IJCS | Volume 32, Nº2, May/June 2019

278 Table 3 - Nutritional composition of Brazil nuts in macronutrients, micronutrients and polyphenols (per 5 g) Nuts Energy (kcal) Protein (g) Fibre (g) Fat (g) SFA (g) MUFA (g) PUFA (g) Vitamin E (mg) Zinc (mg) Selenium (µg) Total polyphenols (mg) Brazil nuts 36,7 0,75 0,4 3,53 0,81 1,19 1,22 0,28 0,2 290,5 12,2 SFA: saturated fatty acids; MUFA: monounsaturated fatty acids; PUFA: polyunsaturated fatty acids Sources: Ros E., 3 Stockler-Pinto et al, 2010, 24 US Department of Agriculture Nutrient Data Base. 25 Silva et al. Nuts and cardiovascular diseases Int J Cardiovasc Sci. 2019;32(3)274-282 Review Article experimental period: during one period, participants consumed a walnut paste-enriched diet and a low-fat meat (LM) diet during the other. In the first group, there was a significant decrease of soluble vascular and intercellular cell adhesionmolecules (sVCAMand sICAM, respectively) and leukotriene B4 (LTB4) compare to the baseline and also compared to the LM diet, improving the proinflammatory status and endothelium damage. 19 A study evaluated the effects of hazelnut-enricheddiet on cardiovascular biomarkers in hypercholesterolemic subjects. The diets were applied to the same group and divided in three periods of four weeks each: control diet I, preconized by the National Cholesterol Education Program adult treatment panel (ATP) III step 2 diet (7% energy from SFA and 200 mg/dietary cholesterol), a hazelnut-enriched diet that corresponded to 18 to 20% of the dietary daily energy intake (49 to 86 g/day) and control diet II, that was equivalent to control diet I. The association of the hazelnut diet with measures of endothelial dysfunction assessed by the flow-mediated dilatation (FMD) technique, showed a significant improvement, besides a significant negative correlation with sVCAM-1 and the enriched hazelnut diet. Among the inflammatory biomarkers, C-reactive protein (CRP) and sVCAM-1 showed a significant reduction during the hazelnut diet. The authors demonstrated that the improvement on biochemical parameters and endothelial dysfunction after the consumption of a hazelnut-enriched diet nearly returned to basal levels after the control diet II, showing the importance of a regular consumption. 20 The recent publication in the Journal of the American College of Cardiology about nutrition trends for prevention and treatment of atherosclerotic cardiovascular diseases recommends the consumption of 30g/day of nuts, regarding portion control to avoid weight gain. 21 Among the nuts, it is worth mentioning the Brazil nuts, as being the largest of the commonly consumed nuts from the Brazil nut tree ( Bertholletia excelsa ), which is a native of South America. The Brazil nut tree was originally discovered growing in hard, well-drained soil along the Amazon River in countries such as Brazil, Peru, Colombia, Venezuela, and Ecuador. Recent studies have been conducted associating Brazil nuts withmany health bene ts, mainly including cholesterol-lowering effects, antioxidant activity, and antiproliferative effects. 22 Brazil nuts Brazil nuts are themain source of selenium, constituents of selenoproteins, such as glutathione peroxidase (GPx) that promote cardiovascular benefits because of their antioxidant properties (Figure 1). Brazil nuts are also a good source of unsaturated fatty acids, with a high content of MUFAs (~50%), proteins, fiber, magnesium, phosphorus, thiamin, niacin, vitamin E, vitamin B, calcium, iron, potassium, zinc and copper. 22,23 (Tables 3 24,25 and 4). Earlier studies involving the consumption of Brazil nuts and its effects on cardiovascular risk factors showed an improvement in antioxidant status and lipid biomarkers. 26,27 A randomized study conducted with 59 New Zealand adults, demonstrated a significant increase in plasma selenium and GPx activity in whole blood after the consumption of two Brazil nuts/day (corresponding to 53 µg of selenium) for 12 weeks, being as effective as the supplementation with 100 µg of selenium seleniomethionine. 26 A significant increase in plasma selenium was also seen in the study by Strunz et al., 27 with 15 normolipidemic subjects after the consumption of 45 g/day (about 11 units) of Brazil nuts for 15 days. Concerning lipid abnormalities, although the lipid plasma profile did not alter, it was observed an