Almond consumption may help reduce cholesterol

A review and meta-analysis study funded by the Almond Board of California and recently published online in the Journal of Nutritional Science has concluded that almonds can have a beneficial effect on total cholesterol, (TC), low-density-lipoprotein cholesterol (LDL-C) and triacylglycerol (TAG) levels in the blood.

The study indicates that almonds are “nutritionally dense” containing fat, dietary fibre and protein as well as some plant sterols and many vitamins and minerals including calcium, iron, magnesium, zinc, thiamine, niacin and vitamin E. Musa-Veloso et al. note that many of these components might help maintain healthy lipid levels in the blood. To investigate this the scientists evaluated recent randomised controlled trials which examined the effects of almonds on blood lipid levels.

Musa-Veloso et al. searched eight literature databases for suitable studies. For inclusion, studies needed to be randomised, controlled human intervention studies which investigated the effect of almond consumption on TC, LDL-C, high-density-lipoprotein cholesterol (HDL-C) and/or TAG. Additionally each study needed to report the amount of almonds consumed, participants had to be aged 18 or over without serious disease and the study had to have a duration of at least 4 weeks.

The search found 18 publications with a total of 27 sets of data – Musa-Veloso et al. considered different almond doses separately hence the higher number of data sets than publications. Of these 27, seventeen were from parallel trials with the remaining 10 from crossover trials. The study notes that the average daily intake of almonds across the 18 studies ranged from 20 to 113g /day with studies lasting between 4 weeks and 18 months. Musa-Veloso et al. note that while the way in which the studies used almonds and the type of almonds used varied as did control arrangements, all 18 studies were considered to be “high quality” when measured using Health Canada’ quality appraisal tool.

Following statistical analysis, Musa-Veloso et al report that when data from all 27 sets was pooled, a statistically significant reduction of fasting TC levels of 0.153 mmol/l was shown. In addition, 25 data sets reported on fasting LDL-C levels and when pooled, these showed a statistically significant reduction of 0.124 mmol/l. Twenty-five sets also reported on the effect of almond consumption on fasting TAG levels and again, when pooled, these data showed a statistically significant reduction of 0.067 mmol/l. Although 22 data sets investigated the effect of consumption on fasting HDL-C levels, no significant effect was found.

Musa-Veloso et al indicate that their findings are similar to those of Phung et al. who conducted a meta-analysis of randomised controlled trials a number of years ago as well as more recent analyses by others. They do note however that a Cochrane review by Martin et al. reported that nut intake had no effect on LDL-C or HDL-C but suggest that this might be due to the study mainly being focused on nut consumption and CVD risk and only containing 4 data sets and using generally healthy subjects.

In discussion, Musa-Veloso state that their subgroup analysis suggests that the improvement on TC and LDL-C is greatest where a daily intake of 45g of almonds was provided for subjects with initially elevated TC and LDL-C levels. They note that the consumption of nuts is encouraged by several ‘heart-healthy” diets and conclude by stating that eating nuts such as almonds should be encouraged in order to “help in the maintenance of normal blood lipid levels and reduce the risk of heart disease”.


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