title: Effect of almond consumption on vascular function in patients with coronary artery disease: a randomized, controlled, cross-over trial.
abstract: OBJECTIVE
  Almonds reduce cardiovascular disease risk via cholesterol reduction, anti-inflammation, glucoregulation, and antioxidation. The objective of this randomized, controlled, cross-over trial was to determine whether the addition of 85 g almonds daily to a National Cholesterol Education Program (NCEP) Step 1 diet (ALM) for 6 weeks would improve vascular function and inflammation in patients with coronary artery disease (CAD).
  
  
  METHODS
  A randomized, controlled, crossover trial was conducted in Boston, MA to test whether as compared to a control NCEP Step 1 diet absent nuts (CON), incorporation of almonds (85 g/day) into the CON diet (ALM) would improve vascular function and inflammation. The study duration was 22 weeks including a 6-weeks run-in period, two 6-weeks intervention phases, and a 4-weeks washout period between the intervention phases. A total of 45 CAD patients (27 F/18 M, 45-77 y, BMI = 20-41 kg/m(2)) completed the study. Drug therapies used by patients were stable throughout the duration of the trial.
  
  
  RESULTS
  The addition of almonds to the CON diet increased plasma α-tocopherol status by a mean of 5.8%, reflecting patient compliance (P ≤0.05). However, the ALM diet did not alter vascular function assessed by measures of flow-mediated dilation, peripheral arterial tonometry, and pulse wave velocity. Further, the ALM diet did not significantly modify the serum lipid profile, blood pressure, C-reactive protein, tumor necrosis factor-α or E-selectin. The ALM diet tended to decrease vascular cell adhesion molecule-1 by 5.3% (P = 0.064) and increase urinary nitric oxide by 17.5% (P = 0.112). The ALM intervention improved the overall quality of the diet by increasing calcium, magnesium, choline, and fiber intakes above the Estimated Average Requirement (EAR) or Recommended Dietary Allowance (RDA).
  
  
  CONCLUSIONS
  Thus, the addition of almonds to a NECP Step 1 diet did not significantly impact vascular function, lipid profile or systematic inflammation in CAD patients receiving good medical care and polypharmacy therapies but did improve diet quality without any untoward effect.
  
  
  BACKGROUND
  The trial was registered with the ClinicalTrials.Gov with the identifier: NCT00782015.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. oliver.chen@tufts.edu.|Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, 02111, USA. oliver.chen@tufts.edu.
authors.forename: C-Y Oliver
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA. moholbro@bu.edu.
authors.forename: Monika
authors.initials: M
authors.lastname: Holbrook
authors.affiliation: Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA. mduess@bu.edu.
authors.forename: Mai-Ann
authors.initials: MA
authors.lastname: Duess
authors.affiliation: Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA. mustali.dohadwala@gmail.com.
authors.forename: Mustali M
authors.initials: MM
authors.lastname: Dohadwala
authors.affiliation: Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA. nhamburg@bu.edu.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. bela.asztalos@tufts.edu.
authors.forename: Bela F
authors.initials: BF
authors.lastname: Asztalos
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. pual.milbury@tufts.edu.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Milbury
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. jeffrey.blumberg@tufts.edu.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Blumberg
authors.affiliation: Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001900:Boston; D002097:C-Reactive Protein; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000178:diet therapy*; D018592:Cross-Over Studies; D019040:E-Selectin / Q000097:blood; D002149:Energy Intake; D005260:Female; D063427:Food Quality; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000652:urine; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D000068181:Prunus dulcis; D063177:Pulse Wave Analysis; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D055815:Young Adult; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019040:E-Selectin; C508600:IL6 protein, human; D015850:Interleukin-6; C546936:SELE protein, human; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D009569:Nitric Oxide; D002097:C-Reactive Protein; D024502:alpha-Tocopherol