IJCS | Volume 32, Nº2, May/June 2019

DOI: 10.5935/2359-4802.20190016 274 REVIEW ARTICLE International Journal of Cardiovascular Sciences. 2019;32(3)274-282 Mailing Address: Milena Barcza Stockler-Pinto Universidade Federal Fluminense - Faculdade de Nutrição - São Domingos. Postal Code: 24020-005, Niterói, RJ - Brazil. E-mail: milbarcza@gmail.com Nuts and Cardiovascular Diseases: Focus on Brazil Nuts Ana Carla Tavares da Silv a, Ludmila F. M. F. Cardoz o, B eatriz Oliveira da Cru z, D enise Mafr a, M ilena Barcza Stockler-Pint o Fluminense Federal University (UFF), Niterói, RJ - Brazil Manuscript received May 03, 2017; revised manuscript April 28, 2018; accepted May 02, 2018. Cardiovascular Diseases; Nuts; Seeds; Diet, High-Protein; Cholesterol; Anti-Oxidants; Anti- Inflammatory Agents. Keywords Abstract Cardiovascular diseases (CVD) are the main cause of death globally and most CVD can be prevented by addressing their risk factors, such as an unhealthy diet. Many authors have studied the benefits of nut consumption on CVD. Nuts contain high amounts of vegetable protein, unsaturated fatty acids, dietary fibers, vitamins, minerals and many other bioactive compounds, like phytosterols and phenolic compounds, which are able to reduce cholesterol levels and promote antioxidant and anti-inflammatory effects, thereby reducing cardiovascular risks. This review aims to describe studies involving the consumption of nuts, including Brazil nuts and CVD risk factors with positive results in the improvement of lipid profile, glucose metabolism, vascular function, and inflammatory and oxidative stress biomarkers. Introduction Cardiovascular diseases (CVD) are the main cause of death globally: more people die annually from CVD than from any other cause. 1 Multiple cardiovascular risk factors, including hyperlipidemia, hypertension, diabetes and smoking are associated with excessive production of reactive oxygen species and increased oxidative stress and inflammation, and promote vascular cell damage. Consequently, increased inflammation and oxidative stress is considered the major mechanism of the pathogenesis of endothelial dysfunction. 2 The use o f b i oac t i ve compounds such as monounsaturated and polyunsaturated fatty acids, phenolic compounds and some minerals to reduce CVD- related oxidative stress and inflammatory processes have been investigated. 3 Nuts are known to contain high lipid content, mostly mono- (MUFA) and polyunsaturated fatty acids (PUFA). Togetherwith others nutrients,MUFA and PUFA may promote plasma cholesterol reduction and exert an anti-oxidant and anti-inflammatory effect, thereby reducing cardiovascular risk factors. 3-5 Edible nuts include tree nuts (almonds, hazelnuts, walnuts, pistachios, pine nuts, cashews, pecans, macadamias, Brazil nuts) and peanuts. They have a similar nutrient composition, containing high amounts of vegetable protein, unsaturated fatty acids, dietary fibers, vitamins, minerals and bioactive compounds, like phytosterols and phenolic compounds. 6 Therefore, the present review aims to describe the effects of nut consumption, as a coadjutant therapy for prevention of cardiovascular diseases, with a special focus on Brazil nuts, considering the lack of studies on the direct effect of Brazil nuts on established cardiovascular risk factors. Methods A literature search was conducted using the PubMed/MEDLINE database for studies on the effects of nut consumption, including Brazil nuts, on CVD risk factors such as lipid profile, glucose metabolism, vascular function, inflammatory and oxidative stress biomarkers. The following MeSH terms were applied in the search: cardiovascular diseases/ brazil nuts/