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Current Atherosclerosis Reports

, Volume 12, Issue 6, pp 397–406 | Cite as

Nuts and Berries for Heart Health

  • Emilio RosEmail author
  • Linda C. Tapsell
  • Joan Sabaté
Article

Abstract

Nuts are nutrient-dense foods with complex matrices rich in unsaturated fatty acids and other bioactive compounds, such as L-arginine, fiber, minerals, tocopherols, phytosterols, and polyphenols. By virtue of their unique composition, nuts are likely to beneficially impact heart health. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity, and glycemic control also appear to be positively influenced by frequent nut consumption without evidence of undue weight gain. Berries are another plant food rich in bioactive phytochemicals, particularly flavonoids, for which there is increasing evidence of benefits on cardiometabolic risk that are linked to their potent antioxidant power.

Keywords

Tree nuts Peanuts Berries Fatty acids Phytochemicals Antioxidants Flavonoids Healthy diets Epidemiologic studies Clinical trials Coronary heart disease Stroke Obesity Metabolic syndrome Visceral adiposity Type 2 diabetes Weight gain Hypertension Blood cholesterol Triglycerides Glycemic control Insulin Oxidation Inflammation Flow-mediated dilatation 

Notes

Acknowledgements

Work supported in part by grants from the Spanish Health Ministry (FIS Thematic Research Networks C03/01 and G03/140) and the California Walnut Commission, Sacramento, CA. CIBERobn is an initiative of ISCIII, Spain.

