Are Phytosterols Responsible for the Low-Density Lipoprotein–Lowering Effects of Tree Nuts?

Abstract

thrombolysis in a developing nation. We found that those patients who were randomized to receive RIC upon arrival at the hospital and before thrombolytic therapy experienced a significant reduction in enzymatic MI size compared with the control group. The size of this cardioprotective effect was comparable to that observed in STEMI patients treated by PPCI, for which studies have reported 25% to 30% reductions in MI size as measured by myocardial single-photon emission computed tomography and cardiac magnetic resonance imaging (3-5). The limitations of our study include the following: 1) although tissue plasminogen activator (t-PA) is the most commonly used thrombolytic agent in developed countries, streptokinase (which costs 10-fold less than t-PA) continues to be used in developing nations; and 2) conducting a randomized control trial in a developing nation with very limited resources was challenging and explains in part why we were only able to obtain data on enzymatic MI size.In conclusion, we have shown that RIC reduced MI size in STEMI patients treated with thrombolysis, making this noninvasive, easily applied, low-cost therapy an attractive option in developing nations where health care resources are limited and current therapy is not optimal.(A) Relation of total phytosterol intake (mg) from nuts and absolute mean difference in LDL. (B) Relation of phytosterol intake (standardized to 1 serving/day [28.4 g] of different nut types) and mean difference in LDL (standardized to 1 serving/day). Phytosterol-LDL associations were modeled using meta-regression. Total phytosterol intake was calculated by multiplying the daily nut intake dose for a given nut type from each trial by the phytosterol content of each nut type, given in Phillips et al. (4).Trials of mixed nuts were excluded. LDL ¼ low-density lipoprotein.Letters J A C C V O L . 6 5 , N O . 2 5 , 2 0 1 5 J U N E 3 0 , 2 0 1 5 : 2 7 6 4 -7 0

Polyphenol intake from a Mediterranean diet decreases inflammatory biomarkers related to atherosclerosis: a substudy of the PREDIMED trial

“…Thus, diets enriched with nuts improved the lipid profile , reduced endothelial dysfunction and ameliorated glycaemic control in diabetes . While cholesterol lowering by nut diets can be ascribed both to unsaturated fatty acids and phytosterols , the improvement in vascular reactivity is likely to be due to their richness in polyphenols, in addition to the fact that they contain L‐arginine, the precursor of the endogenous vasodilator nitric oxide . In addition, nuts ameliorate inflammatory status at the vascular level, reducing levels of ICAM‐1, VCAM‐1 and E‐selectin, which are released from the activated endothelium and circulating monocytes .…”

“…Several feeding trials have also analysed the mechanisms of the health effects of nuts. Thus, diets enriched with nuts improved the lipid profile [44,45], reduced endothelial dysfunction [46,47] and ameliorated glycaemic control in diabetes [48]. While cholesterol lowering by nut diets can be ascribed both to unsaturated fatty acids and phytosterols [45], the improvement in vascular reactivity is likely to be due to their richness in polyphenols, in addition to the fact that they contain L-arginine, the precursor of the endogenous vasodilator nitric oxide [46].…”

A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion

“…A systematic review and meta-analysis examined the relationship between nut consumption and blood lipid levels. A total of 61 trials (42 randomized, 18 non-randomized) totaling 2582 unique participants provided nuts to participants for durations ranging from 3 to 26 weeks [ 58 ]. Compared with controls, each daily serving of nuts lowered LDL-cholesterol (−4.8 mg/dL; 95% CI: -5.5, −4.2) [ 58 ].…”

“…A total of 61 trials (42 randomized, 18 non-randomized) totaling 2582 unique participants provided nuts to participants for durations ranging from 3 to 26 weeks [ 58 ]. Compared with controls, each daily serving of nuts lowered LDL-cholesterol (−4.8 mg/dL; 95% CI: -5.5, −4.2) [ 58 ]. These results complement previous findings from a pooled analysis of intervention trials examining the relationship between nut consumption and blood lipid levels [ 59 ].…”

Nuts and Cardiovascular Diseases: Focus on Brazil Nuts

“…Several studies have been conducted considering the beneficial association between nut consumption ( Table 1) and CVD risk factors (Table 2). 3,[7][8][9][10][11][12][13][14][15][16] Dose-response analysis of nut consumption and the risk of coronary artery disease (CAD) have been described, and a higher consumption of nuts was significantly associated with reduced risk of CAD when compared with a lower consumption. In fact, an increase in nut consumption by one serving per week significantly decreased the risk of CAD by 5%, and the protective effect was associated with a consumption of two servings/week.…”