Effects of different forms of hazelnuts on blood lipids and α-tocopherol concentrations in mildly hypercholesterolemic individuals A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. Serum lipid effects of a high-monounsaturated fat diet based on macadamia nuts. Effect of a diet high in vegetables, fruit, and nuts on serum lipids. A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. Pistachio Nut Consumption and Serum Lipid Levels The effect of almonds on anthropometric measurements and lipid profile in overweight and obese females in a weight reduction program: A randomized controlled clinical trial Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: a prospective study. Dose Response of Almonds on Coronary Heart Disease Risk Factors: Blood Lipids, Oxidized Low-Density Lipoproteins, Lipoprotein(a), Homocysteine, and Pulmonary Nitric Oxide: A Randomized, Controlled, Crossover Trial Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Substituting Walnuts for Monounsaturated Fat Improves the Serum Lipid Profile of Hypercholesterolemic Men and Women Walnut Consumption in Hyperlipidemic Patients Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feeding trial. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes Pistachio intake increases high density lipoprotein levels and inhibits low-density lipoprotein oxidation in rats. Pecans lower low-density lipoprotein cholesterol in people with normal lipid levels. Cholesterol lowering effects of nuts compared with a Canola oil enriched cereal of similar fat composition. Effect of pistachio consumption on plasma lipoprotein subclasses in pre-diabetic subjects. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. Measured energy value of pistachios in the human diet. Effects of walnuts on serum lipid levels and blood pressure in normal men. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia.
Background / Objectives : Diets high in nuts reduce cholesterol , probably due to their favorable lipid profile and other bioactive substances . However , the physical form of the nut may be important as the cell wall of intact nuts may limit the hypocholesterolemic effect of nuts by reducing lipid bioavailability . Therefore , we investigated the effects on blood lipids of incorporating three different forms of hazelnuts ( ground , sliced and whole ) into the usual diet . Subjects/ Methods : In a r and omized crossover study with three phases , 48 mildly hypercholesterolemic participants were asked to consume 30 g of ground , sliced or whole hazelnuts for 4 weeks . Body weight , plasma total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triacylglycerol ( TAG ) , apolipoprotein ( apo ) A1 , apo B100 and α-tocopherol were measured at baseline and at the end of each dietary phase . Results : There were no significant differences in any outcome variable between the different forms of nuts ( all P⩾0.159 ) . However , compared with baseline , mean values at the end of each hazelnut intervention were significantly higher for HDL-C ( P=0.023 ) and α-tocopherol ( P=0.005 ) , and significantly lower for TC ( P<0.001 ) , LDL-C ( P<0.001 ) , TC : HDL-C ratio ( P<0.001 ) , apo B100 ( P=0.002 ) and apo B100:apo A1 ratio ( P<0.001 ) , with no significant difference in body weight ( P=0.813 ) . Conclusions : The ingestion of three different forms of hazelnuts equally improved the lipoprotein profile and α-tocopherol concentrations in mildly hypercholesterolemic individuals . Hazelnuts can therefore be incorporated into the usual diet as a means of reducing cardiovascular disease risk Epidemiologic studies and clinical trials have demonstrated that the unique fatty acid profile of nuts beneficially affects serum lipids/lipoproteins , reducing cardiovascular disease ( CVD ) risk .  Nuts are low in SFA and high in PUFA and monounsaturated fatty acids ( MUFA ) . Macadamia nuts are a rich source of MUFA . A r and omized , crossover , controlled feeding study ( 5-wk diet periods ) compared a Macadamia nut-rich diet [ 42.5 g ( 1.5 ounces)/8.79 MJ ( 2100 kcal ) ] [ MAC ; 33 % total fat ( 7 % SFA , 18 % MUFA , 5 % PUFA ) ] vs. an average American diet [ AAD ; 33 % total fat ( 13 % SFA , 11 % MUFA , 5 % PUFA ) ] on the lipid/lipoprotein profile of mildly hypercholesterolemic ( n = 25 ; 15 female , 10 male ) subjects .  Serum concentrations of total cholesterol ( TC ) and LDL cholesterol ( LDL-C ) following the MAC ( 4.94 + /- 0.17 mmol/L , 3.14 + /- 0.14 mmol/L ) were lower than the AAD ( 5.45 + /- 0.17 mmol/L , 3.44 + /- 0.14 mmol/L ; P < 0.05 ) . The serum non-HDL cholesterol ( HDL-C ) concentration and the ratios of TC : HDL-C and LDL-C : HDL-C were reduced following consumption of the MAC diet ( 3.83 + /- 0.17 , 4.60 + /- 0.24 , and 2.91 + /- 0.17 , respectively ) compared with the AAD ( 4.26 + /- 0.17 , 4.89 + /- 0.24 , and 3.09 + /- 0.18 , respectively ; P < 0.05 ) . There was no change in serum triglyceride concentration . Thus , macadamia nuts can be included in a heart-healthy dietary pattern that reduces lipid/lipoprotein CVD risk factors . Nuts as an isocaloric substitute for high SFA foods increase the proportion of unsaturated fatty acids and decrease SFA , thereby lowering CVD risk BACKGROUND  Nut consumption lowers cardiovascular disease ( CVD ) risk . Studies are lacking about the effects of pistachios , a nutrient-dense nut , on CVD risk factors , dose-response relations , and lipid-lowering mechanisms . OBJECTIVE We evaluated the effects of 2 doses of pistachios , added to a lower-fat diet , on lipids and lipoproteins , apolipoprotein (apo)-defined lipoprotein subclasses , and plasma fatty acids . To investigate the mechanisms of action , we measured cholesteryl ester transfer protein and indexes of plasma stearoyl-CoA desaturase activity ( SCD ) . DESIGN In a r and omized crossover controlled-feeding study , 28 individuals with LDL cholesterol > or = 2.86 mmol/L consumed 3 isoenergetic diets for 4 wk each . Baseline measures were assessed after 2 wk of a typical Western diet . The experimental diets included a lower-fat control diet with no pistachios [ 25 % total fat ; 8 % saturated fatty acids ( SFAs ) , 9 % monounsaturated fatty acids ( MUFAs ) , and 5 % polyunsaturated fatty acids ( PUFAs ) ] , 1 serving/d of a pistachio diet ( 1 PD ; 10 % of energy from pistachios ; 30 % total fat ; 8 % SFAs , 12 % MUFAs , and 6 % PUFAs ) , and 2 servings/d of a pistachio diet ( 2 PD ; 20 % of energy from pistachios ; 34 % total fat ; 8 % SFAs , 15 % MUFAs , and 8 % PUFAs ) . RESULTS The 2 PD decreased ( P < 0.05 compared with the control diet ) total cholesterol ( -8 % ) , LDL cholesterol ( -11.6 % ) , non-HDL cholesterol ( -11 % ) , apo B ( -4 % ) , apo B/apo A-I ( -4 % ) , and plasma SCD activity ( -1 % ) . The 1 PD and 2 PD , respectively , elicited a dose-dependent lowering ( P < 0.05 ) of total cholesterol/HDL cholesterol ( -1 % and -8 % ) , LDL cholesterol/HDL cholesterol ( -3 % and -11 % ) , and non-HDL cholesterol/HDL cholesterol ( -2 % and -10 % ) . CONCLUSIONS Inclusion of pistachios in a healthy diet beneficially affects CVD risk factors in a dose-dependent manner , which may reflect effects on SCD BACKGROUND Recent studies have identified potential beneficial effects of eating nuts , most of which have substantial amounts of monounsaturated fats . Macadamia nuts are 75 % fat by weight , 80 % of which is monounsaturated . OBJECTIVE To examine variations in serum lipid levels in response to a high-monounsaturated fat diet based on macadamia nuts . METHODS A r and omized crossover trial of three 30-day diets was conducted in 30 volunteers aged 18 to 53 years from a free-living population . Each was fed a " typical American " diet high in saturated fat ( 37 % energy from fat ) ; an American Heart Association Step 1 diet ( 30 % energy from fat ) ; and a macadamia nut-based monounsaturated fat diet ( 37 % energy from fat ) in r and om order . Serum total cholesterol , high-density lipoprotein cholesterol , and triglyceride levels were measured . RESULTS Mean total cholesterol level after the typical American diet was 5.20 mmol/L ( 201 mg/dL ) . After the Step 1 diet and the macadamia nut diet , total cholesterol level was 4.99 mmol/L ( 193 mg/dL ) and 4.95 mmol/L ( 191 mg/dL ) , respectively . Low-density lipoprotein cholesterol level was 3.37 mmol/L ( 130 mg/dL ) ( typical diet ) , 3.21 mmol/L ( 124 mg/dL ) ( Step 1 diet ) , and 3.22 mmol/L ( 125 mg/dL ) ( macadamia nut diet ) . High-density lipoprotein cholesterol level was 1.43 mmol/L ( 55 mg/dL ) ( typical ) , 1.34 mmol/L ( 52 mg/dL ) ( Step 1 ) , and 1.37 mmol/L ( 53 mg/dL ) ( macadamia nut ) . Lipid values after the Step 1 and macadamia nut diets were significantly different from those after the typical diet ( P<.05 ) . CONCLUSIONS The macadamia nut-based diet high in monounsaturated fat and the moderately low-fat diet both had potentially beneficial effects on cholesterol and low-density lipoprotein cholesterol levels when compared with a typical American diet We assessed the effect of a diet high in leafy and green vegetables , fruit , and nuts on serum lipid risk factors for cardiovascular disease . Ten healthy volunteers ( seven men and three women aged 33 + /- 4 years [ mean + /- SEM ] ; body mass index , 23 + /- 1 kg/m2 ) consumed their habitual diet ( control diet , 29 % + /- 2 % fat calories ) and a diet consisting largely of leafy and other low-calorie vegetables , fruit , and nuts ( vegetable diet , 25 % + /- 3 % fat calories ) for two 2-week periods in a r and omized crossover design . After 2 weeks on the vegetable diet , lipid risk factors for cardiovascular disease were significantly reduced by comparison with the control diet ( low-density lipoprotein [ LDL ] cholesterol , 33 % + /- 4 % , P < .001 ; ratio of total to high-density lipoprotein [ HDL ] cholesterol , 21 % + /- 4 % , P < .001 ; apolipoprotein [ apo ] B : A-I , 23 % + /- 2 % , P < .001 ; and lipoprotein ( a ) [ Lp(a ) ] , 24 % + /- 9 % , P = .031 ) . The reduction in apo B was related to increased intakes of soluble fiber ( r = .84 , P = .003 ) and vegetable protein ( r = -.65 , P = .041 ) . On the vegetable compared with the control diet , the reduction in total serum cholesterol was 34 % to 49 % greater than would be predicted by differences in dietary fat and cholesterol . A diet consisting largely of low-calorie vegetables and fruit and nuts markedly reduced lipid risk factors for cardiovascular disease . Several aspects of such diets , which may have been consumed early in human evolution , have implication s for cardiovascular disease prevention Frequent consumption of nuts is associated with decreased risk of cardiovascular disease . We investigated the effect of pecans rich in monounsaturated fat as an alternative to the Step 1 diet in modifying serum lipids and lipoproteins in men and women with normal to moderately high serum cholesterol . In a single-blind , r and omized , controlled , crossover feeding study , we assigned 23 subjects ( mean age : 38 y ; 9 women , 14 men ) to follow two diets , each for 4 wk : a Step I diet and a pecan-enriched diet ( accomplished by proportionately reducing all food items in a Step I diet by one fifth for a 20 % isoenergetic replacement with pecans ) . The percentage of energy from fat in the two diets was 28.3 and 39.6 % , respectively . Both diets improved the lipid profile ; however , the pecan-enriched diet decreased both serum total and LDL cholesterol by 0.32 mmol/L ( 6.7 and 10.4 % , respectively ) and triglyceride by 0.14 mmol/L ( 11.1 % ) beyond the Step I diet , while increasing HDL cholesterol by 0.06 mmol/L ( 2.5 mg/dL ) . Serum apolipoprotein B and lipoprotein(a ) decreased by 11.6 and 11.1 % , respectively , and apolipoprotein A1 increased by 2.2 % when subjects consumed the pecan compared with the Step I diet . These differences were all significant ( P < 0.05 ) . A 20 % isoenergetic replacement of a Step I diet with pecans favorably altered the serum lipid profile beyond the Step I diet , without increasing body weight .  Nuts such as pecans that are rich in monounsaturated fat may therefore be recommended as part of prescribed cholesterol-lowering diet of patients or habitual diet of healthy individuals Objective : Clinical and epidemiological studies have reported the beneficial effects of tree nuts and peanuts on serum lipid levels . We studied the effects of consuming 15 % of the daily caloric intake in the form of pistachio nuts on the lipid profiles of free-living human subjects with primary , moderate hypercholesterolemia ( serum cholesterol greater than 210 mg/dL ) . Methods : Design : R and omized crossover trial . Setting : Outpatient dietary counseling and blood analysis . Subjects : 15 subjects with moderate hypercholesterolemia . Intervention : Fours weeks of dietary modification with 15 % caloric intake from pistachio nuts . Measures of Outcome : Endpoints were serum lipid levels of total cholesterol , HDL-C , LDL-C , VLDL-C , triglycerides and apolipoproteins A-1 and B-100 . BMI , blood pressure , and nutrient intake ( total energy , fat , protein , and fiber ) were also measured at baseline , during , and after dietary intervention . Results : No statistically significant differences were observed for total energy or percent of energy from protein , carbohydrate or fat . On the pistachio nut diet , a statistically significant decrease was seen for percent energy from saturated fat ( mean difference , −2.7 % ; 95 % CI , −5.4 % to −0.08 % ; p = 0.04 ) . On the pistachio nut diet , statistically significant increases were seen for percent energy from polyunsaturated fat ( mean difference , 6.5 % ; 95 % CI , 4.2 % to 8.9 % ; p<.0001 ) and fiber intake ( mean difference , 15 g ; 95 % CI , 8.4 g to 22 g ; p = 0.0003 ) . On the pistachio diet , statistically significant reductions were seen in TC/HDL-C ( mean difference , −0.38 ; 95 % CI , −0.57 to −0.19 ; p = 0.001 ) , LDL-C/HDL-C ( mean difference , −0.40 ; 95 % CI , −0.66 to −0.15 ; p = 0.004 ) , B-100/A-1 ( mean difference , −0.11 ; 95 % CI , −0.19 to −0.03 ; p = 0.009 ) and a statistically significant increase was seen in HDL-C ( mean difference , 2.3 ; 95 % CI , 0.48 to 4.0 ; p = 0.02 ) . No statistically significant differences were seen for total cholesterol , triglycerides , LDL-C , VLDL-C , apolipoprotein A-1 or apolipoprotein B-100 . No changes were observed in BMI or blood pressure . Conclusion : A diet consisting of 15 % of calories as pistachio nuts ( about 2–3 ounces per day ) over a four week period can favorably improve some lipid profiles in subjects with moderate hypercholesterolemia and may reduce risk of coronary disease Background : Due to the wholesome benefits of nuts increased consumption of them has been recommended . However , because of nut 's high energy density , the role of them in the treatment of overweight and obesity is vague . This current clinical trial study aims to investigate the effects of a balanced hypocaloric almond-enriched diet ( AED ) ( almond group ) in comparison to a balanced hypocaloric nut-free diet ( NFD ) ( nut-free group ) on body weight and cardiovascular disease risk factors in women with body mass index ( BMI ) > 25 for 3-month . Material s and Methods : A total of 108 overweight and obese women were assigned in our 3-month r and omized controlled trial . The subjects were r and omly divided into two groups regarding a balanced hypocaloric diet with or without almond . The planned reduced calorie diets for both groups were identical except for the almond group who consumed 50 g of almonds daily . Anthropometric and laboratory measurements of the participants who completed the study were made prior to and at the end of the study . Results : A total of 100 subjects completed the study .  Weight , BMI , waist circumference , waist to hip circumference ratio , total cholesterol , and triglyceride , total : High density lipoprotein-cholesterol ( HDL-C ) , fasting blood sugar and diastolic blood pressure decreased significantly in the almond group compared to the nut-free group ( P > 0.001 ) . Greater reduction in low density lipoprotein-cholesterol ( P > 0.002 ) and systolic blood pressure ( P > 0.001 ) and greater increase in HDL-C ( P = 0.001 ) were found in the nut-free group . Conclusion : The balanced hypocaloric AED in comparison to the balanced hypocaloric NFD led to a greater weight-loss and overall better improvements in studied cardiovascular disease risk factors OBJECTIVE Recent studies have suggested that nuts have favorable effects beyond lipid lowering . We aim ed to investigate effect of the Antep pistachio ( Pistacia vera L. ) on blood glucose , lipid parameters , endothelial function , inflammation , and oxidation in healthy young men living in a controlled environment . METHODS A Mediterranean diet was administered to normolipidemic 32 healthy young men ( mean age 22 y , range 21 - 24 ) for 4 wk . After 4 wk , participants continued to receive the Mediterranean diet but pistachio was added for 4 wk by replacing the monounsaturated fat content constituting approximately 20 % of daily caloric intake . Fasting blood sample s and brachial endothelial function measurements were performed at baseline and after each diet . RESULTS Compared with the Mediterranean diet , the pistachio diet decreased glucose ( P<0.001 , -8.8+/-8.5 % ) , low-density lipoprotein ( P<0.001 , -23.2+/-11.9 % ) , total cholesterol ( P<0.001 , -21.2+/-9.9 % ) , and triacylglycerol ( P=0.008 , -13.8+/-33.8 % ) significantly and high-density lipoprotein ( P=0.069 , -3.1+/-11.7 % ) non-significantly . Total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios decreased significantly ( P<0.001 for both ) . The pistachio diet significantly improved endothelium-dependent vasodilation ( P=0.002 , 30 % relative increase ) , decreased serum interleukin-6 , total oxidant status , lipid hydroperoxide , and malondialdehyde and increased superoxide dismutase ( P<0.001 for all ) , whereas there was no significant change in C-reactive protein and tumor necrosis factor-alpha levels . CONCLUSION In this trial , we demonstrated that a pistachio diet improved blood glucose level , endothelial function , and some indices of inflammation and oxidative status in healthy young men . These findings are in accordance with the idea that nuts , in particular pistachio nuts , have favorable effects beyond lipid lowering that deserve to be evaluated with prospect i ve follow-up studies Background —Although recent studies have indicated that nut consumption may improve levels of blood lipids , nuts are not generally recommended as snacks for hyperlipidemic subjects because of their high fat content . Furthermore , the effective dose is still unknown . Methods and Results —The dose-response effects of whole almonds , taken as snacks , were compared with low-saturated fat ( < 5 % energy ) whole-wheat muffins ( control ) in the therapeutic diets of hyperlipidemic subjects . In a r and omized crossover study , 27 hyperlipidemic men and women consumed 3  isoenergetic ( mean 423 kcal/d ) supplements each for 1 month . Supplements provided 22.2 % of energy and consisted of full-dose almonds ( 73±3 g/d ) , half-dose almonds plus half-dose muffins , and full-dose muffins  . Fasting blood , expired air , blood pressure , and body weight measurements were obtained at weeks 0 , 2 , and 4 . Mean body weights differed < 300 g between treatments . The full-dose almonds produced the greatest reduction in levels of blood lipids . Significant reductions from baseline were seen on both half- and full-dose almonds for LDL cholesterol ( 4.4±1.7 % , P = 0.018 , and 9.4±1.9 % , P < 0.001 , respectively ) and LDL : HDL cholesterol ( 7.8±2.2 % , P = 0.001 , and 12.0±2.1 % , P < 0.001 , respectively ) and on full-dose almonds alone for lipoprotein(a ) ( 7.8±3.5 % , P = 0.034 ) and oxidized LDL concentrations ( 14.0±3.8 % , P < 0.001 ) , with no significant reductions on the control diet . No difference was seen in pulmonary nitric oxide between treatments . Conclusions —Almonds used as snacks in the diets of hyperlipidemic subjects significantly reduce coronary heart disease risk factors , probably in part because of the nonfat ( protein and fiber ) and monounsaturated fatty acid components of the nut BACKGROUND AND AIM Effects of pistachio nuts consumption on plasma lipid profile and oxidative status were investigated in healthy volunteers with normal lipid levels . METHODS AND RESULTS The study was conducted in 24 healthy men and 20 healthy women . All subjects consumed their regular diets during a 1-week period . After this period , half of the subjects ( 12 men and 10 women , mean age 32.8 + /- 6.7 years ) were r and omized to a regular diet group and the other half ( 12 men and 10 women , mean age 33.4 + /- 7.2 years ) were r and omized to a pistachio group which involved substituting pistachio nuts for 20 % of their daily caloric intake for 3 weeks . Plasma total cholesterol , low-density lipoprotein ( LDL ) , high-density lipoprotein ( HDL ) , triglyceride , malondialdehyde ( MDA ) and antioxidant potential ( AOP ) were measured before and after the dietary modification from all the subjects . After 3 weeks , with the pistachio diet , the mean plasma total cholesterol , MDA levels and , total cholesterol/HDL and LDL/HDL ratios were found to be significantly decreased ( P < 0.05 , P < 0.05 , P < 0.001 and P < 0.01 , respectively ) ; on the contrary , HDL and AOP levels , and AOP/MDA ratios were significantly increased ( P < 0.001 , P < 0.05 and P < 0.01 , respectively ) . Triglyceride and LDL levels also decreased but this was not statistically significant ( P > 0.05 ) . CONCLUSION These results indicated that consumption of pistachio nuts decreased oxidative stress , and improved total cholesterol and HDL levels in healthy volunteers Lifestyle modification is the cornerstone of population -based strategies for prevention of coronary heart disease and is the first line of therapy in patients with hypercholesterolemia . Diets low in saturated fatty acids and cholesterol have long been recommended to decrease low-density lipoprotein ( LDL ) cholesterol levels and reduce cardiovascular risk ( 1 ) . Ample evidence suggests that polyunsaturated fatty acids and monounsaturated fatty acids have a similar cholesterol-lowering effect when substituted for saturated fatty acids ( 2 - 4 ) . However , most studies of fatty acids and blood lipids have been done with fats and oils , rarely with whole fatty foods . Because people usually buy and consume whole food products , it is desirable to know the effects of specific foods on risk factors for coronary heart disease . Recent reports suggest that the regular consumption of nuts might reduce cardiovascular risk ( 5 ) . Walnuts are particularly rich in polyunsaturated fatty acids ( 6 ) , and epidemiologic evidence suggests that frequent walnut consumption protects against coronary heart disease ( 7 ) . In a controlled feeding trial by Sabat and colleagues ( 8) , a diet in which walnuts represented 55 % of the energy from fat reduced blood cholesterol levels in normal young men when compared with a st and ard low-fat diet . However , the results can not easily be extrapolated to the population at risk for coronary heart disease because women , older age groups , and hypercholesterolemic persons were not studied ( 8) . In addition , because meals were served at a metabolic kitchen , the study did not address the question of whether free-living persons would incorporate substantial quantities of walnuts into their diets . Because oxidized LDL plays a key role in atherogenesis ( 9 ) and oxidative damage involves peroxidation of polyunsaturated fatty acids in LDL lipids ( 10 ) , there is concern that walnut intake may promote LDL oxidation . Therefore , we design ed a dietary intervention study in free-living adult men and women with polygenic hypercholesterolemia to compare the effects of a walnut-rich diet with those of a cholesterol-lowering Mediterranean diet on serum lipid levels , lipoprotein levels , and LDL resistance to oxidation . Methods Patients Adult men and women with polygenic hypercholesterolemia attending the Lipid Clinic of the Hospital Clnic of Barcelona were eligible if they had serum LDL cholesterol concentrations greater than 3.36 mmol/L ( 130 mg/dL ) and triglyceride concentrations less than 2.82 mmol/L ( 250 mg/dL ) ; no evidence of alcohol , tobacco , or drug abuse ; absence of diabetes mellitus and liver , kidney , thyroid , or other endocrine diseases , as assessed by medical history , a complete physical examination , and laboratory tests ; no intake in the previous 8 weeks of medications known to affect lipid metabolism , including hypolipidemic agents and estrogen compounds in women ; infrequent consumption of nuts and no known history of allergy to them ; and no use of multivitamin or vitamin E supplements  . Because the target population had common ( polygenic ) hypercholesterolemia , we excluded persons whose elevated blood cholesterol levels had a strong genetic basis ( such as heterozygous familial hypercholesterolemia or familial combined hyperlipidemia ) , as established by st and ard criteria . On admission to the Lipid Clinic , all patients were advised to follow a  Mediterranean-type hypolipidemic diet ( 11 ) . For a crossover design , statistical power calculations indicated that to detect mean differences of 0.39 mmol/L ( 15 mg/dL ) , 34 patients would need to complete the two treatment periods ( statistic , 0.05 ; power>0.8 ) . From a computerized register of clinical records , 75 hypercholesterolemic patients ( 35 women and 40 men ) who initially met the eligibility criteria were selected for screening and