The Impact of Almond Nut Consumption on Markers of CVD & Metabolic Health
Condition: Cardiovascular Disease
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      The purpose of this study is to investigate the cardio-metabolic health effects of consuming
      almond nuts in place of habitual (usual) snack products in adults at moderate risk of
      developing cardiovascular disease
    

Detailed description: 
      Tree nuts are recommended in the prevention and management of cardiovascular disease (CVD)
      largely based on their LDL (low density lipoprotein) lowering effects, but the CVD risk
      reduction observed with tree nut consumption is greater than that predicted by their
      hypocholesterolemic effects alone. Other health benefits have also been noted by our group,
      such as moderation of postprandial lipemia , as well as by others such as modified
      postprandial glycemia , decreased blood pressure (BP) , improvement in oxidant status and
      weight loss. Robust evidence for the protective cardio-metabolic effects of nuts from the
      PREDIMED study has highlighted the association between nut consumption and decreased risk of
      cardiovascular events, obesity, metabolic syndrome and type 2 diabetes (T2DM). However, there
      is a paucity of evidence on the effects of almonds on vascular function in humans (BP and
      endothelium-dependent vasodilation (EDV)), although there is evidence that almonds promote
      nitric oxide (NO) release in animals consuming high-fat diets. Fundamental to vascular health
      is a well-functioning liver and there is increasing evidence to demonstrate that the
      accumulation of liver fat is a causative factor in the development of cardio-metabolic
      disorders. Non-alcoholic fatty liver disease (NAFLD) is now considered the hepatic
      manifestation of the metabolic syndrome (MetS); recent data has shown that it is linked to
      increased CVD risk via direct effects on vascular function (and EDV) independently of obesity
      and MetS . NAFLD is thought to affect 30% of the population in developed countries, and up to
      two-thirds of people with obesity and 50% of people with hyperlipidemia. Development of fatty
      liver, mainly attributable to obesity and elevated postprandial lipemia, is associated with
      increased inflammation, oxidative stress, insulin resistance, dyslipidemia and impaired EDV,
      and predicts risk of CVD and T2DM .

      Therefore, the long-term goal of this research is to understand the mechanisms underpinning
      how dietary change can drive favourable modification of CVD disease risk and to identify
      patterns in population food choices, specifically almond consumption, that tend to correlate
      with reduced CVD disease risk. The primary aim of this proposal is to investigate, in a
      randomised controlled, parallel arm, 6-wk dietary intervention (n=100) whether replacing
      snacks based on refined carbohydrates and poor in micronutrients/non-nutrient bioactives
      (NNB) with nutrient/NNB-dense, whole almond snacks can influence liver fat content (a key
      metabolic driver of insulin resistance and vascular dysfunction, and a hallmark of metabolic
      syndrome) and EDV (brachial FMD being an independent predictor of CVD events, in addition to
      related biomarkers of cardio-metabolic disease risk. The snacks products provide participants
      with 20% of their energy requirements via either whole almonds or as muffins/crackers that
      have been designed to mimic the average UK snack.
    

Intervention name(s): Almonds; Muffins/Crackers
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): Participants to consume almonds as snacks to contribute to 20% of their energy requirements daily for 4 weeks; Participants to consume muffins/crackers as snacks to contribute to 20% of their energy requirements daily for 4 weeks
NB all participants will have a run in period for 2 weeks whereby muffins are consumed, this is prior to randomisation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Diagnostic
Keywords: Cardiovascular disease; Non alcoholic fatty liver; Diabetes; Almonds; Endothelium-dependent vasodilation; Fecal short chain fatty acids (SCFAs); Snacking