ) and antioxidant capacity . The proportional changes in MDA and Oxygen Radical Absorbance Capacity ( ORAC ) were consistent with a dose-response effect , although no significant within- or between-group differences were observed for these measures . Conclusions Walnut consumption did not significantly change the plasma antioxidant capacity of healthy , well-nourished older adults in this pilot study . However , improvements in linoleic acid and pyridoxal phosphate were observed with chronic consumption , while total plasma thiols were enhanced acutely . Future studies investigating the antioxidant effects of walnuts in humans are warranted , but should include either a larger sample size or a controlled feeding intervention . Trial Registration Clinical Trials.gov : Background : Increased consumption of nuts has been advocated because of their health benefits , but the role of nuts in the treatment of obesity is unclear given their high energy density . Objective : This study was design ed to evaluate the effects of a hypocaloric , almond-enriched diet ( AED ) compared with a hypocaloric nut-free diet ( NFD ) on body weight and cardiovascular disease risk factors in the context of an 18-mo behavioral weight-management program . Design : Overweight and obese individuals [ n = 123 ; age = 46.8 y , BMI ( in kg/m2 ) = 34.0 ] were r and omly assigned to consume an AED or NFD and instructed in traditional behavioral methods of weight control .  Anthropometric and metabolic measurements were made at baseline , 6 mo , and 18 mo . Results : Those in the AED group lost slightly but significantly less weight than did those in the NFD group at 6 mo ( −5.5 compared with −7.4 kg ; P = 0.04 ) , but there were no differences at 18 mo . No significant differences in body composition were found between the groups at 6 or 18 mo . The AED , compared with the NFD , was associated with greater reductions in total cholesterol ( P = 0.03 ) , total : HDL cholesterol ( P = 0.02 ) , and triglycerides ( P = 0.048 ) at 6 mo , and no differences were observed between the groups at 18 mo . Conclusions : The AED and NFD groups experienced clinical ly significant and comparable weight loss at 18 mo . Despite smaller weight loss in the AED group at 6 mo , the AED group experienced greater improvements in lipid profiles . This trial was registered at clinical trials.gov as NCT00194428 Background Cocoa , mixed with other food ingredients , intake can have beneficial effects on cardiovascular disease ( CVD ) biomarkers . We compared the effects of 4 cocoa cream products on some of these biomarkers . Methods and Findings In this multi-centered , r and omized , controlled , double-blind , parallel trial , volunteers ( n = 113 ; age range : 43–65 years ) who were pre-hypertensive , stage-1 hypertensive and hypercholesterolemic received one of 4 cocoa cream products ( 13 g/unit ; 1 g cocoa/unit , 6 units/d ; 465 Kcal/d ) added to a low saturated fat diet for 4 weeks . The groups were : A ) ( n = 28 ) , cocoa cream considered as control ; B ) ( n = 28 ) , cocoa+hazelnut cream ( 30 g/d hazelnuts ) ; C ) ( n = 30 ) , cocoa+hazelnuts+phytosterols ( 2 g/d ) ; and D ) ( n = 27 ) , cocoa+hazelnuts+phytosterols+soluble fiber ( 20 g/d ) the patented “ LMN product ” . Primary outcome measures were BP , LDL-c , apolipoprotein B-100 ( Apo B ) , ApoB/ApoA ratio , oxidized LDL ( oxLDL ) and high-sensitive C-reactive protein ( hsCRP ) determined at baseline and post-cocoa cream product intake . Statistical analysis used was ANCOVA or mixed models ( in case of repeated measurements ) , with baseline observation included as a covariate . After 4 weeks , compared to product A , product C reduced LDL-c by 11.2 % , Apo B by 8.1 % and ApoB/ApoA ratio by 7.8 % ( P = 0.01 ) . LMN  decreased LDL-c by 9.2 % , Apo B-100 by 8.5 % , ApoB/ApoA ratio by 10.5 % , hsCRP by 33.4 % and oxLDL by 5.9 % ( P = 0.01 ) . Surprisingly , even “ control ” product A reduced systolic BP ( −7.89 mmHg ; 95%CI : −11.45 to −4.3 ) and diastolic BP ( −5.54 mmHg ; 95%CI : −7.79 to −3.29 ) . The BP reductions were similar with the other 3 products . Limitations of the study are that the trial period was relatively short and that a better “ BP control ” product would have been preferable . Conclusion The creams ( particularly the LMN ) have anti-inflammatory and antioxidant effects in addition to lowering LDL-c , Apo B and ApoB/ApoA ratio . Thus , the soluble fiber effects amplified with sterols ( as contained in the cocoa creams ) provide new dietary therapeutic perspectives . Trial Registration Clinical trials.gov Objective : Clinical and epidemiological studies have reported the beneficial effects of tree nuts and peanuts on serum lipid levels . We studied the effects of consuming 15 % of the daily caloric intake in the form of pistachio nuts on the lipid profiles of free-living human subjects with primary , moderate hypercholesterolemia ( serum cholesterol greater than 210 mg/dL ) . Methods : Design : R and omized crossover trial . Setting : Outpatient dietary counseling and blood analysis . Subjects : 15 subjects with moderate hypercholesterolemia . Intervention : Fours weeks of dietary modification with 15 % caloric intake from pistachio nuts . Measures of Outcome : Endpoints were serum lipid levels of total cholesterol , HDL-C , LDL-C , VLDL-C , triglycerides and apolipoproteins A-1 and B-100 . BMI , blood pressure , and nutrient intake ( total energy , fat , protein , and fiber ) were also measured at baseline , during , and after dietary intervention . Results : No statistically significant differences were observed for total energy or percent of energy from protein , carbohydrate or fat . On the pistachio nut diet , a statistically significant decrease was seen for percent energy from saturated fat ( mean difference , −2.7 % ; 95 % CI , −5.4 % to −0.08 % ; p = 0.04 ) . On the pistachio nut diet , statistically significant increases were seen for percent energy from polyunsaturated fat ( mean difference , 6.5 % ; 95 % CI , 4.2 % to 8.9 % ; p<.0001 ) and fiber intake ( mean difference , 15 g ; 95 % CI , 8.4 g to 22 g ; p = 0.0003 ) . On the pistachio diet , statistically significant reductions were seen in TC/HDL-C ( mean difference , −0.38 ; 95 % CI , −0.57 to −0.19 ; p = 0.001 ) , LDL-C/HDL-C ( mean difference , −0.40 ; 95 % CI , −0.66 to −0.15 ; p = 0.004 ) , B-100/A-1 ( mean difference , −0.11 ; 95 % CI , −0.19 to −0.03 ; p = 0.009 ) and a statistically significant increase was seen in HDL-C ( mean difference , 2.3 ; 95 % CI , 0.48 to 4.0 ; p = 0.02 ) . No statistically significant differences were seen for total cholesterol , triglycerides , LDL-C , VLDL-C , apolipoprotein A-1 or apolipoprotein B-100 . No changes were observed in BMI or blood pressure . Conclusion : A diet consisting of 15 % of calories as pistachio nuts ( about 2–3 ounces per day ) over a four week period can favorably improve some lipid profiles in subjects with moderate hypercholesterolemia and may reduce risk of coronary disease Background / Objectives : A large intake of walnuts may improve lipid profile and endothelial function . The effect of moderate walnut consumption is not known . We investigated whether a moderate intake of walnuts would affect lipid profile , arterial stiffness and platelet activation in healthy volunteers . Subjects/ Methods : A total of 30 healthy males were recruited into a single-blind r and omized controlled crossover trial of 4 weeks of dietary walnut supplementation ( 15 g/day ) and 4 weeks of control ( no walnuts ) . Arterial stiffness was assessed using pulse waveform analysis to determine the augmentation index and augmented pressure . Platelet activation was determined using flow cytometry to measure circulating platelet – monocyte aggregates . Results : There were no differences in lipid profile after 4 weeks of walnut supplementation compared with control . Dietary intake of α-linolenic acid was increased during the walnut diet ( 2.1±0.4 g/day versus 0.7±0.4 g/day , P<0.0001 ) . There were no differences in augmentation index or augmented pressure  during walnut supplementation . Walnut supplementation did not affect platelet – monocyte aggregation . Conclusions : Dietary intervention with a moderate intake of walnuts does not affect lipid profile , arterial stiffness or platelet activation in man . Our results suggest that the potentially beneficial cardiac effects of walnuts may not be apparent at lower and more practical levels of consumption OBJECTIVE Recent studies have suggested that nuts have favorable effects beyond lipid lowering . We aim ed to investigate effect of the Antep pistachio ( Pistacia vera L. ) on blood glucose , lipid parameters , endothelial function , inflammation , and oxidation in healthy young men living in a controlled environment . METHODS A Mediterranean diet was administered to normolipidemic 32 healthy young men ( mean age 22 y , range 21 - 24 ) for 4 wk . After 4 wk , participants continued to receive the Mediterranean diet but pistachio was added for 4 wk by replacing the monounsaturated fat content constituting approximately 20 % of daily caloric intake . Fasting blood sample s and brachial endothelial function measurements were performed at baseline and after each diet . RESULTS Compared with the Mediterranean diet , the pistachio diet decreased glucose ( P<0.001 , -8.8+/-8.5 % ) , low-density lipoprotein ( P<0.001 , -23.2+/-11.9 % ) , total cholesterol ( P<0.001 , -21.2+/-9.9 % ) , and triacylglycerol ( P=0.008 , -13.8+/-33.8 % ) significantly and high-density lipoprotein ( P=0.069 , -3.1+/-11.7 % ) non-significantly . Total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios decreased significantly ( P<0.001 for both ) . The pistachio diet significantly improved endothelium-dependent vasodilation ( P=0.002 , 30 % relative increase ) , decreased serum interleukin-6 , total oxidant status , lipid hydroperoxide , and malondialdehyde and increased superoxide dismutase ( P<0.001 for all ) , whereas there was no significant change in C-reactive protein and tumor necrosis factor-alpha levels . CONCLUSION In this trial , we demonstrated that a pistachio diet improved blood glucose level , endothelial function , and some indices of inflammation and oxidative status in healthy young men . These findings are in accordance with the idea that nuts , in particular pistachio nuts , have favorable effects beyond lipid lowering that deserve to be evaluated with prospect i ve follow-up studies OBJECTIVE To compare serum lipid profiles and dietary intakes of people with normal lipid levels who consumed pecans and those who did not consume nuts .  