were asked to participate in the study . They were offered free walnuts but no monetary compensation . Study Design A crossover design was used . Patients were r and omly assigned to the two diet sequences by using a computer-generated r and om-number table , with stratification by sex . Because patients followed each diet for 6 weeks and lipoprotein changes due to dietary intervention stabilize in less than 4 weeks ( 12 ) , we did not incorporate a washout period between diets . In their crossover feeding study with walnuts , Sabat and colleagues ( 8) did not observe a carryover effect . In the week before the trial began , patients received expert dietary counseling individually and in a group class . Twice during the pretrial week and on weeks 5 and 6 of each one of the two dietary periods , patients came to the clinic for a medical visit , an interview with the dietitian , anthropometric measurements , and blood extraction . The main outcomes of the study were changes in serum levels of total and LDL cholesterol from the control diet period to the walnut diet period . Secondary outcomes were changes in other lipid variables and oxidizability of LDL particles . The study protocol was approved by the institutional review board of the Hospital Clnic of Barcelona , and all patients gave informed consent . Diets The experimental diets were individually prescribed and were based on estimated energy requirements . Because participants ate on their own , detailed dietary information was provided to them and , if appropriate , to their partners .  Diets were calculated in increments of 200 kcal to cover the range from 1600 to 2200 kcal . The control diet was Mediterranean and was composed of natural foodstuffs . Red meat and eggs were limited , vegetable products and fish were emphasized , olive oil was indicated for culinary use , and no nuts were allowed . The walnut diet was similar to the control diet , but walnuts partially replaced olive oil and other fatty foods . Prepackaged daily allowances of raw , shelled walnuts were provided daily in amounts varying from 41 g to 56 g ( the equivalent of 8 to 11 walnuts ) , according to the participants ' total energy intake . Walnuts were consumed as snacks or with meals in desserts or salads . In the walnut diet , walnuts contributed approximately 18 % of the total energy and 35 % of the total fat . To improve compliance , each family unit was given 1000-g packs of walnuts at the beginning of the walnut diet period .  Adherence to the study diets was carefully monitored . Unannounced 24-hour diet recalls were performed weekly by telephone during the two dietary periods , for a total of 12 recalls per patient . This method allows reliable estimations of food intake ( 13 ) . The nutrient composition of the diets was calculated with Food Processor Plus software , version 5.0 ( ESHA Research , Salem , Oregon ) , which was adapted to nutrient data bases of specific Mediterranean foods when appropriate . We defined noncompliance as at least 20 % deviation from dietary instructions regarding walnut or nutrient intake . Compliance during the walnut diet was also assessed at each clinic visit by a count of the empty walnut packages . The fatty acid content of LDL lipids was analyzed as a biological measure of adherence to the prescribed diets . Laboratory Measurements Blood sample s were obtained after an overnight fast , and serum and EDTA plasma were collected and processed immediately . Serum lipid and apolipoprotein levels were determined as described elsewhere ( 11 ) . In brief , serum cholesterol and triglyceride levels were measured by using enzymatic reagents ( Trinder , Bayer Diagnostics , Tarrytown , New York ) adapted to a Cobas Mira automated analyzer ( Hoffmann-LaRoche , Basel , Switzerl and ) . High-density lipoprotein ( HDL ) cholesterol was quantified after precipitation with phosphotungstic acid and magnesium chloride . Levels of apolipoprotein A-I and apolipoprotein B were determined by an immunoturbidimetric method ( Unimate 3 , Roche Diagnostic Systems , Basel , Switzerl and ) . Measurements of the cholesterol content of very-low-density lipoprotein particles and LDL particles were based on preparative ultracentrifugation ( 11 ) . Lipoprotein(a ) levels were measured by using an immunoturbidimetric method ( Lipoprotein[a ] SPQ II Test Kit , DiaSorin , Stillwater , Minnesota ) . To obtain the LDL fraction for fatty acid and oxidizability studies , lipoproteins were fractionated by sequential centrifugation adjusting with NaBr to separate very-low-density lipoprotein particles ( d=1.006 g/mL ) and to obtain LDL particles ( d=1.063 g/mL ) , as described elsewhere ( 14 ) . Low-density lipoprotein fatty acids were measured by capillary gas chromatography in the cholesteryl ester , phospholipid , and triglyceride lipid fractions ( 14 ) . Low-density lipoprotein susceptibility to oxidation was determined by measuring the -tocopherol content of LDL particles and conjugated diene kinetics after incubation of 50 g of LDL protein with 5 mol of copper sulfate at 37 C ( 15 , 16 ) . Statistical Analysis The two measurements obtained at baseline and at the end of each dietary period were averaged . Means and SDs are presented for each measurement . With methods described by Fleiss ( 17 ) , two-tailed t-tests were used to compare changes in outcome variables in response to dietary treatment and diet period and carryover effects for the two-period crossover design . Differences between the walnut and control diets were also tested by analysis of covariance using general linear models ; baseline values or sex were used as covariates . Analyses were performed by using SAS software ( SAS , Inc. , Cary , North Carolina ) ( 18 ) . Role of the Funding Sources The California Walnut Commission provided funding and walnuts . Research grants were also obtained from national and local nonprofit agencies . The funding sources were not involved in the design of the study and had no role in the collection , analysis , or interpretation of the data or in the decision to su bmi t the manuscript for publication . None of the authors has any financial interest in the nut food industry . Results Patient Characteristics Of the 75 eligible patients , 20 left the study before r and omization for Walnut ( Juglans regia L. ) is described as an anticancer , tonic , blood purifier , and detoxifier agent . It is said that nuts have favorable fatty acids and nutrients . This study was performed to determine the lipid-lowering properties of walnut in a population in Shiraz , Southern Iran . In a r and omized case-control study , 52 volunteers were divided into 2 groups : Group A consumed walnuts , 20 grams per day for 8 weeks and the control group ( group B ) consumed no walnuts .  