title: Effect of pistachio nut consumption on endothelial function and arterial stiffness.
abstract: OBJECTIVE
  Previous studies have demonstrated beneficial effects of regular consumption of pistachio nuts on glycemic, lipid, and oxidative stress parameters. The aim of this study was to determine its effect on vascular health, which has not been adequately studied so far.
  
  
  METHODS
  In this open label, randomized parallel-group study, 60 adults with mild dyslipidemia were randomized to lifestyle modification (LSM) alone or LSM with consumption of 80 g (in-shell) pistachios (equivalent to 40 g or 1.5 oz shelled pistachios) daily for 3 mo. Biochemical parameters, brachial artery flow-mediated vasodilation (BAFMD), and carotid-femoral and brachial-ankle pulse wave velocity (cfPWV and baPWV, respectively) were measured before and after the intervention.
  
  
  RESULTS
  At 3 mo, there was no change in any of the clinical or biochemical parameters in the LSM group. However, the patients in the pistachio group had a significant increase in high-density lipoprotein cholesterol (HDL-C; 35.7 ± 8.8 mg/dL versus 37.8 ± 10.1 mg/dL; P = 0.04) and a reduction in low-density lipoprotein cholesterol (137.2 ± 32.6 mg/dL versus 127.6 ± 34.0 mg/dL; P = 0.02), total cholesterol (TC)-to-HDL-C ratio (5.8 ± 1.3 mg/dL versus 5.3 ± 1.1 mg/dL; P = 0.001), and fasting blood sugar (88.8 ± 7.1 mg/dL versus 86.6 ± 6.3 mg/dL; P = 0.05). Additionally, whereas LSM alone was associated with no improvement in BAFMD or PWV, individuals in the pistachio group had significant reduction in left baPWV (1261.7 ± 187.5 cm/sec versus 1192.4 ± 152.5 cm/sec; P = 0.02) and statistically nonsignificant improvement in most other parameters, including BAFMD. As a result, at 3 mo the patients in the pistachio group had lower cfPWV (770.9 ± 96.5 cm/sec versus 846.4 ± 162.0 cm/sec; P = 0.08), lower left baPWV (1192.4 ± 152.5 cm/sec versus 1326.3 ± 253.7 cm/sec; P = 0.05), and lower average baPWV (1208.2 ± 118.4 cm/sec versus 1295.8 ± 194.1 cm/sec; P = 0.08) compared with the LSM group. Two-way analysis of variance revealed significant treatment effect of pistachio consumption on cfPWV, left baPWV, average baPWV, and BAFMD (P = 0.037, 0.01, 0.07, and 0.046, respectively).
  
  
  CONCLUSIONS
  The present study demonstrates that regular consumption of pistachio nuts not only improves glycemic and lipid parameters, but also results in improvements in vascular stiffness and endothelial function. Importantly, these improvements were seen in apparently healthy individuals and with a diet (including pistachios) and exercise regimen that every adult individual is expected to follow.
authors.affiliation: Department of Cardiology, Medanta-The Medicity, Gurgaon, India.
authors.forename: Ravi R
authors.initials: RR
authors.lastname: Kasliwal
authors.affiliation: Department of Cardiology, Medanta-The Medicity, Gurgaon, India. Electronic address: Manishaiims@hotmail.com.
authors.forename: Manish
authors.initials: M
authors.lastname: Bansal
authors.affiliation: Department of Cardiology, Medanta-The Medicity, Gurgaon, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Mehrotra
authors.affiliation: Department of Dietetics, Medanta-The Medicity, Gurgaon, India.
authors.forename: Kajal Pandya
authors.initials: KP
authors.lastname: Yeptho
authors.affiliation: Department of Cardiothoracic Surgery, Medanta-The Medicity, Gurgaon, India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index / Q000379:methods; D001783:Blood Flow Velocity / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology; D002339:Carotid Arteries / Q000187:drug effects / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005215:Fasting / Q000097:blood; D005260:Female; D005263:Femoral Artery / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008019:Life Style; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D027927:Pistacia; D063177:Pulse Wave Analysis / Q000379:methods; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*; D014664:Vasodilation / Q000187:drug effects* / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D002784:Cholesterol
keywords: Arterial stiffness; Augmentation index; Cardiovascular disease; Hypertension; Pulse wave velocity