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The regular consumption of almonds or dark chocolate and cocoa has favorable effects on biomarkers of coronary heart disease, but the effect of their combined intake is not yet known.
North American researchers conducted a randomized controlled crossover trial, to evaluate the individual and combined effects of almonds, dark chocolate and cocoa consumption on coronary heart disease risk markers.
The investigators studied 31 adults (13 female; mean age 46.3 years), overweight or obese (mean BMI 29.6 kg/m2) with elevated total cholesterol (TC: 210.0 mg/dL) and LDL cholesterol (138.3 mg/dL) but who were otherwise healthy. They evaluated lipid, lipoprotein, and apolipoprotein concentrations, vascular health, and oxidative stress.
The participants consumed all 4 isocaloric diets, randomly, in periods of 4 weeks each, followed by a 2-week washout interval between them.
The studied diets were:
The diets were similar, except for the presence or absence of these treatment foods, which accounted for the major differences in the nutrient profile.
Compared with the average American diet, the almond diet reduced TC, non–HDL-Cholesterol, and LDL-Cholesterol by 4%, 5%, and 7%, respectively (P<0.05).
The combined chocolate and almond diet reduced apolipoprotein B by 5% compared with the average American diet.
For LDL subclasses, relative to the average American diet, the almond diet was associated to a greater reduction in large LDL-free particles (-5.7 vs. -0.3 mg/dL; P=0.04), while with the combined chocolate and almond diet there was a greater decrease in small dense LDL particles (-12.0 vs -5.3 mg/dL; P=0.04). However, there were no significant differences between diets for vascular health biomarkers and oxidative stress.
Therefore, the consumption of nearly one-third cup of almonds a day – either alone or combined with almost one-quarter cup of dark chocolate and a little more than 2 tablespoons of cocoa a day – improved lipid / lipoprotein profiles, when compared with the average American diet without almonds and chocolate.
Lee Y, Berryman CE, West SG, Chen CO, Blumberg JB, Lapsley KG, Preston AG, Fleming JA, Kris-Etherton PM. Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial. J Am Heart Assoc. 2017 Nov 29;6(12).
To evaluate the association of long-term gluten ingestion with the development of coronary heart disease, a cohort of 64,714 women and 45,303 men from the Health Professionals Follow-up Study were prospectively studied. They did not have a history of coronary disease, and completed a semi-quantitative food frequency questionnaire of 131 items in 1986, updated every four years until 2010.
During 26 years of follow-up covering 2,273,931 people per year, coronary heart disease developed in 2,431 women and 4,098 men. Fatal myocardial infarction occurred in 2,286 participants (540 women and 1,746 men) and non-fatal myocardial infarction in 4,243 participants (1,891 women and 2,352 men).
Among the individuals eligible for analysis (64,714 women and 45,303 men), the daily average intake of gluten ranged from 2.6 - 7.5 g for women and 3.3 - 10.0 g for men.
Intake of gluten correlated inversely with alcohol intake, smoking, total fat intake and ingestion of unprocessed red meat. Gluten intake was positively correlated with intake of whole and refined grain intake.
Participants who had an average intake of 2.6 to 3.3 g of gluten had a coronary heart disease incidence rate of 352 per 100,000 people, and those with a mean gluten intake of 7.5 to 10g had a lower rate of 277 events per 100,000 people. There was a difference of 75/100.000 fewer cases of coronary heart disease in those who had higher gluten intake.
The authors conclude that long-term dietary intake of gluten was not associated with the risk of coronary heart disease. However, the exclusion of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. The promotion of gluten-free diets among people without celiac disease should not be encouraged.
Benjamin Lebwohl, Yin Cao, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, Andrew T Cha. Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. BMJ 2017;357:j1892