Nut consumption for the primary prevention of cardiovascular disease

Abstract

Currently there is a lack of evidence for the effects of nut consumption on CVD clinical events in primary prevention and very limited evidence for the effects on CVD risk factors. No conclusions can be drawn and further high quality longer term and adequately powered trials are needed to answer the review question.

The effects of almond consumption on fasting blood lipid levels: a systematic review and meta-analysis of randomised controlled trials

“…In a meta-analysis and dose–response of sixty-one controlled intervention trials, which ranged in duration from 3 to 26 weeks, the consumption of nuts was associated with significant reductions in TC, LDL-C, apoB and TAG, with greater effects observed with a nut intake of 60 g/d and in individuals with T2DM ( 29 ) . In contrast, in a Cochrane review, Martin et al ( 30 ) reported that the intake of nuts had no effects on LDL-C or HDL-C (for TC and TAG, substantial heterogeneity precluded the pooling of results). The Cochrane assessment was based only on three publications (and four strata): Tey et al ( 31 ) (who provided 42 g of hazelnuts to generally healthy male and female adults for 12 weeks); Abazfarad et al ( 9 ) (who provided 50 g of almonds to overweight and obese premenopausal women for 3 months); and Tey et al ( 32 ) (who provided 30 or 60 g of hazelnuts to overweight and obese male and female adults for 12 weeks).…”

Primary prevention of cardiovascular disease: an umbrella review

“…-supplements: vitamin C 12 , antioxidant 13 , vitamin D 14 , selenium 15 , vitamin Co-enzyme Q10 16 , vitamin K 17 , and vitamin, mineral and multivitamin supplements 18 . Fortmann's review 22 included different interventions based on single and paired combination of supplementation with vitamins and minerals supplementation, including vitamin C and selenium. The two reviews on vitamin C 12,18 shared elements such as type of population included and intervention, but they differed in both the outcome measures included and some inclusion criteria (minimum follow-up time for required randomized controlled trials (RCT) (three months) 12 , trials with good or fair quality, studies carried out in countries whose Human Development Index was considered very high 18 )…”

“…The overall number of participants included in these systematic reviews ranged between 60 participants 20 and 215,900 participants for antioxidant supplementation 13 . Only four reviews included less than 500 participants 16,17,22,32 . The number of trials per review ranged between one 17 and 55 19 .…”

“…Low risk of bias for nine of the eleven items included in the AMSTAR checklist (Appendix 1) was showed by all studies, exception made by five studies whose authors did not evaluate the risk of publication bias and/or report the results [18][19][20]22,28,34 (item 10). Eleven studies did not report outcomes of interest, preventing to combine results and, thus, scoring was not applicable.…”

“…Eight of the 24 included reviews reported adverse events related with the interventions: vitamin C 12 , selenium 15 and mineral and multivitamin 18 supplements, increased consumption of fruits and vegetables 20 , and also in nut 22 , green and black tea 23 and dietary fibre 24 consumption (Table 1). Al-Khudairy et al 12 reported one RCT describing death, serious adverse events and adverse event without any further detail.…”