Abstract
Almond consumption may be associated with improvements in serum lipid profiles. The
aim was to evaluate the influence of almonds on lipid parameters to help define the
role of almonds as a lipid modulator. MEDLINE, EMBASE, Cochrane CENTRAL, and the Natural
Medicines Comprehensive Database were searched through July 2008, with no language
restrictions, for randomized controlled trials of almonds in human patients that reported
efficacy data on at least one of the following endpoints: total, low-density lipoprotein
(LDL), or high-density lipoprotein (HDL) cholesterol, triglycerides, or the LDL:HDL
ratio. A manual search of references from primary or review articles was performed
to identify additional relevant trials. Five randomized, controlled trials (totaling
142 participants) met all inclusion criteria. Upon meta-analysis, almond consumption
ranging from 25 to 168 g/day significantly lowered total cholesterol [weighted mean
difference –6.95 mg/dL (95% confidence interval [CI] −13.12 to −0.772) (−0.18 mmol/L
[95% CI −0.34 to −0.02])] and showed a strong trend toward reducing LDL cholesterol
[weighted mean difference –5.79 mg/dL (95% CI –11.2 to 0.00) (–0.15 mmol/L [95% CI
–0.29 to 0.00])]. No significant effect on HDL cholesterol, triglycerides, or LDL:HDL
ratio was found. No statistical heterogeneity was observed for any analysis (I2=0% for all). Review of funnel plots and the Egger's weighted regression statistic
P values suggested a low likelihood of publication bias in all analyses (P>0.25 for all). Almond consumption may decrease total cholesterol and does not significantly
affect LDL or HDL cholesterol, triglycerides, or the LDL:HDL ratio. The current body
of randomized trials does not support the ingestion of almonds solely for their lipid
modifying effects. Both the lipid modulating effects and the safety/tolerability of
almonds should be further investigated through the conduction of larger randomized,
double-blinded trials of longer duration. Such studies might focus specifically on
whether the efficacy of almonds as a lipid modulator varies by dose or comorbidity.
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Biography
O. J. Phung is an outcomes research fellow, University of Connecticut/Hartford Hospital Evidence-Based Practice Center, Hartford
Biography
S. S. Makanji is a PharmD candidate, University of Connecticut School of Pharmacy, Storrs
Biography
C. M. White is a professor of pharmacy practice, University of Connecticut School of Pharmacy, Storrs, and director, University of Connecticut/Hartford Hospital Evidence-Based Practice Center, Hartford
Biography
C. I. Coleman is an assistant professor of pharmacy practice, University of Connecticut School of Pharmacy, Storrs, and methods chief and program director, University of Connecticut/Hartford Hospital Evidence-Based Practice Center, Hartford
Article info
Publication history
Accepted:
November 18,
2008
Footnotes
Meets Learning Need Codes 2000, 4000, 5000, and 9000. To take the Continuing Professional Education quiz for this article, log in to ADA's Online Business Center at www.eatright.org/obc, click the “Journal Article Quiz” button, click “Additional Journal CPE Articles,” and select this article's title from a list of available quizzes.
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© 2009 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
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- Authors' ResponseJournal of the American Dietetic AssociationVol. 109Issue 9
- Almonds Lower LDL CholesterolJournal of the American Dietetic AssociationVol. 109Issue 9
- PreviewPhung and colleagues (1) reported the results of a meta-analysis of five controlled studies (with 142 participants; almond consumption was 25 to 168 g/day) designed to evaluate effects of almonds on lipids and lipoproteins. They concluded that almond consumption significantly lowered total cholesterol “[weighted mean difference 6.95 mg/dL (95% confidence interval [CI] 13.12 to −0.772) (−0.18 mmol/L [95% CI 0.34 to −0.02])] and showed a strong trend toward reducing LDL [low-density lipoprotein] cholesterol [weighted mean difference −5.79 mg/dL (95% CI −11.2 to 0.00) (−0.15 mmol/L [95% CI −0.29 to 0.00])].
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