title: Intake of partially defatted Brazil nut flour reduces serum cholesterol in hypercholesterolemic patients--a randomized controlled trial.
abstract: OBJECTIVE
  Thyroid hormones can lower levels of atherogenic lipoproteins, and selenium is important in thyroid hormone homeostasis. We aimed to investigate the effects of a healthy diet associated with the Brazil nut (Bertholletia excelsa) in dyslipidemic and hypertensive patients.
  
  
  METHODS
  This study was a randomized, placebo-controlled, double-blind trial. Seventy-seven dyslipidemic and hypertensive patients already receiving lipid-lowering drugs received either a dietary treatment associated with partially defatted Brazil nut flour (13 g/day providing 227,5 μg of selenium/day),or with dyed cassava flour as a placebo. All patients received a personalized dietary guideline with nutritional recommendations for dyslipidemia and hypertension and were followed for 90 days.
  
  
  RESULTS
  The Brazil nut group showed reductions in total cholesterol (-20.5 ± 61.2 mg/dL, P = 0.02), non HDL-cholesterol (-19.5 ± 61.2 mg/dL, P = 0.02) and Apo A-1 (-10.2 ± 26.7 mg/dL, P = 0.03) without significant alterations in the Apo B/Apo A-1 ratio. The placebo group showed a reduction in FT3 levels (-0.1 ± 0.4, P = 0.03) and increased Lp(a) levels (5.9 ± 18.0 mg/dL, P = 0.02). There were no statistical differences in blood pressure and serum lipids between Brazil nut and placebo group.
  
  
  CONCLUSIONS
  Supplementation with Brazil nuts seems to favor the maintenance of FT3 levels and contributes to lipemia reduction in hypercholesterolemic and euthyroid patients.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier NCT01990391.
authors.affiliation: Post Graduate Program, Federal Universityof Rio de Janeiro, Professor Rodolpho Paulo Rocco St, 225, Rio de Janeiro, Brazil. beta_franca_carvalho@yahoo.com.br.
authors.forename: Roberta F
authors.initials: RF
authors.lastname: Carvalho
authors.affiliation: Post Graduate Program, Federal Universityof Rio de Janeiro, Professor Rodolpho Paulo Rocco St, 225, Rio de Janeiro, Brazil. grazielle.huguenin@gmail.com.
authors.forename: Grazielle V B
authors.initials: GV
authors.lastname: Huguenin
authors.affiliation: Institute of Public Health Studies, Federal Universityof Rio de Janeiro, Jorge Machado Moreira Square, 100, Rio de Janeiro, Brazil. ronir@iesc.ufrj.br.
authors.forename: Ronir R
authors.initials: RR
authors.lastname: Luiz
authors.affiliation: ClinicofAtherosclerosisand Cardiovascular DiseasePrevention, National Cardiology Institute, Laranjeiras St, 374, Rio de Janeiro, Brazil. anniebello@gmail.com.
authors.forename: Annie S B
authors.initials: AS
authors.lastname: Moreira
authors.affiliation: Post Graduate Program, Federal Universityof Rio de Janeiro, Professor Rodolpho Paulo Rocco St, 225, Rio de Janeiro, Brazil. glauciamoraesoliveira@gmail.com.
authors.forename: Glaucia M M
authors.initials: GM
authors.lastname: Oliveira
authors.affiliation: Post Graduate Program, Federal Universityof Rio de Janeiro, Professor Rodolpho Paulo Rocco St, 225, Rio de Janeiro, Brazil. glorimar@nutricao.ufrj.br.|Nutrition and Dietetic Department, Josué de Castro Institute of Nutrition, Federal Universityof Rio de Janeiro, 373, 2nd floor, block J, Carlos Chagas FilhoAv, Ilha do Governador, 21941-902, Rio de Janeiro, Brazil. glorimar@nutricao.ufrj.br.
authors.forename: Glorimar
authors.initials: G
authors.lastname: Rosa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D031383:Bertholletia; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D004032:Diet; D004311:Double-Blind Method; D005247:Feeding Behavior; D005260:Female; D005433:Flour; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D008297:Male; D002365:Manihot; D008875:Middle Aged; D012643:Selenium / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D012643:Selenium