DESIGN Eight-week , r and omized , controlled study of pecan treatment group vs control group . SUBJECT Nineteen people with normal lipid levels completed the study ; 10 had been r and omly assigned to the pecan treatment group ( 7 women , 3 men , mean age = 45 + /- 10 years ) and 9 to the control group ( 8 women , 1 man , mean age = 37 + /- 12 years ) . INTERVENTION The pecan treatment group consumed 68 g pecans per day for 8 weeks plus self-selected diets . The pecans contributed 459 kcal and 44 g fat daily . The control group avoided nuts and consumed self-selected diets . MAIN OUTCOME MEASURES Total serum cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , and total triglyceride levels were measured at the time of entrance to the study ( baseline ) , week 4 , and week 8 . Computer analyses were done on five 3-day food records . STATISTICAL ANALYSIS Comparisons were made using analysis of variance or paired t test . RESULTS LDL-C was lowered in the pecan treatment group from 2.61 + /- 0.49 mmol/L at baseline to 2.35 + /- 0.49 at week 4 ( P < .05 ) and to 2.46 + /- 0.59 at week 8 ( P < .05 ) . At week 8 , total cholesterol and HDL-C in the pecan treatment group were significantly lower ( P < .05 ) than in the control group ( total cholesterol : 4.22 + /- 0.83 vs 5.02 + /- 0.54 mmol/L ; HDL-C : 1.37 + /- 0.23 vs 1.47 + /- 0.34 mmol/L ) . Dietary fat , monounsaturated fat , polyunsaturated fat , insoluble fiber , magnesium , and energy were significantly higher in the pecan treatment group than in the control group . Body mass indexes and body weights were unchanged in both groups . APPLICATIONS Pecans can be included in a healthful diet when energy intake and potential weight gain are addressed OBJECTIVES Oxidation and level of plasma lipids are closely implicated in the development of coronary heart disease ( CHD ) . Dietary almond supplementation may participate in beneficial effects on CHD lipid risk factor levels and their susceptibility to oxidative modification . The aim of this study was to evaluate the effects of dietary supplementation with almond on serum lipid levels and their relation to lipid oxidation parameters in men with mild hyperlipidemia . DESIGN Thirty ( 30 ) healthy volunteer men ( age 45.57 ± 7.14 years and body-mass index 24.29 ± 2.15 kg/m(2 ) ) with mild hyperlipidemia received 60 g almond daily  for 4 weeks . OUTCOME MEASURES Overnight fasting blood sample s were obtained before and after supplementation . Serum levels of lipids , lipoproteins , and apolipoproteins and copper-induced serum lipid oxidation were determined . Lipid oxidation was followed by monitoring of the change of conjugated dienes in diluted serum after addition of Cu(2 + ) . A number of quantitative parameters including lag-time , maximal rate of oxidation ( V-max ) , and maximal amount of lipid peroxide products ( OD-max ) were evaluated . RESULTS After 4 weeks , almond supplementation significantly decreased low-density lipoprotein cholesterol , total cholesterol ( TC ) , and apolipoprotein B100 ( apo-B100 ) . At baseline , there was little correlation between lipid risk factors and lipid oxidation parameters , but a positive correlation was observed between TC and lag-time ( r = 0.6 , p = 0.001 ) , negative correlation between TC with V-max and OD-max ( r = -0.65 , p < 0.001 and r = -0.61 , p = 0.001 ) , and also positive correlation between apo-B100 with V-max and OD-max ( r = 0.48 , p = 0.01 and r = 0.54 , p = 0.003 ) after almond supplementation . CONCLUSIONS These results demonstrated that almond supplementation , in addition to lowering effects on serum levels of CHD lipid risk factors , may contribute to a dramatic change in the relation of lipid risk factors and susceptibility of serum lipids to oxidative modification . This may be due to the distribution of different almond phenolic antioxidants in different components of serum including nonlipoprotein molecules such as serum albumin Abstract : The effects of almond consumption on DNA damage and oxidative stress among cigarette smokers were studied . Thirty healthy adult male regular smokers were r and omly divided into three groups , 10 subjects per group . Group A ( control group ) did not receive any almonds . Subjects in Groups B and C received 3 oz and 6 oz ( 84 g and 168 g ) of almonds each day respectively for 4 wk . Two known biomarkers for DNA damage , urinary 8-hydroxy-2’-deoxyguanosine ( 8-OH-dG ) and single str and DNA breaks of peripheral blood lymphocytes , were measured by enzyme-linked immunosorbent assay and comet assay , respectively . In addition , plasma malondialdehyde ( MDA ) level , superoxide dismutase ( SOD ) , and glutathione peroxidase ( GSH-Px ) activities were measured as biomarkers for oxidative stress . The results showed lower levels of urinary 8-OH-dG and single str and DNA breaks in the two almond-treated groups as compared with the control group . Furthermore , MDA levels in the almond-treated groups were lower than the controls . However , no significant effects of almonds  on SOD and GSH-Px activities were found . In conclusion , results from this pilot study indicate that almond consumption has preventive effects on oxidative stress and DNA damage caused by smoking . A larger , r and omized , placebo-controlled clinical trial on almonds will be initiated in the near future BACKGROUND Increased consumption of n-3 ( omega-3 ) fatty acids decreases the incidence of coronary heart disease ( CHD ) . OBJECTIVE The objective was to determine whether walnuts ( plant n-3 fatty acid ) and fatty fish ( marine n-3 fatty acid ) have similar effects on serum lipid markers at intakes recommended for primary prevention of CHD . DESIGN In a r and omized crossover feeding trial , 25 normal to mildly hyperlipidemic adults consumed 3 isoenergetic diets ( approximately 30 % total fat and < 10 % saturated fat ) for 4 wk each : a control diet ( no nuts or fish ) , a walnut diet ( 42.5 g walnuts/10.1 mJ ) , or a fish diet ( 113 g salmon , twice/wk ) . Fasting blood was drawn at baseline and at the end of each diet period and analyzed for serum lipids . RESULTS Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet ( 4.87 + /- 0.18 and 2.77 + /- 0.15 mmol/L , respectively ) were