title: Influence of body mass index and serum lipids on the cholesterol-lowering effects of almonds in free-living individuals.
abstract: OBJECTIVE
  Short-term (4-9 weeks) human feeding trials have shown nut consumption to reduce serum total cholesterol (TC) and LDL-cholesterol (LDL). We hypothesized that individual levels of BMI, LDL, TC and triglycerides modify the cholesterol-lowering effect of almonds in a 24-week almond supplementation trial in a free-living population.
  
  
  RESULTS
  We performed secondary analysis on data from a previously published study. Using a sequential study design, all participants followed their habitual diets during the first six months (control), and then consumed an almond-supplemented diet (habitual + almonds) for another six months. 100 adults enrolled; 19 were lost to attrition. Those who completed the study were men (n = 43) and women (n = 38) with mean (SD) age 49.4 (13.6) years. During almond supplementation, we found statistically significant changes in TC (-0.22 mmol/L), LDL (-0.22 mmol/L), TC:HDL (-0.35), and LDL:HDL (-0.28) in participants with baseline LDL levels ≥ 3.30 mmol/L, but not among normocholesterolemic individuals. Direction and magnitude of change were similar among individuals with TC ≥ 5.20 mmol/L but not in the lower strata. Tests of interaction (diet × TC and diet × LDL) were significant. Reductions in the ratios TC:HDL, and LDL:HDL were significant among those with BMI < 25 kg/m(2), but not in heavier individuals; however, formal tests of interaction did not reach significance.
  
  
  CONCLUSIONS
  We provide strong evidence that the cholesterol-lowering effect of almonds is responsive among hypercholesterolemic individuals, and weak evidence that BMI modifies the effect of almonds on serum lipids.
authors.affiliation: Department of Nutrition, School of Public Health, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA 92350, USA. kjaceldo@llu.edu
authors.forename: K
authors.initials: K
authors.lastname: Jaceldo-Siegl
authors.forename: J
authors.initials: J
authors.lastname: Sabaté
authors.forename: M
authors.initials: M
authors.lastname: Batech
authors.forename: G E
authors.initials: GE
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001823:Body Composition; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts; D027861:Prunus; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides