IJCS | Volume 32, Nº2, May/June 2019

275 Table 1 - Nuts Picture Usual name Scientific name Brazil Nuts Bertholletia excelsa H.B.K. American almonds Pakistani almonds Prunus dulcis Pistachios Pistacia vera Walnuts Juglans regia Hazelnuts Corylus avellana Silva et al. Nuts and cardiovascular diseases Int J Cardiovasc Sci. 2019;32(3)274-282 Review Article coronary artery disease/atherosclerosis/nuts/oxidative stress/inflammation. Inclusion criteria for article selection were: full articles published in English; articles investigating the effects of the consumption of nuts on cardiovascular disease and risk factors; articles indexed in Pubmed/MEDLINE database in the last ten years. Nuts and cardiovascular disease Several studies have been conducted considering the beneficial association between nut consumption (Table 1) and CVD risk factors (Table 2). 3,7-16 Dose-response analysis of nut consumption and the risk of coronary artery disease (CAD) have been described, and a higher consumption of nuts was significantly associated with reduced risk of CAD when compared with a lower consumption. In fact, an increase in nut consumption by one serving per week significantly decreased the risk of CAD by 5%, and the protective effect was associated with a consumption of two servings/week. 7 A study that evaluated nut consumption and cardiovascular risk factors in the United States population, showed a mean usual intake of tree nuts of 44,3 ± 1,6 g/day. Nut consumption was significantly associated with beneficial effects in body mass index, waist circumference, blood pressure, insulin resistance, lower chance of obesity and overweight and increase in high-density lipoprotein cholesterol (HDL-c) levels. 8 The lipid profile inCADpatients and the consumption of almonds was assessed by Jamshed et al. 9 In their study, participants were divided in three groups: non-intervention, Pakistani almonds and American almonds. After the consumption of 10g/day of Pakistani or American almonds for 6 weeks, the authors observed an increase in HDL-c levels, and a decrease in triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), very low density lipoprotein (VLDL), total cholesterol (TC) to HDL-c and LDL to HDL-c ratios, and in the atherogenic index (calculated by the non-HDL/ HDL-c ratio) in comparison with non-consumers. There were no significant differences in the cardiovascular risk factors evaluated between the Pakistani almond consumers and the American almond consumers. The authors concluded that consumption of almonds can improve lipid profile and could be used as an adjuvant in the treatment of dyslipidemias. 9 Kasliwal et al., 10 evaluated the effects of daily supplementation of 80 g of pistachios in shell, roasted and salted for three months and observed a significant increase in HDL-c and decrease in LDL-c, TC/HDL-c ratio and fasting blood glucose. Vascular function was also evaluated bymeasurement of the brachial artery flow- mediatedvasodilatation (BAFMD), andcarotid femoral and brachial-ankle pulse wave velocity (cfPWV and baPWV, respectively).After supplementation, therewas a significant reduction in left baPWV. These results demonstrated the positive effect of pistachios on the lipid profile and the vascular function in dyslipidemic adult patients. 10 Sauder et al., 11 evaluated the effects of 59 g – 128 g of pistachios on lipid profile, glycemic control, inflammation and endothelial function in type-2 diabetes patients. After four weeks the authors observed that TC, TC/HDL-c ratio and TG, as well as fructosamine levels were significantly reduced. 11 Damasceno et al., 12 evaluated three types of diets in hypercholesterolemic subjects - a diet enriched with virgin olive oil (35 to 50 g daily), almonds (50 to 75 g daily) or walnuts (40 to 65 g daily) for four weeks. The amounts of each nutrient were calculated according to total energy intake. Among the three diets, almond-enriched diet