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. 2023 Aug 2;14(5):1005–1028. doi: 10.1016/j.advnut.2023.07.010

TABLE 5.

Intake of almonds on cardiovascular and gut health, 2017–2023

Reference Study design Study duration Subject characteristics n Nut type, quantity Control Relevant outcomes
Cardiovascular health
Lee 2017 [33] Randomized, 4-period crossover, controlled-feeding trial 4 wk OW and obese males and females (mean age 46 y) 31 Almond, 42.5 g/d Isocaloric diet, excluding almonds ↓ TC1, non-HDL-C1, LDL-C1, ApoB1, SysBP1, DiaBP1
No Δ in FMD
Liu 2017 [34] Randomized, controlled trial 16 wk Healthy males and females (mean age 26 y) 169 Almond, 56 g/d, (1) premeal or (2) between meals Isocaloric snack ↓ TC1, LDL-C1, non-HDL-C1
Bhardwaj 2018 [18] Randomized, controlled, crossover trial PP HFM OW males and females (mean age 42 y) 27 Almond, 77 g Walnut, 60 g ↓ sVCAM1
↑ FMD (nonsignificant)
Dhillon 2018 [35] Randomized, controlled trial 8 wk Healthy males and females (mean age 18 y) 73 Almond, 56.7 g/d Isocaloric snack ↓ TC1, HDL-C1, 1LDL-C
No Δ in RHI, AIx, BP
Jung 2018 [36] Randomized, controlled, crossover trial 4 wk OW and obese males and females (mean age 52 y) 84 Almond, 56 g/d Isocaloric snack ↓ TC1, LDL-C1, non-HDL-C1
Liu 2018 [37] Randomized, controlled trial 20 wk Healthy males and females (mean age 27 y) 85 Almond, 56 g/d Isocaloric snack ↓ DiaBP1, TC2, HDL-C2, LDL-C2, non-HDL-C2, TG2, VLDL-C2
Bowen 2019 [38] Randomized, controlled trial 8 wk OW and obese males and females at risk for T2DM (mean age 61 y) 76 Almond, 56 g/d Isocaloric snack Women only: ↓ TC:HDL-C ratio1
Coates 2020 [39] Randomized, controlled trial 12 wk OW and obese males and postmenopausal females (mean age 65 y) 128 Almond, 15% energy Isocaloric snack ↓ TG1, SysBP1
No Δ in ICAM-1, VCAM-1, SAC or LAC
Dikariyanto 2020 [40] Randomized, controlled trial 6 wk Males and females at risk for CVD (mean age 56 y) 105 Almond, 20% of energy Isocaloric snack ↑ FMD2
↓ LDL-C1, non-HDL-C1
No Δ TG, HDL-C or BP
Dikariyonto 2020 [41] Randomized, controlled trial 6 wk Males and females at risk for CVD (mean age 56 y) 105 Almond, 20% of energy Isocaloric snack ↑ HRV1
Palacios 2020 [42] Randomized, controlled, crossover trial 6 wk OW and obese males and females with prediabetes (mean age 48 y) 33 Almond, 85 g/d Isocaloric snack ↑ApoA1, HDL3-C1
Gut health
Holscher 2018 [43] Randomized, 5-arm crossover, controlled-feeding trial 3 wk Healthy males and females (mean age 57 y) 18 (1) Almond, 42 g/d (whole), (2) Almond, 42 g/d (roasted), (3) Almond, 42 g/d (roasted, chopped)
(4) Almond butter, 42 g/d
Exclusion of almonds Chopped: ↑ Lachnospira1Roseburia1, Oscillospira1
Whole: ↑ Dialister1
Dhillon 2019 [44] Randomized, controlled trial 8 wk Healthy males and females (mean age 18 y) 73 Almond, 56.7 g/d Isocaloric snack ↑ alpha-diversity1
Bacteroides fragilis1
Choo 2021 [45] Randomized, controlled trial 8 wk OW and obese males and females at risk for T2DM (mean age 61 y) 69 Almond, 56 g/d Isocaloric snack Ruminococcaceae1
Creedon 2022 [46] 3-arm, parallel-design randomized, controlled trial 4 wk Healthy males and females (mean age 28 y) 79 Almond, 56 g/d Isocaloric snack ↑ SCFA (butyrate)1
No Δ in bifidobacteria

Includes human clinical trials that focus on only one functional food (ie, a single type of nut or berry) with outcomes of known physiologically relevant measures related to vascular function and gut health over the past 5 y (2017–2023). Excludes interventions using mixtures of different types of nuts or berries, nut- or berry-containing meals, and nut or berry extracts or oils. Also excludes interventions where nut or berry intake was in combination with other potentially confounding factors (ie, diet or lifestyle modifications including physical activity and dietary counseling).

Abbreviations: AIx, augmentation index; BP, blood pressure; CKD, chronic kidney disease; DiaBP, diastolic blood pressure; FMD, flow-mediated dilation; HDL-C, HDL cholesterol; HRV, heart rate variability; ICAM-1, intercellular adhesion molecule-1; IDL-C, IDL cholesterol; LAC, large artery compliance; LDL-C, low-density lipoprotein cholesterol; LDL:HDL, LDL cholesterol to HDL-cholesterol ratio; MAP, mean arterial pressure; MetS, metabolic syndrome; OW, overweight; oxLDL, oxidized low-density lipoprotein cholesterol; PP HFM, postprandial high fat meal; PSV, brachial artery peak systolic velocity; SAC, small artery compliance; SBA, secondary bile acids; sVCAM-1, soluble vascular cell adhesion molecule-1; SysBP, systolic blood pressure; TC, total cholesterol; TC:HDL, total cholesterol to HDL-cholesterol ratio; T2DM, type 2 diabetes mellitus; TG, triglycerides; TMAO, trimethylamine N-oxide; UM, urolithin metabotype; VLDL-C, VLDL cholesterol.

1

denotes statistical significance <0.05.

2

denotes statistical significance <0.001.