lower than in those who followed the control diet ( 5.14 + /- 0.18 and 3.06 + /- 0.15 mmol/L , respectively ) and those who followed the fish diet ( 5.33 + /- 0.18 and 3.2 + /- 0.15 mmol/L , respectively ; P < 0.0001 ) . The fish diet result ed in decreased serum triglyceride and increased HDL-cholesterol concentrations ( 1.0 + /- 0.11 and 1.23 + /- 0.05 mmol/L , respectively ) compared with the control diet ( 1.12 + /- 0.11 and 1.19 + /- 0.05 mmol/L , respectively ) and the walnut diet ( 1.11 + /- 0.11 mmol/L , P < 0.05 , and 1.18 + /- 0.05 mmol/L , P < 0.001 , respectively ) . The ratios of total cholesterol : HDL cholesterol , LDL cholesterol : HDL cholesterol , and apolipoprotein B : apolipoprotein A-I were lower ( P < 0.05 ) in those who followed the walnut diet compared with those who followed the control and fish diets . CONCLUSION Including walnuts and fatty fish in a healthy diet lowered serum cholesterol and triglyceride concentrations , respectively , which affects CHD risk favorably Objective : To determine the serum cholesterol , apolipoproteins and LDL oxidizability in young Japanese women and men during walnut consumption and to evaluate its active principle . Design : Experimental study with a r and omized design .Subjects : Twenty healthy women and 20 healthy men . Interventions : Subjects were r and omly assigned to consume each of two mixed natural diets for 4 weeks in a cross-over design . Reference and walnut diets were design ed and the walnut diet had 12.5 % of the energy derived from walnuts ( 44–58 g/day ) . Results : The total cholesterol and serum apolipoprotein B concentrations , and the ratio of LDL cholesterol to HDL cholesterol was significantly lowered in women and men when fed on the walnut diet , than when on the reference diet ( P≤0.05 ) . The LDL cholesterol concentration was significantly lowered in women on the walnut diet ( 0.22 mmol/l , P=0.0008 ) , whereas this decrease was not significant in men ( 0.18 mmol/l , P=0.078 ) . The most prominent change in the fatty acid composition of the cholesteryl esters from serum after the walnut diet was an elevation of α-linolenic acid in women ( 76 % , P<0.001 ) and men ( 107 % , P<0.001 ) . This elevation was negatively correlated to the change in LDL cholesterol in women ( r=0.496 , P=0.019 ) and men ( r=0.326 , P=0.138 ) . The LDL oxidizability in women was not influenced by the diets ( P=0.19 ) . Conclusions : α-Linolenic acid in the walnut diet appears to be responsible for the lowering of LDL cholesterol in women . Sponsorship : Kyushu University ( Fukuoka , Japan ) and the California Walnut Commission ( California , USA ) Almond consumption is associated with ameliorations in obesity , hyperlipidemia , hypertension , and hyperglycemia . The hypothesis of this 12-week r and omized crossover clinical trial was that almond consumption would improve glycemic control and decrease the risk for cardiovascular disease in 20 Chinese patients with type 2 diabetes mellitus ( T2DM ) ( 9 male , 11 female ; 58 years old ; body mass index , 26 kg/m² ) with mild hyperlipidemia . After a 2-week run-in period , patients were assigned to either a control National Cholesterol Education Program step II diet ( control diet ) or an almond diet for 4 weeks , with a 2-week washout period between alternative diets . Almonds were added to the control diet to replace 20 % of total daily calorie intake . Addition of approximately 60 g almonds per day increased dietary intakes of fiber , magnesium , polyunsaturated fatty acid , monounsaturated fatty acid , and vitamin E. Body fat determined with bioelectrical impedance analysis was significantly lower in patients consuming almonds ( almonds vs control : 29.6 % vs 30.4 % ) . The almond diet enhanced plasma α-tocopherol level by a median 26.8 % ( 95 % confidence intervals , 15.1 - 36.6 ) compared with control diet . Furthermore , almond intake decreased total cholesterol , low-density lipoprotein cholesterol , and the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol by 6.0 % ( 1.6 - 9.4 ) , 11.6 % ( 2.8 - 19.1 ) , and 9.7 % ( 0.3 - 20.9 ) , respectively . Plasma apolipoprotein ( apo ) B levels , apo B/apo A-1 ratio , and nonesterified fatty acid also decreased significantly by 15.6 % ( 5.1 - 25.4 ) , 17.4 % ( 2.8 - 19.9 ) , and 5.5 % ( 3.0 - 14.4 ) , respectively . Compared with subjects in the control diet , those in the almond diet had 4.1 % ( 0.9 - 12.5 ) , 0.8 % ( 0.4 - 6.3 ) , and 9.2 % ( 4.4 - 13.2 ) lower levels of fasting insulin , fasting glucose , and homeostasis model assessment of insulin resistance index , respectively . Our results suggested that incorporation of almonds into a healthy diet has beneficial effects on adiposity , glycemic control , and the lipid profile , thereby potentially decreasing the risk for cardiovascular disease in patients with type 2 diabetes mellitus Objective : To compare two low fat diets one rich in walnuts on parameters of lipid metabolism in a group of hyperlipidaemic subjects . Design : A r and omised cross over study . Setting : Department of Human Nutrition , University of Otago , Dunedin , New Zeal and Subjects : Twenty one men with mean ( s.d ) levels of total and LDL cholesterol of 6.58 ( 0.60 ) and 4.63 ( 0.58 ) respectively . Interventions : For two periods of four weeks subjects were asked to consume two low fat diets ( fat 30 % total energy ) , one containing , on average , 78 g/d walnuts . Walnuts obtained through Lincoln University and the Walnut Growers Group ( South Canterbury ) . Results : Participants reported a higher total fat intake on the walnut diet ( 38 % compared with 30 % on