Disclosure

The authors have received research funding from the California Walnut Commission, Sacramento, CA and are non-paid members of its Scientific Advisory Committee.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Fraser GE, Sabaté J, Beeson WL, Strahan TM: A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med 1992, 152:1416–1424.CrossRefPubMedGoogle Scholar
  2. 2.
    Sabaté J, Fraser GE, Burke K, et al.: Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med 1993, 328:603–607.CrossRefPubMedGoogle Scholar
  3. 3.
    Sabaté J, Salas-Salvadó J, Ros E, eds: Nuts: nutrition and health outcomes. Br J Nutr 2006, 96(Suppl 2):S1–S102.Google Scholar
  4. 4.
    King JC, Rechkemmer G, Geiger CJ, eds: Second International Nuts and Health Symposium, 2007. J Nutr 2008, 138:1734S–1765S.Google Scholar
  5. 5.
    US Food and Drug Administration: Qualified Health Claims: Letter of Enforcement Discretion — Nuts and Coronary Heart Disease. Rockville, MD: US Food & Drug Administration; 2003:1–4.Google Scholar
  6. 6.
    Nash SD, Nash DT: Nuts as part of a healthy cardiovascular diet. Curr Atheroscler Rep 2008, 10:529–535.CrossRefPubMedGoogle Scholar
  7. 7.
    •• Basu A, Rhone M, Lyons TJ: Berries: emerging impact on cardiovascular health. Nutr Rev 2010, 68:168–177. This is a complete review of epidemiologic studies suggesting a cardiovascular benefit of berry consumption and of berry feeding trials showing improvement of intermediate biomarkers, with discussion of mechanisms.CrossRefPubMedGoogle Scholar
  8. 8.
    Määttä-Riihinen KR, Kamal-Eldin A, Mattila PH, et al.: Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem 2004, 52:4477–4486.CrossRefPubMedGoogle Scholar
  9. 9.
    Sabaté J, Wien M: Nuts, blood lipids and cardiovascular disease. Asia Pac J Clin Nutr 2010, 19:131–136.PubMedGoogle Scholar
  10. 10.
    Kelly JH, Sabaté J: Nuts and coronary heart disease: an epidemiological perspective. Br J Nutr 2006, 96:S61–S67.CrossRefPubMedGoogle Scholar
  11. 11.
    • Kris-Etherton PM, Hu FB, Ros E, Sabaté J: The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008, 138:1746S–1751S. This is an informative review on epidemiologic and clinical studies published up to 2007 relating nut consumption to heart health.PubMedGoogle Scholar
  12. 12.
    Jiang R, Manson JE, Stampfer MJ, et al.: Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 2002, 288:2554–2560.CrossRefPubMedGoogle Scholar
  13. 13.
    Kochar J, Gaziano JM, Djoussé L: Nut consumption and risk of type II diabetes in the Physicians’ Health Study. Eur J Clin Nutr 2010, 64:75–79.CrossRefPubMedGoogle Scholar
  14. 14.
    Li TY, Brennan AM, Wedick NM, et al.: Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr 2009, 139:1333–1338.CrossRefPubMedGoogle Scholar
  15. 15.
    Djoussé L, Gaziano JM, Kase CS, Kurth T: Nut consumption and risk of stroke in US male physicians. Clin Nutr 2010 Apr 8 PMID: 20381933.Google Scholar
  16. 16.
    Djoussé L, Rudich T, Gaziano JM: Nut consumption and risk of heart failure in the Physicians’ Health Study I. Am J Clin Nutr 2008, 88:930–933.PubMedGoogle Scholar
  17. 17.
    Djoussé L, Rudich T, Gaziano JM: Nut consumption and risk of hypertension in US male physicians. Clin Nutr 2009, 28:10–14.CrossRefPubMedGoogle Scholar
  18. 18.
    xMartínez-Lapiscina EH, Pimenta AM, Beunza JJ, et al.: Nut consumption and incidence of hypertension: The SUN prospective cohort. Nutr Metab Cardiovasc Dis 2010, 20:359–365.Google Scholar
  19. 19.
    Jiang R, Jacobs DR Jr, Mayer-Davis E, et al.: Nut and seed consumption and inflammatory markers in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2006, 163:222–231.CrossRefPubMedGoogle Scholar
  20. 20.
    Mantzoros CS, Williams CJ, Manson JA, et al.: Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women. Am J Clin Nutr 2006, 84:328–335.PubMedGoogle Scholar
  21. 21.
    Salas-Salvadó J, Garcia-Arellano A, Estruch R, et al., for the PREDIMED Investigators: Components of the Mediterranean-type food pattern and serum inflammatory markers among patients at high risk for cardiovascular disease. Eur J Clin Nutr 2008, 62:651–659.Google Scholar
  22. 22.
    •• Sabaté J, Oda K, Ros E: Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med 2010, 170:821–827. This pooled analysis of 583 patients from 25 clinical studies with different nuts confirms their cholesterol-lowering effect and has sufficient statistical power to detect interesting interactions by type of background diet, baseline lipid levels, and BMI.CrossRefPubMedGoogle Scholar
  23. 23.
    Lefevre M, Champagne CM, Tulley RT, et al.: Individual variability in cardiovascular disease risk factor responses to low-fat and low-saturated-fat diets in men: body mass index, adiposity, and insulin resistance predict changes in LDL cholesterol. Am J Clin Nutr 2005, 82:957–963.PubMedGoogle Scholar
