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European Journal of Nutrition

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Open Access 01-09-2018 | Original Contribution

The effect of almonds on vitamin E status and cardiovascular risk factors in Korean adults: a randomized clinical trial

Authors: Hana Jung, C.-Y. Oliver Chen, Jeffrey B. Blumberg, Ho-Kyung Kwak

Published in: European Journal of Nutrition | Issue 6/2018

Abstract

Purpose

Almonds have shown to beneficially modify some cardiovascular risk factors in clinical trials conducted in diverse ethnic populations but this relationship has never been tested in Koreans. Thus, we tested the impact of almonds consumed as a snack within the context of a typical Korean diet on cardiovascular risk factors.

Methods

We conducted a randomized, crossover trial in a free-living setting with a 2-week run-in period, two 4-week intervention phases, and a 2-week washout period between interventions. Eighty four overweight/obese participants (11 M/73 F; 52.4 ± 0.6 year; 25.4 ± 0.22 kg/m²) consumed either 56 g of almonds or isocaloric cookies daily for 4 weeks.

Results

Mean % daily energy intake at baseline was 64.8, 21.3, and 14.9% from carbohydrate, fat, and protein, respectively. The addition of 56 g of almonds daily decreased carbohydrate energy to 55.0%, increased fat to 32.0%, and maintained protein at 14.7%. Consuming the almonds increased intake of MUFA by 192.3%, PUFA by 84.5%, vitamin E by 102.7%, and dietary fiber by 11.8% and decreased % energy from carbohydrate by 14.1%. Total caloric intake was increased by the almonds, but body weight, waist circumference, and body composition were not affected. Almonds in overweight and obese Korean adults decreased TC, LDL-C, and non-HDL-C by 5.5, 4.6, and 6.4%, respectively, compared to the cookie control (P ≤ 0.05). Almonds increased plasma α-tocopherol by 8.5% (P ≤ 0.05) from the baseline and tended to increase its value as compared to cookies (P = 0.055). Neither the almonds nor cookies altered plasma protein carbonyls, MDA or oxLDL. Of serum inflammatory markers, IL-10 was decreased by almond intake (P ≤ 0.05), and ICAM-1, IL-1β, and IL-6 tended to be lower with almonds, compared to the cookies.

Conclusions

Almonds at 56 g/day consumed as a snack favorably modified the Korean diet by increasing MUFA, PUFA, vitamin E, and dietary fiber intake and decreasing % energy intake from carbohydrate. Almonds also enhanced plasma α-tocopherol status and serum TC and LDL-C in overweight and obese Koreans. Thus, including almonds in typical Korean diets as a snack can help healthy overweight/obese individuals improve nutritional status and reduce their risk for CVD.

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Assmann G, Carmena R, Cullen P, Fruchart J-C, Jossa F, Lewis B, Mancini M, Paoletti R, Disease ITFftPoCH (1999) Coronary heart disease: reducing the risk a worldwide view. Circulation 100(18):1930–1938CrossRefPubMed

Ministry of Health and Welfare of Korea, Korea Centers for Disease Control and Prevention (2014) Korea Health Statistics. Sejong: Ministry of Health and Welfare of Korea

Committee for the Korean guidelines for the management of dyslipidemia (2016) 2015 Korean guidelines for the management of dyslipidemia. Circ J 46(3):275–306

Jellinger P, Smith D, Mehta A, Ganda O, Handelsman Y, Rodbard H, Shepherd M, Seibel J (2012) American Association of Clinical Endocrinologists’ guidelines for management of dyslipidemia and prevention of atherosclerosis. Endoc Pract 18(1):1–78CrossRef

Qi L, Ding X, Tang W, Li Q, Mao D, Wang Y (2015) Prevalence and risk factors associated with dyslipidemia in Chongqing, China. Int J Environ Res Public Health 12(10):13455–13465CrossRefPubMedPubMedCentral

Quyyumi AA (1998) Endothelial function in health and disease: new insights into the genesis of cardiovascular disease. Am J Med 105(1):32S–39SCrossRefPubMed

Bassett J, Organization WH (2000) The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia, Sydney

Song Y, Joung H (2012) A traditional Korean dietary pattern and metabolic syndrome abnormalities. Nutr, Metab Cardiovasc Dis 22(5):456–462CrossRef

Kim J, Jo I, Joung H (2012) A rice-based traditional dietary pattern is associated with obesity in Korean adults. J Acad Nutr Diet 112(2):246–253CrossRefPubMed

10.