Triglycerides , total high-density lipoprotein ( HDL ) , and low-density lipoprotein ( LDL ) levels were checked for each subject prior to , after 4 weeks , and at 8 weeks after the beginning of the study . In group A , the mean plasma TG level dropped by 17.1 % from the baseline and HDL cholesterol also increased significantly by 9 % . It was shown that frequent consumption of nuts in the daily diet was associated with a potentially decreased risk of coronary artery disease by decreasing the level of triglyceride and increasing the level of HDL BACKGROUND Frequent consumption of nuts may lower the risk of cardiovascular disease by favorably altering serum lipid and lipoprotein concentrations . OBJECTIVE We compared the effects of 2 amounts of almond intake with those of a National Cholesterol Education Program Step I diet on serum lipids , lipoproteins , apolipoproteins , and glucose in healthy and mildly hypercholesterolemic adults . DESIGN In a r and omized crossover design , 25 healthy subjects ( 14 men , 11 women ) with a mean ( + /- SD ) age of 41 + /- 13 y were fed 3 isoenergetic diets for 4 wk each after being fed a 2-wk run-in diet ( containing 34 % of energy from fat ) . The experimental diets included a Step I diet , a low-almond diet , and a high-almond diet , in which almonds contributed 0 % , 10 % , and 20 % of total energy , respectively . RESULTS Inverse relations were observed between the percentage of energy in the diet from almonds and the subject 's total cholesterol ( P value for trend < 0.001 ) , LDL-cholesterol ( P < 0.001 ) , and apolipoprotein B ( P < 0.001 ) concentrations and the ratios of LDL to HDL cholesterol ( P < 0.001 ) and of apolipoprotein B to apolipoprotein A ( P < 0.001 ) . Compared with the Step I diet , the high-almond diet reduced total cholesterol ( 0.24 mmol/L or 4.4 % ; P = 0.001 ) , LDL cholesterol ( 0.26 mmol/L or 7.0 % ; P < 0.001 ) , and apolipoprotein B ( 6.6 mg/dL or 6.6 % ; P < 0.001 ) ; increased HDL cholesterol ( 0.02 mmol/L or 1.7 % ; P = 0.08 ) ; and decreased the ratio of LDL to HDL cholesterol ( 8.8 % ; P < 0.001 ) . CONCLUSIONS Isoenergetic incorporation of approximately 68 g of almonds ( 20 % of energy ) into an 8368-kJ ( 2000-kcal ) Step I diet markedly improved the serum lipid profile  of healthy and mildly hypercholesterolemic adults .  Total and LDL-cholesterol concentrations declined with progressively higher intakes of almonds , which suggests a dose-response relation Objective : The authors tested the hypothesis that in adults with prediabetes , an almond-enriched American Diabetes Association ( ADA ) diet improves measures of insulin sensitivity and other cardiovascular risk factors compared with an ADA nut-free diet . Methods : Design : R and omized parallel-group trial . Setting : Outpatient dietary counseling and blood analysis . Subjects : Sixty-five adult participants with prediabetes . Intervention : Sixteen weeks of dietary modification featuring an ADA diet containing 20 % of energy from almonds ( approximately 2 oz per day ) . Measures of Outcome : Outcomes included fasting glucose , insulin , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides , TC : HDL-C , and HbA1c , which were measured at weeks 0 , 8 , and 16 . Body weight , body mass index ( BMI ) , waist circumference , blood pressure , and nutrient intake were measured at weeks 0 , 4 , 8 , 12 , and 16 . Results : The almond-enriched intervention group exhibited greater reductions in insulin ( −1.78 µU/ml vs. + 1.47 µU/ml , p = 0.002 ) , homeostasis model analysis for insulin resistance ( −0.48 vs. + 0.30 , p = 0.007 ) , and homeostasis model analysis for beta-cell function ( −13.2 vs. + 22.3 , p = 0.001 ) compared with the nut-free control group . Clinical ly significant declines in LDL-C were found in the almond-enriched intervention group ( −12.4 mg/dl vs. −0.4 mg/dl ) as compared with the nut-free control group . No changes were observed in BMI ( −0.4 vs. −0.7 kg/m2 , p = 0.191 ) , systolic blood pressure ( −4.4 mm Hg vs. −3.5 mm Hg , p = 0.773 ) , or for the other measured cardiovascular risk factors . Conclusions : An ADA diet consisting of 20 % of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinical ly significant improvements in LDL-C in adults with prediabetes There is increasing evidence that nuts have protective effects against coronary artery disease by improving lipid profile and inhibiting lipid oxidation . However , data about pistachio nuts are limited , and to our knowledge , there is no study investigating the effects of pistachio intake on lipid oxidation and serum antioxidant levels . This study , therefore , sought to determine the effects of pistachio intake on serum lipids and determine whether consumption of pistachio would alter serum antioxidant levels . Rats were r and omly divided into three groups ( n=12 for each ) : control group fed basic diet for 10 weeks and treated groups fed basic diet plus pistachio which constituted 20 % and 40 % of daily caloric intake , respectively . Consumption of pistachio as 20 % of daily caloric intake increased high-density lipoprotein ( HDL ) levels and decreased total cholesterol (TC)/HDL ratio , compared with those not taking pistachio . However , TC , low-density lipoprotein ( LDL ) cholesterol and triglyceride levels were unaffected by pistachio consumption . Consumption of pistachio as 20 % of daily caloric intake increased serum paraoxonase activity by 35 % and arylesterase activity by 60 % , which are known to inhibit LDL cholesterol oxidation , compared with the control group . However , increased antioxidant activity was blunted when pistachio intake was increased to 40 % of daily caloric intake . In conclusion , the present results show that consumption of pistachio as 20 % of daily caloric intake leads to significant improvement in HDL and TC/HDL ratio and inhibits LDL cholesterol oxidation . These results suggest that pistachio may be beneficial for both prevention and treatment of coronary artery disease OBJECTIVE To compare serum lipid profiles and dietary intakes of people with normal lipid levels who consumed pecans and those who did not consume nuts .  