  24. 24.
    Knopp RH, Retzlaff B, Fish B, et al.: Effects of insulin resistance and obesity on lipoproteins and sensitivity to egg feeding. Arterioscler Thromb Vasc Biol 2003, 23:1437–1443.CrossRefPubMedGoogle Scholar
  25. 25.
    Hannah JS, Jablonshki KA, Howard BV: The relationship between weight and response to cholesterol lowering diets in women. Int J Obes Relat Metab Disord 1997, 21:445–450.CrossRefPubMedGoogle Scholar
  26. 26.
    Simonen P, Gylling H, Howard AN, Miettinen TA: Introducing a new component of the metabolic syndrome: low cholesterol absorption. Am J Clin Nutr 2000, 72:82–88.PubMedGoogle Scholar
  27. 27.
    Segura R, Javierre C, Lizarraga MA, Ros E: Other relevant components of nuts: phytosterols, folate and minerals. Br J Nutr 2006, 96(Suppl 2):S36–44. [Erratum in Br J Nutr 2008, 99:447–448]CrossRefPubMedGoogle Scholar
  28. 28.
    Escurriol V, Cofán M, Serra M, et al.: Serum sterol responses to increasing plant sterol intake from natural foods in the Mediterranean diet. Eur J Nutr 2009, 48:373–382.CrossRefPubMedGoogle Scholar
  29. 29.
    Mukuddem-Petersen J, Stonehouse W, Jerling JC, et al.: Effects of a high walnut and high cashew nut diet on selected markers of the metabolic syndrome: a controlled feeding trial. Br J Nutr 2007, 97:1144–1153.Google Scholar
  30. 30.
    Casas-Agustench P, López-Uriarte P, Bulló M, et al.: Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis 2009 Dec 21 PMID: 20031380.Google Scholar
  31. 31.
    •• Banel DK, Hu FB: Effects of walnut consumption on blood lipids and other cardiovascular risk factors: a meta-analysis and systematic review. Am J Clin Nutr 2009, 90:56–63. This is a meta-analysis of 13 walnut feeding trials showing a consistent cholesterol-lowering effect of walnut-enriched diets.CrossRefPubMedGoogle Scholar
  32. 32.
    Rajaram S, Haddad EH, Mejía A, Sabaté J: Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. Am J Clin Nutr 2009, 89:1657S–1663S.CrossRefPubMedGoogle Scholar
  33. 33.
    Ma Y, Njike VY, Millet J, et al.: Effects of walnut consumption on endothelial function in type 2 diabetic subjects: a randomized controlled crossover trial. Diabetes Care 2010, 33:227–232.CrossRefPubMedGoogle Scholar
  34. 34.
    Torabian S, Haddad E, Cordero-MacIntyre Z, et al.: Long-term walnut supplementation without dietary advice induces favorable serum lipid changes in free-living individuals. Eur J Clin Nutr 2010, 64:274–279.CrossRefPubMedGoogle Scholar
  35. 35.
    Tapsell LC, Batterham MJ, Teuss G, et al.: Long-term effects of increased dietary polyunsaturated fat from walnuts on metabolic parameters in type II diabetes. Eur J Clin Nutr 2009; 63:1008–1015.CrossRefPubMedGoogle Scholar
  36. 36.
    Estruch R, Martínez-González MA, Corella D, et al., on behalf of the PREDIMED Study Investigators: Effects of a Mediterranean-style diet on cardiovascular risk factors. A randomized trial. Ann Intern Med 2006, 145:1–11.Google Scholar
  37. 37.
    • Barceló F, Perona JS, Prades J, et al.: Mediterranean-style diet effect on the structural properties of the erythrocyte cell membrane of hypertensive patients: the Prevención con Dieta Mediterránea Study. Hypertension 2009, 54:1143–1150. This report describes changes in membrane lipid composition that could justify a blood pressure–lowering effect of nut and olive oil consumption.CrossRefPubMedGoogle Scholar
  38. 38.
    •• Ros E: Nuts and novel biomarkers of cardiovascular disease. Am J Clin Nutr 2009, 89(Suppl):1649S–1656S. This is a comprehensive review of the potential of nuts to improve cardiovascular risk beyond the lipid profile, with a thorough discussion of mechanisms.CrossRefPubMedGoogle Scholar
  39. 39.
    •• López-Uriarte P, Bulló M, Casas-Agustench P, et al.: Nuts and oxidation: a systematic review. Nutr Rev 2009, 67:497–508. This is a complete evaluation of studies relating nut consumption to oxidative and inflammatory processes.CrossRefPubMedGoogle Scholar
  40. 40.
    Blomhoff R, Carlsen MH, Frost Andersen L, Jacobs DR Jr: Health benefits of nuts: potential role of antioxidants. Br J Nutr 2006, 96(Suppl 2):S52–S60.CrossRefPubMedGoogle Scholar
  41. 41.
    • Fitó M, Guxens M, Corella D, et al., on behalf of the PREDIMED Study Investigators: Effect of a traditional Mediterranean diet on lipoprotein oxidation. A randomized, controlled trial. Arch Intern Med 2007, 167:1195–1203. This study showed that Mediterranean diets enriched with nuts or virgin olive oil reduced circulating levels of oxidized LDL compared with a control diet.Google Scholar
  42. 42.
    • Mena MP, Sacanella E, Vázquez-Agell M, et al.: Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the Mediterranean diet. Am J Clin Nutr 2009, 89:248–256. Mediterranean diets enriched with nuts or virgin olive oil reduce circulating inflammatory markers and inhibit expression of their ligands in blood mononuclear cells.CrossRefPubMedGoogle Scholar
