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Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study^1,2,3

¹ From Integrative Biosciences (SKG and PMK-E) and the Departments of Nutritional Sciences (CDK, DB, and PMK-E) and Biobehavioral Health (SGW and CDK), Pennsylvania State University; Oklahoma Medical Research Foundation, (PA)

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 randomized crossover controlled-feeding study, 28 individuals with LDL cholesterol 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.