the low fat diet P<0.01 ) The most consistent change in fatty acid profile of triacylglycerol , phospholipid and cholesterol ester on the walnut diet was a significant ( P<0.01 ) increase in linoleic acid . Triacylglycerol linolenate also increased significantly ( P<0.01 ) . Total and LDL cholesterol were lower on both experimental diets than at baseline , 0.25 mmol/l and 0.36 mmol/l respectively on the walnut diet and 0.13 mmol/l and 0.20 mmol/l respectively on the low fat diet . High density lipoprotein cholesterol was higher on both the walnut and low fat diets when compared to baseline ( 0.15 mmol/l and 0.12 mmol/l , respectively ) . When comparing the walnut and low fat diets only apo B was significantly lower ( P<0.05 ) on the walnut diet . Conclusions : Despite an unintended increase in the total fat intake on the walnut diet , fatty acid profile of the major lipid fractions showed changes which might be expected to reduce risk of cardiovascular disease . The reduction of apolipoprotein B suggests a reduction in lipoprotein mediated risk , the relatively low myristic acid content of both diets perhaps explaining the absence of more extensive differences in lipoprotein levels on the two diets . Sponsorship : Nutrition Department University of Otago , New Zeal and OBJECTIVE The aim of this study was to examine the effect of a moderate-fat diet inclusive of walnuts on blood lipid profiles in patients with type 2 diabetes . RESEARCH DESIGN AND METHODS This was a parallel r and omized controlled trial comparing three dietary advice groups each with 30 % energy as fat : low fat , modified low fat , and modified low fat inclusive of 30 g of walnuts per day .  Fifty-eight men and women , mean age 59.3 + /- 8.1 years , started the trial . Dietary advice was given at baseline with monthly follow-up and fortnightly phone calls for support .  Body weight , percent body fat , blood lipids , HbA1c , total antioxidant capacity , and erythrocyte fatty acid levels were measured at 0 , 3 , and 6 months . Data were assessed by repeated- measures ANOVA with an intention-to-treat model . RESULTS The walnut group achieved a significantly greater increase in HDL cholesterol-to-total cholesterol ratio ( P=0.049 ) and HDL ( P=0.046 ) than the two other treatment groups . A 10 % reduction in LDL cholesterol was also achieved in the walnut group , reflecting a significant effect by group ( P=0.032 ) and time ( P=0.036 ) . There were no significant differences between groups for changes in body weight , percent body fat , total antioxidant capacity , or HbA1c levels . The higher dietary polyunsaturated fat-to-saturated fat ratio and intakes of omega-3 fatty acids in the walnut group were confirmed by erythrocyte biomarkers of dietary intake . CONCLUSIONS Structured " whole of diet " advice that included 30 g of walnuts/day delivering substantial amounts of polyunsaturated fatty acid improved the lipid profile of patients with type 2 diabetes 1 . Recent studies have identified potential beneficial effects of eating nuts , most of which have substantial amounts of monounsaturated fatty acids ( MUFA ) .  Macadamia nuts consist of 75 % fat by weight , 80 % of which is MUFA ( palmitoleic acid ) 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 prospect i ve 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 The objective of this study was to assess the dose-response effect of almond intake on plasma and red blood cell tocopherol concentrations in healthy adults enrolled in a r and omized , crossover feeding trial . Participants were 16 healthy men and women , aged 41+/-13 years . After a 2-week run-in period , participants were fed three diets for 4 weeks each : a control diet , a low-almond diet , and a high-almond diet , in which almonds contributed 0 % , 10 % , and 20 % of total energy , respectively . Changes in blood tocopherol levels were assayed by high pressure liquid chromatography . Incorporating almonds into the diet helped meet the revised Recommended Dietary Allowance of 15 mg/day alpha-tocopherol and increased lipid-adjusted plasma and red blood cell alpha-tocopherol concentrations . A significant dose-response effect was observed between percent energy in the diet from almonds and plasma ratio of alpha-tocopherol to total cholesterol Objective : There is a widely held view that , due to high fat content , snacking on nuts will lead to weight gain , ultimately causing unhealthy changes in lipid profiles . This study is design ed to study the effects of pistachio snack consumption on body weight and lipid levels in obese participants under real-world conditions . Methods : Participants were r and omly assigned to consume 1 of 2 isocaloric weight reduction diets for 12 weeks , with each providing 500 cal per day less than resting metabolic rate . Each diet included an afternoon snack of either 53 g ( 240 cal ) of salted pistachios ( n = 31 ) or 56 g of salted pretzels ( 220 cal ; n = 28 ) . Results : Both groups lost weight during the 12-week study ( time trend , p < 0.001 ) , but there were significant differences in the changes in body mass index between the pretzel and pistachio groups ( pistachio , 30.1 ± 0.4 to 28.8 ± 0.4 vs. pretzel , 30.9 ± 0.4 to 30.3 ± 0.5 ) . At 6 and 12 weeks , triglycerides were significantly lower in the pistachio group compared with the pretzel group ( 88.04 ± 9.80 mg/dL vs. 144.56 ± 18.86 mg/dL , p = 0.01 at 6 weeks and 88.10 ± 6.78 mg/dL vs. 132.15 ± 16.76 mg/dL , p = 0.02 at 12 weeks ) , and there was a time trend difference between the 2 groups over the 12 weeks ( p < 0.01 ) . There were no significant differences in total