Table 4.

The effect of nuts on plasma concentration of small dense low density lipoprotein (LDL), LDL particle number, and LDL particle size

Author, Year	Intervention	Dose per day	Treatment duration	Subjects	Method of assessment	Main outcomes	Final effects of specific diet ingredients or nutraceuticals on LDL (number, size and concentration)
Hernández-Alonso et al. 2015 [89]	PD, control diet	PD; 50% carbohydrates, 33% fat, including 57 g/d of pistachios, Control diet, 55% carbohydrates, 30% fat	2 weeks	54 prediabetic patients	NMR	Small LDL particle was significantly decreased in PD compared to the control diet (change: − 28.07 nM vs + 16.49 nM), whereas the LDL particle size did not significantly change between two groups.	Small dense LDL ↓ LDL particle size —
Chen et al. 2015 [90]	Almonds	85 g/day	6 weeks	45 patients with coronary artery disease	Olympus AU400 auomated analyzer	No significant effect was observed on small density LDL-C following consumption of almonds.	Small dense LDL —
Yücesan et al. 2010 [88]	Hazelnut	1 g/kg/day	4 weeks	21 healthy adults	ND	After 30 days, small LDL was significantly decreased (− 0.04 mmol/l) as compared with baseline.	Small dense LDL↓
Almario et al. 2001 [91]	HD, HD + W, LFD, LFD + W	48 g walnuts/8460 kJ energy intake	6 weeks	18 hyperhypidemic adults	NMR	All four diets did not influence in LDL particle size. However, walnut supplementation led to a significant reduction in distribution of cholesterol in the small LDL compared with HD (− 12.7%).	LDL particle size — distribution of cholesterol in the small LDL ↓
Lee et al. [92]	AAD, ALD, CHOC, CHOC+ALD	ADD; no treatment foods or ALD; 42.5 g/d of almonds or CHOC; 18 g/d of cocoa powder and 43 g/d of dark chocolate	22 weeks	48 obese or overweight adults	ND	Consumption of dark chocolate, cocoa, and almonds significantly reduced small LDL particles (− 6.7 mg/dl) compared with the AAD.	Small dense LDL ↓
Damasceno et al. 2013 [93]	MeDiet + EVOO, MeDiet + nuts, Control diet	(MeDiet + EVOO); 1 L/week extra-virgin olive oil, or (MeDiet + nuts); 30 g/day of mixed nuts (15 g walnuts, 7.5 g hazelnuts and 7.5 g almonds), or Control diet; advised on a low-fat diet	1 year	169 diabetics, hyperlipidemic or hypertensive	NMR spectroscopy	Medium-small LDL (10%), and very small LDL (11%) decreased significantly in (MeDiet + nuts) group compare with baseline. However, small dense LDL particles decreased significantly in MeDiet + nuts group compare with control group. LDL size increased significantly in MeDiet + nuts group (+ 0.2 nm) compared with baseline and the change was statistically significant compared to the other groups.	Small dense LDL↓ LDL particle size ↑
Holligan et al. 2014 [94]	1PD, 2PD, Control	1PD; one serving (32–63 g) of pistachios per day (10% energy from pistachios) (30% total fat and 8% saturated fatty acids), or 2PD; two servings (63–126 g) of pistachios per day (20% energy from pistachios) (34% total fat and 8% saturated fatty acids), or Control; lower-fat diet (25% total fat and 8% saturated fatty acids)	4 weeks	28 healthy adults	removed from the plasma by filtration after the formation of aggregates with a polyanion and divalent cation-based reagent, and sdLDL levels were then determined using a Cobas 6000 analyser, with reagents obtained	The 2PD treated group revealed significantly reductions in small dense LDL in compared with 1PD (− 0.14 mmol/l) and control group (− 0.21 mmol/l).	Small dense LDL ↓

sdLDL small dense Low-Density Lipoprotein, LDL-C Low-density lipoprotein cholesterol, PD Pistachio-supplemented diet, HD Habitual diet, HD + W habitual diet plus walnuts, LFD low-fat diet, LFD + W low-fat diet plus walnuts, AAD Average American diet, ALD Almond diet, CHOC chocolate diet, MeDiet + EVOO Mediterranean diets with extra-virgin olive oil supplementation, MeDiet + nuts Mediterranean diets with nuts supplementation, NMR Nuclear magnetic resonance, mg/dl milligrams per decilitre, nmol/l. nanomoles per litre, mmol/l millimoles per litre, nm nanometer, ND no data