Walnut consumption in a weight reduction intervention: effects on body weight, biological measures, blood pressure and satiety

Cheryl L Rock, Shirley W Flatt, Hava-Shoshana Barkai, Bilge Pakiz, Dennis D Heath, Cheryl L Rock, Shirley W Flatt, Hava-Shoshana Barkai, Bilge Pakiz, Dennis D Heath

Abstract

Background: Dietary strategies that help patients adhere to a weight reduction diet may increase the likelihood of weight loss maintenance and improved long-term health outcomes. Regular nut consumption has been associated with better weight management and less adiposity. The objective of this study was to compare the effects of a walnut-enriched reduced-energy diet to a standard reduced-energy-density diet on weight, cardiovascular disease risk factors, and satiety.

Methods: Overweight and obese men and women (n = 100) were randomly assigned to a standard reduced-energy-density diet or a walnut-enriched (15% of energy) reduced-energy diet in the context of a behavioral weight loss intervention. Measurements were obtained at baseline and 3- and 6-month clinic visits. Participants rated hunger, fullness and anticipated prospective consumption at 3 time points during the intervention. Body measurements, blood pressure, physical activity, lipids, tocopherols and fatty acids were analyzed using repeated measures mixed models.

Results: Both study groups reduced body weight, body mass index and waist circumference (time effect p < 0.001 for each). Change in weight was -9.4 (0.9)% vs. -8.9 (0.7)% (mean [SE]), for the standard vs. walnut-enriched diet groups, respectively. Systolic blood pressure decreased in both groups at 3 months, but only the walnut-enriched diet group maintained a lower systolic blood pressure at 6 months. The walnut-enriched diet group, but not the standard reduced-energy-density diet group, reduced total cholesterol and low-density lipoprotein cholesterol (LDL-C) at 6 months, from 203 to 194 mg/dL and 121 to 112 mg/dL, respectively (p < 0.05). Self-reported satiety was similar in the groups.

Conclusions: These findings provide further evidence that a walnut-enriched reduced-energy diet can promote weight loss that is comparable to a standard reduced-energy-density diet in the context of a behavioral weight loss intervention. Although weight loss in response to both dietary strategies was associated with improvements in cardiovascular disease risk factors, the walnut-enriched diet promoted more favorable effects on LDL-C and systolic blood pressure.

Trial registration: The trial is registered at ( NCT02501889 ).

Keywords: Blood pressure; Cardiovascular disease risk factors; Nuts; Satiety; Weight loss.

Conflict of interest statement

Ethics approval and consent to participate

The UCSD institutional review board approved the study protocol (#151015), and all participants provided written informed consent. Prior to recruitment and operationalizing the study, the trial was registered at http://www.clinicaltrials.gov (NCT02501889).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart for study participants