cholesterol , high-density lipoprotein cholesterol , low-density lipoprotein cholesterol , insulin , or glucose between the 2 groups . Conclusion : Pistachios can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern that pistachios will cause weight gain . By comparison to refined carbohydrate snacks such as pretzels , pistachios may have beneficial effects on triglycerides as well Objective : To compare the lipid-altering effect of roasted salted almonds and roasted almond butter with that of raw almonds , as part of a plant-based diet . Methods : Thirty-eight free-living , hypercholesterolemic men ( n = 12 ) and women ( n = 26 ) with a mean total serum cholesterol ( TC ) of 245 + 29 mg/dL ( mean + SD ) followed a heart-healthy diet  including 100 g of one of three forms of almonds : roasted salted almonds , roasted almond butter or raw almonds for four weeks . Measurements of serum TC , triglycerides ( TG ) , selected lipoproteins and blood pressure were taken at baseline and after four weeks . Results : All three forms of almonds in the context of a heart-healthy diet significantly lowered low-density lipoprotein-cholesterol ( LDL ) from baseline to the completion of the study . Both raw and roasted almonds significantly lowered TC , whereas the decrease by almond butter ( in a smaller cohort ) did not reach statistical significance . High-density lipoprotein-cholesterol ( HDL ) did not significantly change with raw or roasted almonds but slightly increased with almond butter . At the end of the study , blood pressure did not change significantly from baseline values for any of the groups . Conclusion : These results suggest that unblanched almonds — whether raw , dry roasted , or in roasted butter form — can play an effective role in cholesterol-lowering , plant-based diets BACKGROUND In a recent six-year follow-up study , we found that frequent consumption of nuts was associated with a reduced risk of ischemic heart disease .  To explore possible explanations for this finding , we studied the effects of nut consumption on serum lipids and blood pressure . METHODS We r and omly placed 18 healthy men on two mixed natural diets  , each diet to be followed for four weeks . Both diets conformed to the National Cholesterol Education Program Step 1 diet and contained identical foods and macronutrients , except that 20 percent of the calories of one diet ( the walnut diet ) were derived from walnuts ( offset by lesser amounts of fatty foods , meat , and visible fat [ oils , margarine , and butter ] ) . RESULTS With the reference diet , the mean ( + /- SD ) serum values for total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol were , respectively , 182 + /- 23 , 112 + /- 16 , and 47 + /- 11 mg per deciliter ( 4.71 + /- 0.59 , 2.90 + /- 0.41 , and 1.22 + /- 0.28 mmol per liter ) . With the walnut diet , the mean total cholesterol level was 22.4 mg per deciliter ( 0.58 mmol per liter ) lower than the mean level with the reference diet ( 95 percent confidence interval , 28 to 17 mg per deciliter [ 0.72 to 0.44 mmol per liter ] ) ; the LDL and HDL cholesterol levels were , respectively , 18.2 mg per deciliter ( 0.47 mmol per liter ) ( P < 0.001 ) and 2.3 mg per deciliter ( 0.06 mmol per liter ) ( P = 0.01 ) lower . These lower values represented reductions of 12.4 , 16.3 , and 4.9 percent in the levels of total , LDL , and HDL cholesterol , respectively . The ratio of LDL cholesterol to HDL cholesterol was also lowered ( P < 0.001 ) by the walnut diet .  Mean blood-pressure values did not change during either dietary period . CONCLUSIONS Incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet while maintaining the intake of total dietary fat and calories decreases serum levels of total cholesterol and favorably modifies the lipoprotein profile in normal men . The long-term effects of walnut consumption and the extension of this finding to other population groups deserve further study Objective : The authors tested the hypothesis that in adults with prediabetes , an almond-enriched American Diabetes Association ( ADA ) diet improves measures of insulin sensitivity and other cardiovascular risk factors compared with an ADA nut-free diet . Methods : Design : R and omized parallel-group trial . Setting : Outpatient dietary counseling and blood analysis . Subjects : Sixty-five adult participants with prediabetes . Intervention : Sixteen weeks of dietary modification featuring an ADA diet containing 20 % of energy from almonds ( approximately 2 oz per day ) . Measures of Outcome : Outcomes included fasting glucose , insulin , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides , TC : HDL-C , and HbA1c , which were measured at weeks 0 , 8 , and 16 . Body weight , body mass index ( BMI ) , waist circumference , blood pressure , and nutrient intake were measured at weeks 0 , 4 , 8 , 12 , and 16 . Results : The almond-enriched intervention group exhibited greater reductions in insulin ( −1.78 µU/ml vs. + 1.47 µU/ml , p = 0.002 ) , homeostasis model analysis for insulin resistance ( −0.48 vs. + 0.30 , p = 0.007 ) , and homeostasis model analysis for beta-cell function ( −13.2 vs. + 22.3 , p = 0.001 ) compared with the nut-free control group . Clinical ly significant declines in LDL-C were found in the almond-enriched intervention group ( −12.4 mg/dl vs. −0.4 mg/dl ) as compared with the nut-free control group . No changes were observed in BMI ( −0.4 vs. −0.7 kg/m2 , p = 0.191 ) , systolic blood pressure ( −4.4 mm Hg vs. −3.5 mm Hg , p = 0.773 ) , or for the other measured cardiovascular risk factors . Conclusions : An ADA diet consisting of 20 % of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinical ly significant improvements in LDL-C in adults with prediabetes Walnut ( Juglans regia L. ) is described as an anticancer , tonic , blood purifier , and detoxifier agent . It is said that nuts have favorable fatty acids and nutrients . This study was performed to determine the lipid-lowering properties of walnut in a population in Shiraz , Southern Iran . In a r and omized case-control study , 52 volunteers were divided into 2 groups : Group A consumed walnuts , 20 grams per day for 8 weeks and the control group ( group B ) consumed no walnuts .  