Kim YN, Cho YO (2015) Vitamin E status of 20- to 59-year-old adults living in the Seoul metropolitan area of South Korea. Nutr Res Pract 9(2):192–198CrossRefPubMedPubMedCentral

11.

Reiter E, Jiang Q, Christen S (2007) Anti-inflammatory properties of α-and γ-tocopherol. Mol Aspects Med 28(5): 668–691CrossRefPubMedPubMedCentral

12.

Singh RB, Ghosh S, Niaz MA, Singh R, Beegum R, Chibo H, Shoumin Z, Postiglione A (1995) Dietary intake, plasma levels of antioxidant vitamins, and oxidative stress in relation to coronary artery disease in elderly subjects. Am J Cardiol 76(17):1233–1238CrossRefPubMed

13.

O’Neil CE, Keast DR, Fulgoni VL, Nicklas TA (2010) Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health and Nutrition Examination Survey (NHANES) 1999–2004. Asia Pac J Clin Nutr 19(1):142PubMed

14.

Hu FB, Stampfer MJ (1999) Nut consumption and risk of coronary heart disease: a review of epidemiologic evidence. Curr Atheroscler Rep 1(3):204–209CrossRefPubMed

15.

Li S-C, Liu Y-H, Liu J-F, Chang W-H, Chen C-M, Chen C-YO (2011) Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism 60(4):474–479CrossRefPubMed

16.

Li N, Jia X, Chen C-YO, Blumberg JB, Song Y, Zhang W, Zhang X, Ma G, Chen J (2007) Almond consumption reduces oxidative DNA damage and lipid peroxidation in male smokers. J Nutr 137(12):2717–2722CrossRefPubMed

17.

Liu J-F, Liu Y-H, Chen C-M, Chang W-H, Chen CO (2012) The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial. Eur J Nutr 52(3):1–9

18.

Tan S, Mattes R (2013) Appetitive, dietary and health effects of almonds consumed with meals or as snacks: a randomized, controlled trial. Eur J Clin Nutr 67(11):1205–1214CrossRefPubMedPubMedCentral

19.

Wien M, Bleich D, Raghuwanshi M, Gould-Forgerite S, Gomes J, Monahan-Couch L, Oda K (2010) Almond consumption and cardiovascular risk factors in adults with prediabetes. J Am Coll Nutr 29(3):189–197CrossRefPubMed

20.

Berryman CE, Preston AG, Karmally W, Deckelbaum RJ, Kris-Etherton PM (2011) Effects of almond consumption on the reduction of LDL-cholesterol: a discussion of potential mechanisms and future research directions. Nutr Rev 69(4):171–185CrossRefPubMed

21.

Musa-Veloso K, Paulionis L, Poon T, Lee HY (2016) The effects of almond consumption on fasting blood lipid levels: a systematic review and meta-analysis of randomised controlled trials. J Nutr Sci 5(34):1–15

22.

Liu Z, Lee H-J, Garofalo F, Jenkins DJ, El-Sohemy A (2011) Simultaneous measurement of three tocopherols, all-trans-retinol, and eight carotenoids in human plasma by isocratic liquid chromatography. J Chromatogr Sci 49(3):221–227CrossRef

23.

Volpi N, Tarugi P (1998) Improvement in the high-performance liquid chromatography malondialdehyde level determination in normal human plasma. J Chromatogr B Biomed Sci Appl 713(2):433–437CrossRefPubMed

24.

Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL (2003) Markers of inflammation and cardiovascular disease application to clinical and public health practice: a statement for healthcare professionals from the centers for disease control and prevention and the American Heart Association. Circulation 107(3):499–511CrossRefPubMed

25.

Burns AM, Zitt MA, Rowe CC, Langkamp-Henken B, Mai V, Nieves C, Ukhanova M, Christman MC, Dahl WJ (2016) Diet quality improves for parents and children when almonds are incorporated into their daily diet: a randomized, crossover study. Nutr Res 36(1):80–89CrossRefPubMed

26.

Chen CO, Holbrook M, Duess M-A, Dohadwala MM, Hamburg NM, Asztalos BF, Milbury PE, Blumberg JB, Vita JA (2015) Effect of almond consumption on vascular function in patients with coronary artery disease: a randomized, controlled, cross-over trial. Nutr J 14(1):1CrossRef

27.

Foster GD, Shantz KL, Vander Veur SS, Oliver TL, Lent MR, Virus A, Szapary PO, Rader DJ, Zemel BS, Gilden-Tsai A (2012) A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity. Am J Clin Nutr 96(2):249–254CrossRefPubMedPubMedCentral

28.

Expert Panel on Detection (2001) Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19):2486–2497CrossRef

29.

Ministry of Health and Welfare, The Korean Nutrition Society (2015) Dietary Reference Intakes for Koreans 2015. Sejong: Ministry of Health and Welfare

30.

Fraser GE, Bennett HW, Jaceldo KB, Sabaté J (2002) Effect on body weight of a free 76 kilojoule (320 calorie) daily supplement of almonds for 6 months. J Am Coll Nutr 21(3):275–283CrossRefPubMed

31.

Cassady BA, Hollis JH, Fulford AD, Considine RV, Mattes RD (2009) Mastication of almonds: effects of lipid bioaccessibility, appetite, and hormone response. Am J Clin Nutr 89(3):794–800CrossRefPubMed

32.

Hull S, Re R, Chambers L, Echaniz A, Wickham MS (2015) A mid-morning snack of almonds generates satiety and appropriate adjustment of subsequent food intake in healthy women. Eur J Nutr 54(5):803–810CrossRefPubMed

33.

Jenkins DJ, Kendall CW, Marchie A, Parker TL, Connelly PW, Qian W, Haight JS, Faulkner D, Vidgen E, Lapsley KG (2002) Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein (a), homocysteine, and pulmonary nitric oxide a randomized, controlled, crossover trial. Circulation 106(11):1327–1332CrossRefPubMed

34.

Novotny JA, Gebauer SK, Baer DJ (2012) Discrepancy between the Atwater factor predicted and empirically measured energy values of almonds in human diets. Am J Clin Nutr 96(2):296–301CrossRefPubMedPubMedCentral

35.

Jaceldo-Siegl K, Sabaté J, Rajaram S, Fraser GE (2004) Long-term almond supplementation without advice on food replacement induces favourable nutrient modifications to the habitual diets of free-living individuals. Brit J Nutr 92(03):533–540CrossRefPubMed

36.

Jambazian PR, Haddad E, Rajaram S, Tanzman J, Sabaté J (2005) Almonds in the diet simultaneously improve plasma α-tocopherol concentrations and reduce plasma lipids. J Am Diet Assoc 105(3):449–454CrossRefPubMed

37.

Jaceldo-Siegl K, Sabaté J, Batech M, Fraser G (2011) Influence of body mass index and serum lipids on the cholesterol-lowering effects of almonds in free-living individuals. Nutr Metab Cardiovasc Dis 21:S7–S13CrossRefPubMed

38.

Spiller GA, Miller A, Olivera K, Reynolds J, Miller B, Morse SJ, Dewell A, Farquhar JW (2003) Effects of plant-based diets high in raw or roasted almonds, or roasted almond butter on serum lipoproteins in humans. J Am Coll Nutr 22(3):195–200CrossRefPubMed

39.