DESIGN Eight-week , r and omized , controlled study of pecan treatment group vs control group . SUBJECT Nineteen people with normal lipid levels completed the study ; 10 had been r and omly assigned to the pecan treatment group ( 7 women , 3 men , mean age = 45 + /- 10 years ) and 9 to the control group ( 8 women , 1 man , mean age = 37 + /- 12 years ) . INTERVENTION The pecan treatment group consumed 68 g pecans per day for 8 weeks plus self-selected diets . The pecans contributed 459 kcal and 44 g fat daily . The control group avoided nuts and consumed self-selected diets . MAIN OUTCOME MEASURES Total serum cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , and total triglyceride levels were measured at the time of entrance to the study ( baseline ) , week 4 , and week 8 . Computer analyses were done on five 3-day food records . STATISTICAL ANALYSIS Comparisons were made using analysis of variance or paired t test . RESULTS LDL-C was lowered in the pecan treatment group from 2.61 + /- 0.49 mmol/L at baseline to 2.35 + /- 0.49 at week 4 ( P < .05 ) and to 2.46 + /- 0.59 at week 8 ( P < .05 ) . At week 8 , total cholesterol and HDL-C in the pecan treatment group were significantly lower ( P < .05 ) than in the control group ( total cholesterol : 4.22 + /- 0.83 vs 5.02 + /- 0.54 mmol/L ; HDL-C : 1.37 + /- 0.23 vs 1.47 + /- 0.34 mmol/L ) . Dietary fat , monounsaturated fat , polyunsaturated fat , insoluble fiber , magnesium , and energy were significantly higher in the pecan treatment group than in the control group . Body mass indexes and body weights were unchanged in both groups . APPLICATIONS Pecans can be included in a healthful diet when energy intake and potential weight gain are addressed BACKGROUND AND AIM Small quantities of nuts protect against subsequent cardiovascular risk . There is speculation that the cholesterol lowering effect associated with nut consumption arises primarily from the fatty acid composition of nuts but may be caused by some other component . To evaluate this possibility we compared the effect of various nuts , against a Canola oil based cereal with a comparable fatty acid profile , on lipids , lipoproteins and fatty acids to determine whether the fatty acid profile of nuts explains their cholesterol lowering effects . METHODS AND RESULTS Twenty-eight men and women with mean ( s.d . ) levels of total and low density lipoprotein cholesterol of 6.0 ( 1.1 ) mmol/L , and 4.1 ( 1.0 ) mmol/L , respectively and a mean body mass index ( BMI ) of 26.9 ( 3.2 ) kg/m2 took part in a r and omised cross over trial . For two periods of six weeks , separated by a four-week washout , participants were asked to consume a low saturated fat diet , which included either 30 g/d nuts ( nut diet ) or one serving of a cereal containing Canola oil ( cereal diet ) . There were no significant differences in the lipids , lipoproteins , plasma fatty acids or other variables between the two diets at the end of the study . Total cholesterol ( TC ) and low density lipoprotein cholesterol ( LDL-C ) were lower on both experimental diets than at baseline , 0.51 mmol/L and 0.40 mmol/L ( p<0.001 , p<0.01 ) , respectively on the nut diet and 0.42 mmol/L and 0.37 mmol/L ( p<0.001 , p<0.01 ) , respectively on the cereal diet . CONCLUSION A 30 g serving of nuts , or a serving of a Canola oil enriched cereal with a similar fatty acid composition reduced total and LDL cholesterol to a similar extent when consumed as part of a lipid lowering diet . Results suggest that foods with a similar fatty acid composition to nuts can produce comparable decreases in lipoprotein mediated cardiovascular risk BACKGROUND AND AIMS Nuts have been demonstrated to improve several cardiovascular risk factors and the lipid profile in diabetic and pre-diabetic subjects . However , analysis of conventional serum lipid profiles does not completely explain the atherogenic risk associated with pre-diabetes . We therefore investigated whether chronic consumption of pistachio modifies the lipoprotein subclasses to a healthier profile in pre-diabetic subjects . METHODS AND RESULTS R and omized cross-over clinical trial in 54 subjects with pre-diabetes . Subjects consumed a pistachio-supplemented diet ( PD , 50 % carbohydrates , 33 % fat , including 57 g/d of pistachios daily ) and a control diet ( CD , 55 % carbohydrates , 30 % fat ) for 4 months each , separated by a 2-week wash-out . Diets were isocaloric and matched for protein , fiber and saturated fatty acids . Nuclear magnetic resonance ( NMR ) was performed to determine changes in plasma lipoprotein subclasses . Small low-density lipoprotein particles ( sLDL-P ) significantly decreased after pistachio consumption compared to the nut-free diet ( P = 0.023 ) . The non-high-density lipoprotein particles ( non-HDL-P i.e. VLDL-P plus LDL-P ) significantly decreased under the PD compared to CD ( P = 0.041 ) . The percentage of sHDL-P increased by 2.23 % after the PD compared with a reduction of 0.08 % after the CD ( P = 0.014 ) . Consequently , the overall size of HDL-P significantly decreased in the PD ( P = 0.007 ) . CONCLUSION Chronic pistachio consumption could modify the lipoprotein particle size and subclass concentrations independently of changes in total plasma lipid profile , which may help to explain the decreased risk of cardiovascular disease and mortality associated with those individuals who frequently consumed nuts . REGISTRATION NUMBER This study is registered at www . clinical trials.gov as NCT01441921 This study was conducted to assess the cholesterol-lowering potential of macadamia nuts .  Seventeen hypercholesterolemic men ( mean age 54 y ) were given macadamia nuts ( 40 - 90 g/d ) , equivalent to 15 % energy intake , for 4 wk . Plasma total cholesterol , LDL cholesterol , HDL cholesterol , triglycerides and homocysteine concentrations and the fatty acid composition of plasma lipids were determined before and after treatment . Plasma MUFA 16:1(n-7 ) , 18:1(n-7 ) and 20:1(n-9 ) were elevated after intervention with macadamia nuts .  