STUDY: A dose-response relationship in which 7g of almonds lowered low-density (LDL) cholesterol levels by 1%.

JOURNAL: Circulation. 2002;106:000-000

AUTHORS: David J. A. Jenkins, MD

ABSTRACT: Although nuts have been touted to be beneficial for heart disease, some physicians have hesitated to recommend them due to their high fat content. In a calorie-controlled trial investigators demonstrated a dose-response relationship in which 7g of almonds lowered low-density (LDL) cholesterol levels by 1%.

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COMMENTARY: This study suggests that replacing carbohydrates with monounsaturated fat — within the context of a diet that is low in saturated, trans fat and cholesterol — favorably affects cholesterol levels and cardiovascular risk.

This three-phase, randomized, crossover design study enrolled 27 patients with high cholesterol, including 15 men and 12 postmenopausal women. Average age was 64 years, and average baseline total cholesterol level was 260 mg/dL. The three test diets, which each subject followed for one month, included an isoenergetic supplement (mean, 423 kcal/day) comprising 22.2% of caloric intake. The full-dose almond supplement consisted of about 74 g of almonds daily; the half-dose almond supplement included about 37 g or a "handful" of almonds; and the control supplement was a low-saturated fat, whole-wheat muffin.

Full-dose almonds produced the greatest reduction in blood lipid levels, and the control diet produced no significant reductions. Compared with baseline, both half- and full-dose almonds reduced LDL cholesterol (4.4% ±1.7%, P=.018, and 9.4% ±1.9%, P<.001, respectively) and ratio of LDL to high-density lipoprotein (HDL) cholesterol (7.8% ±2.2%, P=.001, and 12.0% ±2.1%, P<.001). Full-dose almonds reduced lipoprotein(a) by 7.8% ±3.5% (P=.034) and oxidized LDL concentrations by 14.0% ±3.8% (P<.001). There was no difference in pulmonary nitric oxide between treatments.

If you look at the ratio of LDL to HDL, the reduction was 7.8% for the half dose and 12% for the full dose by the fourth week. That ratio is very important in assessing cardiovascular risk.



It is recommended that physicians encourage patients to eat almonds as part of a healthy balanced diet, provided they are natural or "dry roasted" without added oils or salts.

The dose-response to almonds appears linear in the acceptable range of intake, with a 1% reduction in LDL cholesterol resulting from each 7g portion of almonds.

Eat a small handfull a day. Try to substitute these for an unhealthier snack that you would have eaten.