Triglycerides , total high-density lipoprotein ( HDL ) , and low-density lipoprotein ( LDL ) levels were checked for each subject prior to , after 4 weeks , and at 8 weeks after the beginning of the study . In group A , the mean plasma TG level dropped by 17.1 % from the baseline and HDL cholesterol also increased significantly by 9 % . It was shown that frequent consumption of nuts in the daily diet was associated with a potentially decreased risk of coronary artery disease by decreasing the level of triglyceride and increasing the level of HDL Background : A number of recent studies indicate that antioxidants reduce the oxidative stress associated with the development of coronary heart diseases ( CHD ) . Objective : ( i ) To investigate whether the erythrocyte catalase ( CAT ) , superoxide dismutase ( SOD ) , total glutathione , reduced glutathione ( GSH ) , oxidized glutathione ( GSSG ) , and lipid peroxidation ( LPO ) , and serum uric acid and paraoxonase-1 ( PON1 ) are modified at increased CHD-risk individuals consuming walnut-enriched meat ( WM ) , ( ii ) to evaluate whether these changes were influenced by basal serum cholesterol , body mass index or smoking habit . Design : The study was a non blinded , cross-over , placebo-controlled trial in which 22 volunteers ( 60 % overweight and 40 % obese ) with increased CHD-risk were r and omly assigned to receive WM or control meat ( CM ) during two different periods of 5 weeks . Results : A significant interaction time*treatment ( p < 0.05 ) was observed in all enzymes and substrates tested except HDL-C , uric acid and LPO . The treatment significantly increased CAT activity , total glutathione and GSSG ( p < 0.05 ) . Significant gender*time*treatment interaction ( p = 0.043 ) for total glutathione was found increasing at the end of the WM period in male but not changing in female . Total glutathione and GSH/GSSG ratio ( p < 0.05 ) were lower in smokers . Hypercholesterolemics presented higher uric acid ( p < 0.05 ) but no enzyme activities or substrate concentrations were different from those of normocholesterolemics . Conclusions : The WM tested appears to be a functional food as it improved the antioxidant status of increased CHD-risk volunteers . Despite its high energy content , it also appears adequate for overweight and obese people because did not exert negative effect upon body weight BACKGROUND AND AIM Effects of pistachio nuts consumption on plasma lipid profile and oxidative status were investigated in healthy volunteers with normal lipid levels . METHODS AND RESULTS The study was conducted in 24 healthy men and 20 healthy women . All subjects consumed their regular diets during a 1-week period . After this period , half of the subjects ( 12 men and 10 women , mean age 32.8 + /- 6.7 years ) were r and omized to a regular diet group and the other half ( 12 men and 10 women , mean age 33.4 + /- 7.2 years ) were r and omized to a pistachio group which involved substituting pistachio nuts for 20 % of their daily caloric intake for 3 weeks . Plasma total cholesterol , low-density lipoprotein ( LDL ) , high-density lipoprotein ( HDL ) , triglyceride , malondialdehyde ( MDA ) and antioxidant potential ( AOP ) were measured before and after the dietary modification from all the subjects . After 3 weeks , with the pistachio diet , the mean plasma total cholesterol , MDA levels and , total cholesterol/HDL and LDL/HDL ratios were found to be significantly decreased ( P < 0.05 , P < 0.05 , P < 0.001 and P < 0.01 , respectively ) ; on the contrary , HDL and AOP levels , and AOP/MDA ratios were significantly increased ( P < 0.001 , P < 0.05 and P < 0.01 , respectively ) . Triglyceride and LDL levels also decreased but this was not statistically significant ( P > 0.05 ) . CONCLUSION These results indicated that consumption of pistachio nuts decreased oxidative stress , and improved total cholesterol and HDL levels in healthy volunteers BACKGROUND AND AIM Small quantities of nuts protect against subsequent cardiovascular risk . There is speculation that the cholesterol lowering effect associated with nut consumption arises primarily from the fatty acid composition of nuts but may be caused by some other component . To evaluate this possibility we compared the effect of various nuts , against a Canola oil based cereal with a comparable fatty acid profile , on lipids , lipoproteins and fatty acids to determine whether the fatty acid profile of nuts explains their cholesterol lowering effects . METHODS AND RESULTS Twenty-eight men and women with mean ( s.d . ) levels of total and low density lipoprotein cholesterol of 6.0 ( 1.1 ) mmol/L , and 4.1 ( 1.0 ) mmol/L , respectively and a mean body mass index ( BMI ) of 26.9 ( 3.2 ) kg/m2 took part in a r and omised cross over trial . For two periods of six weeks , separated by a four-week washout , participants were asked to consume a low saturated fat diet , which included either 30 g/d nuts ( nut diet ) or one serving of a cereal containing Canola oil ( cereal diet ) . There were no significant differences in the lipids , lipoproteins , plasma fatty acids or other variables between the two diets at the end of the study . Total cholesterol ( TC ) and low density lipoprotein cholesterol ( LDL-C ) were lower on both experimental diets than at baseline , 0.51 mmol/L and 0.40 mmol/L ( p<0.001 , p<0.01 ) , respectively on the nut diet and 0.42 mmol/L and 0.37 mmol/L ( p<0.001 , p<0.01 ) , respectively on the cereal diet . CONCLUSION A 30 g serving of nuts , or a serving of a Canola oil enriched cereal with a similar fatty acid composition reduced total and LDL cholesterol to a similar extent when consumed as part of a lipid lowering diet . Results suggest that foods with a similar fatty acid composition to nuts can produce comparable decreases in lipoprotein mediated cardiovascular risk CONTEXT Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified . OBJECTIVE To assess major lipids and apolipoproteins in vascular risk . DESIGN , SETTING , AND PARTICIPANTS Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospect i ve studies , mostly in Europe and North America . During 2.79 million person-years of follow-up , there were 8857 nonfatal myocardial infa rct ions , 3928 coronary heart disease [ CHD ] deaths , 2534 ischemic strokes , 513 hemorrhagic strokes , and 2536 unclassified strokes . MAIN OUTCOME MEASURES Hazard ratios ( HRs ) , adjusted for several conventional factors , were calculated for 1-SD higher values : 0.52 log(e ) triglyceride , 15 mg/dL high-density lipoprotein cholesterol ( HDL-C ) , 43 mg/dL non-HDL-C , 29 mg/dL apolipoprotein AI , 29 mg/dL apolipoprotein B , and 33 mg/dL directly measured low-density lipoprotein cholesterol ( LDL-C )  . Within- study regression analyses were adjusted for within-person variation and combined using meta- analysis . RESULTS The rates of CHD per 1000 person-years in the bottom and top thirds of baseline lipid distributions , respectively , were 2.6 and 6.2 with triglyceride , 6.4 and 2.4 with HDL-C , and 2.3 and 6.7 with non-HDL-C. Adjusted HRs for CHD were 0.99 ( 95 % CI , 0.94 - 1.05 ) with triglyceride , 0.78 ( 95 % CI , 0.74 - 0.82 ) with HDL-C , and 1.50 ( 95 % CI , 1.39 - 1.61 ) with non-HDL-C. Hazard ratios were at least as strong in participants who did not fast as in those who did . The HR for CHD was 0.35 ( 95 % CI , 0.30 - 0.42 ) with a combination of 80 mg/dL lower non-HDL-C and 15 mg/dL higher HDL-C. For the subset with apolipoproteins or directly measured LDL-C , HRs were 1.50 ( 95 % CI , 1.38 - 1.62 ) with the ratio non-HDL-C/HDL-C , 1.49 ( 95 % CI , 1.39 - 1.60 ) with the ratio apo B/apo AI , 1.42 ( 95 % CI , 1.06 - 1.91 ) with non-HDL-C , and 1.38 ( 95 % CI , 1.09 - 1.73 ) with directly measured LDL-C. Hazard ratios for ischemic stroke were 1.02 ( 95 % CI , 0.94 - 1.11 ) with triglyceride , 0.93 ( 95 % CI , 0.84 - 1.02 ) with HDL-C , and 1.12 ( 95 % CI , 1.04 - 1.20 ) with non-HDL-C. CONCLUSION Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride Background / Objectives : Diets high in nuts reduce cholesterol , probably due to their favorable lipid profile and other bioactive substances . However , the physical form of the nut may be important as the cell wall of intact nuts may limit the hypocholesterolemic effect of nuts by reducing lipid bioavailability . Therefore , we investigated the effects on blood lipids of incorporating three different forms of hazelnuts ( ground , sliced and whole ) into the usual diet . Subjects/ Methods : In a r and omized crossover study with three phases , 48 mildly hypercholesterolemic participants were asked to consume 30 g of ground , sliced or whole hazelnuts for 4 weeks . Body weight , plasma total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triacylglycerol ( TAG ) , apolipoprotein ( apo ) A1 , apo B100 and α-tocopherol were measured at baseline and at the end of each dietary phase . Results : There were no significant differences in any outcome variable between the different forms of nuts ( all P⩾0.159 ) . However , compared with baseline , mean values at the end of each hazelnut intervention were significantly higher for HDL-C ( P=0.023 ) and α-tocopherol ( P=0.005 ) , and significantly lower for TC ( P<0.001 ) , LDL-C ( P<0.001 ) , TC : HDL-C ratio ( P<0.001 ) , apo B100 ( P=0.002 ) and apo B100:apo A1 ratio ( P<0.001 ) , with no significant difference in body weight ( P=0.813 ) . Conclusions : The ingestion of three different forms of hazelnuts equally improved the lipoprotein profile and α-tocopherol concentrations in mildly hypercholesterolemic individuals . Hazelnuts can therefore be incorporated into the usual diet as a means of reducing cardiovascular disease risk
target: Significant heterogeneity was not observed by nut type or other factors .
  Tree nut intake  lowers total cholesterol , LDL cholesterol , ApoB , and triglycerides .
  The major determinant of cholesterol lowering appears to be nut dose rather than nut type .
background: BACKGROUND The effects of nuts on major cardiovascular disease ( CVD ) risk factors , including dose-responses and potential heterogeneity by nut type or phytosterol content , are not well established .
  OBJECTIVES We examined the effects of tree nuts ( walnuts , pistachios , macadamia nuts , pecans , cashews , almonds , hazelnuts , and Brazil nuts ) on blood lipids [ total cholesterol , low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein , and triglycerides ] , lipoproteins [ apolipoprotein A1 , apolipoprotein B ( ApoB ) , and apolipoprotein B100 ] , blood pressure , and inflammation ( C-reactive protein ) in adults aged ≥18 y without prevalent CVD .