Plasma ( n-6 ) and ( n-3 ) PUFA concentrations were unaffected by macadamia nut consumption . Plasma total cholesterol and LDL cholesterol concentrations decreased by 3.0 and 5.3 % , respectively , and HDL cholesterol levels increased by 7.9 % in hypercholesterolemic men after macadamia nut consumption . Plasma triglyceride and homocysteine concentrations were not affected by treatment . Macadamia nut consumption was associated with a significant increase in the relative intake of MUFA and a reduced relative intake of saturated fatty acids and PUFA . This study demonstrates that macadamia nut consumption as part of a healthy diet favorably modifies the plasma lipid profile in hypercholesterolemic men despite their diet being high in fat Previous studies have suggested that lipid from nuts is more poorly absorbed than that from other food sources . If lipid from nuts is poorly absorbed , then the metabolisable energy contained in the nuts is less than that predicted by the Atwater general factors . A crossover feeding study was conducted in which sixteen volunteers consumed pistachios for 3 weeks as part of a controlled diet . Pistachio doses were 0 , 42 and 84 g/d . Urine and faecal sample s were collected , and urine , faeces and diet were analysed for N , fat , total dietary fibre , ash and combustible energy . Blood was also collected after each treatment period and analysed for plasma lipids . Energy value of pistachio nuts was calculated from differences in energy excretion during the different dietary treatments . The measured energy density  of pistachios was found to be 22·6 kJ/g , which is 5 % less than the currently accepted energy value of 23·7 kJ/g , as calculated using the Atwater general factors . The pistachio nut intervention lowered LDL-cholesterol by 6 % , but did not significantly change plasma total cholesterol , HDL-cholesterol or TAG . In conclusion , pistachio nuts contain less metabolisable energy than that calculated from the Atwater general factors . Accurate information about metabolisable energy content of foods is important for reliable food labelling BACKGROUND In a recent six-year follow-up study , we found that frequent consumption of nuts was associated with a reduced risk of ischemic heart disease .  To explore possible explanations for this finding , we studied the effects of nut consumption on serum lipids and blood pressure . METHODS We r and omly placed 18 healthy men on two mixed natural diets  , each diet to be followed for four weeks . Both diets conformed to the National Cholesterol Education Program Step 1 diet and contained identical foods and macronutrients , except that 20 percent of the calories of one diet ( the walnut diet ) were derived from walnuts ( offset by lesser amounts of fatty foods , meat , and visible fat [ oils , margarine , and butter ] ) . RESULTS With the reference diet , the mean ( + /- SD ) serum values for total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol were , respectively , 182 + /- 23 , 112 + /- 16 , and 47 + /- 11 mg per deciliter ( 4.71 + /- 0.59 , 2.90 + /- 0.41 , and 1.22 + /- 0.28 mmol per liter ) . With the walnut diet , the mean total cholesterol level was 22.4 mg per deciliter ( 0.58 mmol per liter ) lower than the mean level with the reference diet ( 95 percent confidence interval , 28 to 17 mg per deciliter [ 0.72 to 0.44 mmol per liter ] ) ; the LDL and HDL cholesterol levels were , respectively , 18.2 mg per deciliter ( 0.47 mmol per liter ) ( P < 0.001 ) and 2.3 mg per deciliter ( 0.06 mmol per liter ) ( P = 0.01 ) lower . These lower values represented reductions of 12.4 , 16.3 , and 4.9 percent in the levels of total , LDL , and HDL cholesterol , respectively . The ratio of LDL cholesterol to HDL cholesterol was also lowered ( P < 0.001 ) by the walnut diet .  Mean blood-pressure values did not change during either dietary period . CONCLUSIONS Incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet while maintaining the intake of total dietary fat and calories decreases serum levels of total cholesterol and favorably modifies the lipoprotein profile in normal men . The long-term effects of walnut consumption and the extension of this finding to other population groups deserve further study BACKGROUND Elevated serum cholesterol levels play an important role in the development of coronary artery disease . Previous studies have suggested that nut consumption benefits lipid profile .  Pistachio nuts are widely available , inexpensive and frequently consumed by the general population . OBJECTIVE To determine whether substituting 20 % of the daily caloric intake in the form of pistachio nuts will improve the lipid profiles of humans with primary , moderate hypercholesterolemia . DESIGN Controlled , r and omized crossover design . SETTING Outpatient dietary modification , counseling and blood analysis . PATIENTS Ten patients with moderate hypercholesterolemia . INTERVENTION Three weeks of dietary modification with 20 % caloric intake from pistachio nuts . MEASUREMENTS Body weight , blood pressure , total cholesterol , LDL , HDL , and triglycerides were monitored . Lipid profiles were analyzed prior to , during and after dietary modification . RESULTS After three weeks , there was a decrease in total cholesterol ( p<0.04 ) , an increase in HDL ( p<0.09 ) , a decrease in the total cholesterol/HDL ratio ( p<0.01 ) and a decrease in the LDL/HDL ratio ( p<0.02 ) . Triglycerides and LDL levels decreased , but not significantly . Body weight and blood pressure remained constant throughout the study . CONCLUSIONS Results suggest that eating pistachio nuts instead of other dietary fat calories can improve lipid profiles , thereby decreasing coronary risk . Further studies will be required to confirm these results and to determine the mechanism of this effect
Significant heterogeneity was not observed by nut type or other factors .
Tree nut intake  lowers total cholesterol , LDL cholesterol , ApoB , and triglycerides .
The major determinant of cholesterol lowering appears to be nut dose rather than nut type .
BACKGROUND The effects of nuts on major cardiovascular disease ( CVD ) risk factors , including dose-responses and potential heterogeneity by nut type or phytosterol content , are not well established .
OBJECTIVES We examined the effects of tree nuts ( walnuts , pistachios , macadamia nuts , pecans , cashews , almonds , hazelnuts , and Brazil nuts ) on blood lipids [ total cholesterol , low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein , and triglycerides ] , lipoproteins [ apolipoprotein A1 , apolipoprotein B ( ApoB ) , and apolipoprotein B100 ] , blood pressure , and inflammation ( C-reactive protein ) in adults aged ≥18 y without prevalent CVD .