• Assessment
    In adults, what is the relationship between a portfolio diet containing almonds and novel risk factors or markers of cardiovascular disease?
    • Conclusion

      Although the direct impact of almonds is not discernable, almonds as an isocaloric component of a portfolio diet (low in saturated fat, incorporating viscous fiber, soybean protein and plant sterols) appears to reduce some novel risk factors or markers of CVD. Two studies reported four-week compliance to a portfolio diet containing almonds significantly reduced the level of small LDL cholesterol particles; one study reported decrease in cholesterol content in the small LDL particle. Another study using this same vegan diet for one-year reported a slight, but statistically significant reduction in hemoglobin and hematocrit, an increase in platelet volume and an approximately 10% change in neutrophils and neutrophil-lymphocyte ratio. A portfolio diet containing almonds was found to be equally as effective as a first generation statin medication in reducing C-reactive protein (CRP) levels.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between a portfolio diet containing almonds and the risk of coronary heart disease in adults?
    • Conclusion

      No evidence exists to describe the relationship between a portfolio diet containing almonds and the risk of CHD.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between consuming almonds and cholesterol levels in patients with hyperlipidemia?
    • Conclusion

      Based on the results of five small studies, as an component of a low saturated fat diet, 2.5 to 3.5oz (70 to 100g) of almonds per day (isocalorically replaced) resulted in a reduction of approximately 4% to 11% in total cholesterol and 7% to 12% in LDL-cholesterol

      Two of the five studies showed a 1.7% to 3.5%  increase in HDL-cholesterol level with a consumption of approximately 2.5oz (70g) of almonds. One study showed a dose-dependent reduction in total cholesterol (6% vs. 3.4% reduction in total cholesterol and 9.4% vs. 4.4% change in LDL-cholesterol levels) following consumption of 2.5oz (70g) and 1.3oz (37g) almonds respectively.

      Further research is needed to verify these findings.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between a portfolio diet containing almonds and cholesterol levels in patients with normal cholesterol?
    • Conclusion

      No evidence exists to describe the relationship between a portfolio diet containing almonds and cholesterol levels in patients with normal cholesterol.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between consuming almonds and the risk of coronary heart disease in adults?
    • Conclusion

      No evidence exists to describe the relationship between consuming almonds and the risk of CHD.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Intervention
    In adults, what is the relationship between consuming almonds and novel risk factors or markers of cardiovascular disease?
    • Conclusion

      More research is needed on the effect of almonds, and other dietary factors on novel risk factors of CVD. In addition, the effect of novel risk factors on CVD morbidity and mortality needs further investigation.

      One small study (final N=27) with a high attrition rate (37%) found almonds when isocalorically incorporated in the diet, decreased two markers of oxidative stress, serum malondialdehyde and urinary isoprostane output.

       

       

       

       

       

       

       
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between a portfolio diet containing almonds and cholesterol levels in patients with hyperlipidemia?
    • Conclusion

      Seven studies assessed the effect of a portfolio diet incorporating almonds isocalorically on blood lipid levels in hyperlipidemic adults. Six studies assessed the efficacy of a portfolio diet provided by a metabolic kitchen for a four-week period and found it reduced LDL-cholesterol by approximately 30%. A self-selected portfolio diet followed for one-year produced a 12.8±2% LDL-cholesterol reduction. All studies were conducted by the same research laboratory and patients participated in multiple trials. The direct impact of almonds is not discernable.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between consuming almonds and cholesterol levels in patients with normal cholesterol levels?
    • Conclusion

      It is difficult to isolate the independent effect of almonds on serum lipid levels. Three small studies conducted in men and women on an experimental diet showed preliminary evidence that a diet high almond content (isocalorically replaced with 2.3  to 3 oz. or 66 to 84g) lowers total serum cholesterol 4 to 13% and LDL-cholesterol levels 6 to 15%. One neutral quality study found a therapeutic lifestyle change (TLC) diet incorporating isocaloric amounts of almonds and chocolate, had no effect on serum cholesterol levels.  

      Additional research is needed to a demonstrate the independent effect of almonds in people consuming a self-selected diet.

       

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.