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A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial.
Circulation. 2004 Apr 06; 109(13):1609-14.Circ

Abstract

BACKGROUND

Epidemiological studies suggest that nut intake decreases coronary artery disease (CAD) risk. Nuts have a cholesterol-lowering effect that partly explains this benefit. Endothelial dysfunction is associated with CAD and its risk factors and is reversed by antioxidants and marine n-3 fatty acids. Walnuts are a rich source of both antioxidants and alpha-linolenic acid, a plant n-3 fatty acid.

METHODS AND RESULTS

To test the hypothesis that walnut intake will reverse endothelial dysfunction, we randomized in a crossover design 21 hypercholesterolemic men and women to a cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content in which walnuts replaced approximately 32% of the energy from monounsaturated fat. Participants followed each diet for 4 weeks. After each intervention, we obtained fasting blood and performed ultrasound measurements of brachial artery vasomotor function. Eighteen subjects completing the protocol had suitable ultrasound studies. Compared with the Mediterranean diet, the walnut diet improved endothelium-dependent vasodilation and reduced levels of vascular cell adhesion molecule-1 (P<0.05 for both). Endothelium-independent vasodilation and levels of intercellular adhesion molecule-1, C-reactive protein, homocysteine, and oxidation biomarkers were similar after each diet. The walnut diet significantly reduced total cholesterol (-4.4+/-7.4%) and LDL cholesterol (-6.4+/-10.0%) (P<0.05 for both). Cholesterol reductions correlated with increases of both dietary alpha-linolenic acid and LDL gamma-tocopherol content, and changes of endothelium-dependent vasodilation correlated with those of cholesterol-to-HDL ratios (P<0.05 for all).

CONCLUSIONS

Substituting walnuts for monounsaturated fat in a Mediterranean diet improves endothelium-dependent vasodilation in hypercholesterolemic subjects. This finding might explain the cardioprotective effect of nut intake beyond cholesterol lowering.

Authors+Show Affiliations

Lipid Clinic at the Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain. eros@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15037535

Citation

Ros, Emilio, et al. "A Walnut Diet Improves Endothelial Function in Hypercholesterolemic Subjects: a Randomized Crossover Trial." Circulation, vol. 109, no. 13, 2004, pp. 1609-14.
Ros E, Núñez I, Pérez-Heras A, et al. A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation. 2004;109(13):1609-14.
Ros, E., Núñez, I., Pérez-Heras, A., Serra, M., Gilabert, R., Casals, E., & Deulofeu, R. (2004). A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation, 109(13), 1609-14.
Ros E, et al. A Walnut Diet Improves Endothelial Function in Hypercholesterolemic Subjects: a Randomized Crossover Trial. Circulation. 2004 Apr 6;109(13):1609-14. PubMed PMID: 15037535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. AU - Ros,Emilio, AU - Núñez,Isabel, AU - Pérez-Heras,Ana, AU - Serra,Mercè, AU - Gilabert,Rosa, AU - Casals,Elena, AU - Deulofeu,Ramón, Y1 - 2004/03/22/ PY - 2004/3/24/pubmed PY - 2004/7/24/medline PY - 2004/3/24/entrez SP - 1609 EP - 14 JF - Circulation JO - Circulation VL - 109 IS - 13 N2 - BACKGROUND: Epidemiological studies suggest that nut intake decreases coronary artery disease (CAD) risk. Nuts have a cholesterol-lowering effect that partly explains this benefit. Endothelial dysfunction is associated with CAD and its risk factors and is reversed by antioxidants and marine n-3 fatty acids. Walnuts are a rich source of both antioxidants and alpha-linolenic acid, a plant n-3 fatty acid. METHODS AND RESULTS: To test the hypothesis that walnut intake will reverse endothelial dysfunction, we randomized in a crossover design 21 hypercholesterolemic men and women to a cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content in which walnuts replaced approximately 32% of the energy from monounsaturated fat. Participants followed each diet for 4 weeks. After each intervention, we obtained fasting blood and performed ultrasound measurements of brachial artery vasomotor function. Eighteen subjects completing the protocol had suitable ultrasound studies. Compared with the Mediterranean diet, the walnut diet improved endothelium-dependent vasodilation and reduced levels of vascular cell adhesion molecule-1 (P<0.05 for both). Endothelium-independent vasodilation and levels of intercellular adhesion molecule-1, C-reactive protein, homocysteine, and oxidation biomarkers were similar after each diet. The walnut diet significantly reduced total cholesterol (-4.4+/-7.4%) and LDL cholesterol (-6.4+/-10.0%) (P<0.05 for both). Cholesterol reductions correlated with increases of both dietary alpha-linolenic acid and LDL gamma-tocopherol content, and changes of endothelium-dependent vasodilation correlated with those of cholesterol-to-HDL ratios (P<0.05 for all). CONCLUSIONS: Substituting walnuts for monounsaturated fat in a Mediterranean diet improves endothelium-dependent vasodilation in hypercholesterolemic subjects. This finding might explain the cardioprotective effect of nut intake beyond cholesterol lowering. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15037535/A_walnut_diet_improves_endothelial_function_in_hypercholesterolemic_subjects:_a_randomized_crossover_trial_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000124477.91474.FF?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -