In the JournalsPerspective

Almonds, dark chocolate reduce CHD risk in adults with overweight, obesity

Penny M. Kris-Etherton

Adults with overweight or obesity who incorporated almonds alone or combined with dark chocolate into their diets improved their lipid profiles, according to a study published in the Journal of the American Heart Association.

“It’s important to put this into context: The message is not that people should go out and eat a lot of chocolate and almonds to lower their LDL,” Penny M. Kris-Etherton, PhD, RD, distinguished professor of nutrition at Pennsylvania State University, said in a press release. “People are allowed to have about 270 discretionary calories a day, and when foods like almonds, dark chocolate and cocoa are consumed together as a discretionary food, they confer health benefits unlike other discretionary foods such as frosted doughnuts.”

Yujin Lee, PhD, of the department of nutritional sciences at Pennsylvania State University at the time of the study and now a postdoctoral fellow at Tufts University Friedman School of Nutritional Science in Boston, and colleagues reviewed data from 31 participants (mean age, 46 years; 13 women) from the National Health and Nutrition Examination Survey 1999-2000 who had a BMI between 25 kg/m2 and 40 kg/m2. Those who met criteria such as elevated BP, smoking and history of MI or stroke were excluded.

Participants were assigned to follow one of four diets for 4 weeks: average American diet; 42.5 g per day of almonds; 18 g per day of cocoa powder and 43 g per day of dark chocolate; or all three foods. A 2-week washout period occurred before crossing over to the subsequent test diet. Data such as weight and food logs, fasting blood samples, BP, total cholesterol and triglycerides, glucose and plasma nitric oxide were assessed throughout the study period.

During the almond diet, participants had lower levels of non-HDL (154 mg/dL vs. 162.8 mg/dL; P = .006), LDL (126.4 vs. 135.6; P = .003) and total cholesterol (195.4 mg/dL vs. 204.6 mg/dL; P = .004) compared with the average American diet.

Apolipoprotein B was lower during the chocolate and almond diet (101.9 mg/dL) vs. the average American diet (107.5 mg/dL; P = .02).

The almond diet reduced large buoyant LDL particles by 5.7 mg/dL compared with 0.3 mg/dL with the average American diet (P = .04). Small dense LDL particles were reduced by 12 mg/dL in the chocolate and almond diet and 5.3 mg/dL with the average American diet (P = .04).

Oxidative stress and vascular health were not significantly affected by any of the diets.

“On the basis of our findings, incorporating almonds, dark chocolate and cocoa into a healthy diet that does not exceed energy needs may reduce the risk of coronary heart disease,” Lee and colleagues wrote. – by Darlene Dobkowski

Disclosures: The study was funded by The Hershey Company and the Almond Board of California. Lee reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Penny M. Kris-Etherton

Adults with overweight or obesity who incorporated almonds alone or combined with dark chocolate into their diets improved their lipid profiles, according to a study published in the Journal of the American Heart Association.

“It’s important to put this into context: The message is not that people should go out and eat a lot of chocolate and almonds to lower their LDL,” Penny M. Kris-Etherton, PhD, RD, distinguished professor of nutrition at Pennsylvania State University, said in a press release. “People are allowed to have about 270 discretionary calories a day, and when foods like almonds, dark chocolate and cocoa are consumed together as a discretionary food, they confer health benefits unlike other discretionary foods such as frosted doughnuts.”

Yujin Lee, PhD, of the department of nutritional sciences at Pennsylvania State University at the time of the study and now a postdoctoral fellow at Tufts University Friedman School of Nutritional Science in Boston, and colleagues reviewed data from 31 participants (mean age, 46 years; 13 women) from the National Health and Nutrition Examination Survey 1999-2000 who had a BMI between 25 kg/m2 and 40 kg/m2. Those who met criteria such as elevated BP, smoking and history of MI or stroke were excluded.

Participants were assigned to follow one of four diets for 4 weeks: average American diet; 42.5 g per day of almonds; 18 g per day of cocoa powder and 43 g per day of dark chocolate; or all three foods. A 2-week washout period occurred before crossing over to the subsequent test diet. Data such as weight and food logs, fasting blood samples, BP, total cholesterol and triglycerides, glucose and plasma nitric oxide were assessed throughout the study period.

During the almond diet, participants had lower levels of non-HDL (154 mg/dL vs. 162.8 mg/dL; P = .006), LDL (126.4 vs. 135.6; P = .003) and total cholesterol (195.4 mg/dL vs. 204.6 mg/dL; P = .004) compared with the average American diet.

Apolipoprotein B was lower during the chocolate and almond diet (101.9 mg/dL) vs. the average American diet (107.5 mg/dL; P = .02).

The almond diet reduced large buoyant LDL particles by 5.7 mg/dL compared with 0.3 mg/dL with the average American diet (P = .04). Small dense LDL particles were reduced by 12 mg/dL in the chocolate and almond diet and 5.3 mg/dL with the average American diet (P = .04).

Oxidative stress and vascular health were not significantly affected by any of the diets.

“On the basis of our findings, incorporating almonds, dark chocolate and cocoa into a healthy diet that does not exceed energy needs may reduce the risk of coronary heart disease,” Lee and colleagues wrote. – by Darlene Dobkowski

Disclosures: The study was funded by The Hershey Company and the Almond Board of California. Lee reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

    Perspective
    Alice H. Lichtenstein

    Alice H. Lichtenstein

    The study confirmed replacing butter, cheese and refined grains with almonds had a favorable effect of plasma lipids. There was no additional benefit of cocoa powder and chocolate. This is important because prior work had suggested a benefit.
    The findings confirm current recommendations to replace foods high in saturated fat with unsaturated fat.
    This was a well-conducted study that assessed the effect of substituting one group of foods for another — butter, cheese and refined grains with almonds — and found a benefit. It does not suggest there will be a benefit from just adding almonds to the diet without making other changes. For example, sprinkling almonds onto a hot fudge sundae is unlikely to result in a benefit.

    • Alice H. Lichtenstein, DSc
    • Gershoff Professor of Nutrition Science and Policy Director, Senior Scientist, Cardiovascular Nutrition Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University

    Disclosures: Lichtenstein reports no relevant financial disclosures.