Spiller GA, Jenkins DA, Bosello O, Gates JE, Cragen LN, Bruce B (1998) Nuts and plasma lipids: an almond-based diet lowers LDL-C while preserving HDL-C. J Am Coll Nutr 17(3):285–290CrossRefPubMed

40.

Abbey M, Noakes M, Belling GB, Nestel PJ (1994) Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr 59(5):995–999CrossRefPubMed

41.

Ruisinger JF, Gibson CA, Backes JM, Smith BK, Sullivan DK, Moriarty PM, Kris-Etherton P (2015) Statins and almonds to lower lipoproteins (the STALL Study). J Clinic Lipidol 9(1):58–64CrossRef

42.

Lee YJ, Nam GE, Seo JA, Yoon T, Seo I, Lee JH, Im D, Bahn K-N, Jeong SA, Kang TS (2014) Nut consumption has favorable effects on lipid profiles of Korean women with metabolic syndrome. Nutr Res 34(9):814–820CrossRefPubMed

43.

Han JM, Jo AN, Lee SM, Bae HS, Jun DW, Cho YK, Suk KT, Yoon JH, Ahn SB, Cho YJ (2014) Associations between intakes of individual nutrients or whole food groups and non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol 29(6):1265–1272CrossRefPubMed

44.

Chung CE (2007) Dietary intakes and food sources of total sugars from Korean National Health and Nutrition Examination Survey 2001–2002. Korean J Nutr 40(Suppl):9–21

45.

Lee HS, Kwon SO, Yon M, Kim D, Lee JY, Nam J, Kwon OS (2014) Dietary total sugar intake of Koreans: based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008–2011. J Nutr Health 47(4):268–276CrossRef

46.

US Food Drug Administration (2003) Qualified health claims: letter of enforcement discretion—nuts and coronary heart disease. US Food and Drug Administration, Rockville, pp 1–4

47.

Choudhury K, Clark J, Griffiths HR (2014) An almond-enriched diet increases plasma α-tocopherol and improves vascular function but does not affect oxidative stress markers or lipid levels. Free Radic Res 48(5):599–606CrossRefPubMed

48.

Kim J, Yang Y, Yang Y, Oh S, Hong Y, Lee E, Kwon O (2011) Diet quality scores and oxidative stress in Korean adults. Eur J Clin Nutr 65(12):1271–1278CrossRefPubMed

49.

Rajaram S, Connell KM, Sabaté J (2010) Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. Brit J Nutr 103(06):907–912CrossRefPubMed

50.

Welsh P, Murray HM, Ford I, Trompet S, de Craen AJ, Jukema JW, Stott DJ, McInnes IB, Packard CJ, Westendorp RG (2011) Circulating interleukin-10 and risk of cardiovascular events a prospective study in the elderly at risk. Arterioscler Thromb Vasc Biol 31(10):2338–2344CrossRefPubMed

51.

Hwang S-J, Ballantyne CM, Sharrett AR, Smith LC, Davis CE, Gotto AM, Boerwinkle E (1997) Circulating adhesion molecules VCAM-1, ICAM-1, and E-selectin in carotid atherosclerosis and incident coronary heart disease cases the Atherosclerosis Risk In Communities (ARIC) study. Circulation 96(12):4219–4225CrossRefPubMed

52.

van Beek L, Lips MA, Visser A, Pijl H, Ioan-Facsinay A, Toes R, Berends FJ, van Dijk KW, Koning F, van Harmelen V (2014) Increased systemic and adipose tissue inflammation differentiates obese women with T2DM from obese women with normal glucose tolerance. Metabolism 63(4):492–501CrossRefPubMed

Title: The effect of almonds on vitamin E status and cardiovascular risk factors in Korean adults: a randomized clinical trial
Authors: Hana Jung
C.-Y. Oliver Chen
Jeffrey B. Blumberg
Ho-Kyung Kwak
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 6/2018
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-017-1480-5

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Conclusions

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