NUTRITION
 

                 Almonds as effective as statins

            Eating nuts daily can lower LDL levels up to 9.4%

                 By Kylie Taggart

                 TORONTO – A handful of almonds helps lower serum cholesterol levels by
                 about 4%, a new study suggests.
                    Four per cent may not seem like much, but when combined with other
                 healthy foods, the nuts could help lower cholesterol to the same extent as statin
                 medications, said Dr. David Jenkins, lead investigator of the study and director
                 of the clinical nutrition and risk factor modification centre at St. Michael's
                 Hospital in Toronto.
                    In order to determine the cholesterol-lowering properties of almonds, Dr.
                 Jenkins and colleagues studied 27 men and women with high cholesterol.
                    Each person was randomly rotated through three low-fat, one-month long
                 diets which included either a snack of whole wheat muffins, 37 g of almonds
                 (about a handful) or 74 g of almonds. Each person had the caloric content of
                 the snacks tailored for their individual energy needs. The muffins had the
                 equivalent amount of calories, protein, saturated fat and polyunsaturated fat as
                 the almonds. The starch in the muffins was replaced with the monounsaturated
                 fat from the nuts in the almond diets.
                    There were significant reductions in low-density lipoprotein (LDL)
                 cholesterol levels from baseline following the almond diets, but not with the
                 muffin diet. The full dose almond diet reduced LDL cholesterol levels from
                 baseline by an average of 9.4%, and the half-dose almond diet reduced LDL
                 cholesterol by 4.4%.
                    "So that was our surprise, to see there was, in fact, a dose response and
                 benefits which could not be accounted for simply by the difference in saturated
                 fat and starch between the two treatments," Dr. Jenkins said.
                    The almond diet also brought about improvements in apolipoprotein B, Lp(a)
                 levels, the total cholesterol-HDL cholesterol ratio and HDL cholesterol levels.
                    Two of the subjects taking statin medications responded similarly to the rest
                 of the group.
                    With these levels of LDL cholesterol reductions, cardiovascular disease risk
                 would be cut by about 20% for the whole almond diet and 18% with the half
                 dose almond diet, Dr. Jenkins said.
                    If nuts are eaten as part of a healthy diet which includes other
                 cholesterol-lowering foods, LDL cholesterol could be reduced by as much as
                 25%, Dr. Jenkins said. Other cholesterol-lowering foods include soy products,
                 plant sterols and grains such as oat, oat bran, psyllium and barley.
                    "You're getting toward what one must get with drug therapy," he said.
                    Nuts have not always been recommended in the diets of people with chronic
                 diseases like heart disease because of their high calorie content. However,
                 participants in this study did not gain weight.
                    "We found if people substitute almonds sensibly in the diet, and they're aware
                 that they're foods, they're not prone to any significant change in weight," Dr.
                 Jenkins said.
                    Physicians should remind patients not to eat oiled or highly salted or sugared
                 nuts, he said. The best choices are dry-roasted and lightly salted nuts.
                    Previous studies have shown other types of nuts also possess
                 cholesterol-lowering properties.
                    There are data on walnuts, hazelnuts, pistachios and peanuts (which is really
                 a legume, not a nut) showing beneficial effect on blood lipids.
                    "Some of these people find the low-fat diets hard to take, so to add extra
                 horsepower I think (eating nuts) is a good approach," said Dr. Peter Jones,
                 professor in the school of dietetics and human nutrition at McGill University in
                 Montreal. Dr. Jones was asked to comment on the study by the Medical Post.
                    Dr. Jones pointed out nuts are a main component of the vegetarian diet. The
                 vegetarian diet has beaten all other diets in its ability to lower the risk of
                 cardiovascular disease, Dr. Jones said.
                    Both Dr. Jenkins and Dr. Jones said they would recommend nuts to their
                 patients as a way to lower cholesterol, especially for people who did not want
                 to go on lipid-lowering medications such as statins.
                    "Obviously statins have shown themselves to be very beneficial and no one is
                 denying their use. All I'm saying is unless we want to have a larger part of the
                 middle-aged population on a statin we'd better do better with diet," Dr. Jenkins
                 said.
                    He and colleagues are currently testing what is called the "portfolio diet"
                 which is a combination of cholesterol lowering foods. They are presently
                 recruiting patients for a trial which compares the portfolio diet with statin
                 medication.
                    Dr. Jenkins's current study was published in a recent issue of Circulation.