  43. 43.
    Bes-Rastrollo M, Sabaté J, Gómez-Gracia E, et al.: Nut consumption and weight gain in a Mediterranean cohort: the SUN Study. Obesity (Silver Spring) 2007, 15:107–116.CrossRefGoogle Scholar
  44. 44.
    • Bes-Rastrollo M, Wedick NM, Martínez-González MA, et al.: Prospective study of nut consumption, long-term weight change, and obesity risk in women. Am J Clin Nutr 2009, 89:1913–1919. These two reports from large prospective cohorts show inverse associations between the frequency of nut consumption and weight gain, thus allaying the fear of undue weight gain when eating these high-fat foods.CrossRefPubMedGoogle Scholar
  45. 45.
    Casas-Agustench P, Bulló M, Ros E, et al.: Cross-sectional association of nut intake with adiposity in a Mediterranean population. Nutr Metab Cardiovasc Dis 2010 Mar 8 PMID: 20219336.Google Scholar
  46. 46.
    • Salas-Salvadó J, Fernández-Ballart J, Ros E, et al.: Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med 2008, 168:2449–2458. The 1-year results of this ongoing large primary prevention trial show that the Mediterranean diet with nuts is associated with a reduction of metabolic syndrome.CrossRefPubMedGoogle Scholar
  47. 47.
    Mattes RD, Dreher ML: Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr 2010, 19:137–141.PubMedGoogle Scholar
  48. 48.
    Storlien LH, Baur LA, Kriketos AD, et al.: Dietary fats and insulin action. Diabetologia 1996, 39:621–631.CrossRefPubMedGoogle Scholar
  49. 49.
    Jenkins DJ, Kendall CW, Marchie A, et al.: Effect of almonds on insulin resistance in non-diabetic hyperlipidemic subjects: a randomized controlled crossover trial. Metabolism 2008, 57:882–887.CrossRefPubMedGoogle Scholar
  50. 50.
    •• Risérus U, Willett WC, Hu FB: Dietary fats and prevention of type 2 diabetes. Progr Lipid Res 2009, 48:44–51. This is an excellent review of epidemiologic and clinical studies that examined dietary fatty acids in relation to risk of diabetes or changes in intermediate markers, with discussion of mechanisms.CrossRefGoogle Scholar
  51. 51.
    Josse AR, Kendall CW, Augustin LS, et al.: Almonds and post prandial glycemia—a dose-response study. Metabolism 2007, 56:400–404.CrossRefPubMedGoogle Scholar
  52. 52.
    Jenkins DJ, Kendall CW, Josse AR, et al.: Almonds decease postprandial glycemia, insulinemia and oxidative damage in healthy individuals. J Nutr 2006, 136:2987–2992.PubMedGoogle Scholar
  53. 53.
    Ruel G, Pomerleau S, Couture P, et al.: Low-calorie cranberry juice supplementation reduces plasma oxidized LDL and cell adhesion molecule concentrations in men. Br J Nutr 2008, 99:352–359.CrossRefPubMedGoogle Scholar
  54. 54.
    Duthie SJ, Jenkinson AM, Crozier A, et al.: The effects of cranberry juice consumption on oxidative status and biomarkers relating to heart disease and cáncer in healthy human volunteers. Eur J Clin Nutr 2006, 45:113–122.CrossRefGoogle Scholar
  55. 55.
    Erlund I, Koli R, Alfthan G, et al.: Favorable effects of berry consumption on platelet function, blood pressure and HDL cholesterol Am J Clin Nutr 2008, 87:323–331.PubMedGoogle Scholar
  56. 56.
    Lehtonen HM, Suomela JP, Tahvonen R, et al.: Berry meals and risk factors associated with metabolic syndrome. Eur J Clin Nutr 2010, 64:614–621.CrossRefPubMedGoogle Scholar
  57. 57.
    Törrönen R, Sarkkinen E, Tapola N, et al.: Berries modify the postprandial plasma glucose response to sucrose in healthy subjects. Br J Nutr 2010, 103:1094–1097.PubMedGoogle Scholar
  58. 58.
    Seeram NP: Recent trends and advances in berry health benefits research. J Agric Food Chem 2010, 58:3869–3870.CrossRefPubMedGoogle Scholar
  59. 59.
    • Burns Kraft TF, Dey M, Roger RB, et al.: Phytochemical composition and metabolic performance enhancing activity of dietary berries traditionally used by Native North Americans. J Agric Food Chem 2008, 56:654–660. This study is a good example of the potent bioactivity from minor compounds present in plant foods, in this case wild berries from North America.CrossRefPubMedGoogle Scholar
  60. 60.
    US Department of Agriculture: Nutrient data base. Available at http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl. Accessed April 26, 2010.

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Lipid Clinic, Endocrinology and Nutrition ServiceInstitut d’Investigacions Biomèdiques August Pi i Sunyer, Hospital ClínicBarcelonaSpain
  2. 2.Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn)Instituto de Salud Carlos III (ISCIII)Spain
  3. 3.Illawarra Health and Medical Research Institute and Smart Foods CentreUniversity of WollongongWollongongAustralia
  4. 4.Department of Nutrition, School of Public HealthLoma Linda UniversityLoma LindaUSA

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