References

    1. Jensen MD, Ryan DH, Apovian CM, et al. Guidelines (2013) for managing overweight and obesity in adults. Obesity. 2014;22:i–xvi. doi: 10.1002/oby.20778.
    1. Fleming JA, Kris-Etherton PM. Macronutrient content of the diet: what do we know about energy balance and weight maintenance? Curr Obes Rep. 2016;5:208–213. doi: 10.1007/s13679-016-0209-8.
    1. Delzenne N, Blundell J, Brouns F, et al. Gastrointestinal targets of appetite regulation in humans. Obes Rev. 2010;11:234–250. doi: 10.1111/j.1467-789X.2009.00707.x.
    1. Mattes RD, Kris-Etherton PM, Foster GD. Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. J Nutr. 2008;138:1741S–1745S.
    1. Mattes RD, Dreher ML. Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr. 2010;19:137–141.
    1. Natoli S, McCoy P. A review of the evidence: nuts and body weight. Asia Pac J Clin Nutr. 2007;16:588–597.
    1. Bes-Rastrollo M, Wedick NM, Martinez-Gonzalez MA, et al. Prospective study of nut consumption, long-term weight change, and obesity risk in women. Am J Clin Nutr. 2009;89:1913–1919. doi: 10.3945/ajcn.2008.27276.
    1. Babio N, Toledo E, Estruch R, et al. Mediterranean diets and metabolic syndrome status in the PREDIMED randomized trial. CMAJ. 2014;186:E649–E657. doi: 10.1503/cmaj.140764.
    1. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–241. doi: 10.1056/NEJMoa0708681.
    1. Austel A, Ranke C, Wagner N, et al. Weight loss with a modified Mediterranean-type diet using fat modification: a randomized controlled trial. Eur J Clin Nutr. 2015;69:878–884. doi: 10.1038/ejcn.2015.11.
    1. Freisling H, Noh H, Slimani N, et al. Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study. Eur J Nutr. 2017; doi: 10.1007/s00394-017-1513-0.
    1. Wien MA, Sabate JM, Ikle DN, et al. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord. 2003;27:1365–1372. doi: 10.1038/sj.ijo.0802411.
    1. Pelkman CL, Fishell VK, Maddox DH, et al. Effects of moderate-fat (from monounsaturated fat) and low-fat weight-loss diets on the serum lipid profile in overweight and obese men and women. Am J Clin Nutr. 2004;79:204–212.
    1. Li Z, Song R, Nguyen C, et al. Pistachio nuts reduce triglycerides and body weight by comparison to refined carbohydrate snack in obese subjects on a 12-week weight loss program. J Am Coll Nutr. 2010;29:198–203. doi: 10.1080/07315724.2010.10719834.
    1. Foster GD, Shantz KL, Vander Veur SS, et al. A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity. Am J Clin Nutr. 2012;96:249–254. doi: 10.3945/ajcn.112.037895.
    1. Abazarfard Z, Salehi M, Keshavarzi S. The effect of almonds on anthropometric measurements and lipid profile in overweight and obese females in a weight reduction program: a randomized controlled clinical trial. J Res Med Sci. 2014;19:457–464.
    1. Neale EP, Tapsell LC, Martin A, et al. Impact of providing walnut samples in a lifestyle intervention for weight loss: a secondary analysis of the HealthTrack trial. Food Nutr Res. 2017;61 doi: 10.1080/16546628.2017.1344522.
    1. Rock CL, Flatt SW, Pakiz B, et al. Effects of diet composition on weight loss, metabolic factors and biomarkers in a 1-year weight loss intervention in obese women examined by baseline insulin resistance status. Metabolism. 2016;65:1605–1613. doi: 10.1016/j.metabol.2016.07.008.
    1. Brennan AM, Sweeney LL, Liu X, Mantzoros CS. Walnut consumption increases satiation but has no effect on insulin resistance or the metabolic profile over a 4-day period. Obesity. 2010;18:1176–1182. doi: 10.1038/oby.2009.409.
    1. Rock CL, Flatt SW, Barkai HS, et al. A walnut-containing meal had similar effects on early satiety, CCK, and PYY, but attenuated the postprandial GLP-1 and insulin response compared to a nut-free control meal. Appetite. 2017;117:51–57. doi: 10.1016/j.appet.2017.06.008.
    1. Rolls BJ. The relationship between dietary energy density and energy intake. Physiol Behav. 2009;97:609–615. doi: 10.1016/j.physbeh.2009.03.011.
    1. Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381. doi: 10.1016/j.jbi.2008.08.010.
    1. McArdle WD, Katch FI, Katch VL. Exercise physiology: energy, nutrition, and human performance. 6. Philadelphia: Lippincott Williams & Wilkins; 2007.
    1. Milne HM, Wallman KE, Gordon S, et al. Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat. 2008;108:279–288. doi: 10.1007/s10549-007-9602-z.
    1. US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. . Accessed 19 Sept 2017.
    1. Gibbons C, Finlayson G, Dalton M, et al. Metabolic Phenotyping guidelines: studying eating behaviour in humans. J Endocrinol. 2014;222:G1–12. doi: 10.1530/JOE-14-0020.
    1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.
    1. Le T, Flatt SW, Natarajan L, et al. Effects of diet composition and insulin resistance status on plasma lipid levels in a weight loss intervention in women. J Am Heart Assoc. 2016;5 doi: 10.1161/JAHA.115.0002771.
    1. Del Gobbo LC, Falk MC, Feldman R, et al. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015;102:1347–1356. doi: 10.3945/ajcn.115.110965.
    1. Sabate J, Oak K, Ros E. Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med. 2010;10:821–827. doi: 10.1001/archinternmed.2010.79.
    1. Mohammadifard N, Salehi-Abargouei A, Salas-Salvado J, et al. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr. 2015;101:966–982. doi: 10.3945/ajcn.114.091595.
    1. US Department of Agriculture, ARS Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 28, 2016. . Accessed 19 Sept 2017.
    1. Ros E, Nunez I, Perez-Heras A, et al. A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation. 2004;109:1609–1614. doi: 10.1161/01.CIR.0000124477.91474.FF.
    1. Haddad EH, Gaban-Chong N, Oda K, et al. Effect of a walnut meal on postprandial oxidative stress and antioxidants in healthy individuals. Nutr J. 2014;13:4. doi: 10.1186/1475-2891-13-4.
    1. Donnan MSHD, Flatt SW, Pakiz B, Quintana EL, Rana BK, Natarajan L, Rock CL. Factors associated with tocopherol status in obese women: effects of diet composition and weight loss. Vitam Miner. 2016;5:3.
    1. Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–1290. doi: 10.1056/NEJMoa1200303.
    1. Li Y, Hruby A, Bernstein AM, Ley SH, Wang DD, Chiuve SE, et al. Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease. J Am Coll Cardiol. 2015;66:1538–1548. doi: 10.1016/j.jacc.2015.07.055.
    1. Siri-Tarino Chiu S, Bergeron N, Krauss RM. Saturated fats versus polyunsaturated fats versus carbohydrates for cardiovascular disease prevention and treatment. Annu Rev Nutr. 2015;35:517–543. doi: 10.1146/annurev-nutr-071714-034449.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa