Dyslipidemia Clinical Trial
Official title:
Effects of Almond Intake on Atherogenic Lipoprotein Particles in Individuals With Increased Abdominal Adiposity
Increased abdominal adiposity is a key feature of metabolic syndrome, which describes a
cluster of cardiovascular disease (CVD) risk factors that also includes insulin resistance,
high blood pressure and an atherogenic lipoprotein phenotype characterized by increased
plasma triglycerides, low HDL-C, and increased levels of small LDL particles. While lifestyle
intervention remains the cornerstone for managing obesity and metabolic syndrome, the optimal
dietary macronutrient distribution for improving blood lipids and CVD risk remains a topic of
controversy. While both low carbohydrate diets and weight reduction are effective for
managing atherogenic dyslipidemia, long-term compliance is low, and it becomes imperative to
identify alternative dietary approaches.
Increased consumption of almonds has been shown to lower LDL-C, an effect that exceeds that
predicted from changes in fatty acid intake. However, although LDL-C lowering by almonds has
been demonstrated in patients with diabetes, there have been no trials in non-diabetic
patients with abdominal obesity. Moreover, there is limited information of the effects of
almond intake on LDL particle subclasses.
The overall objective of the present study is to determine whether lipoprotein measures of
CVD risk in individuals with increased abdominal adiposity are reduced by almond
supplementation in a diet with overall macronutrient content that conforms to current
guidelines. Our main hypothesis is that in these individuals, almond consumption can reduce
levels of small and medium LDL particles without the need to restrict dietary carbohydrates
to levels below those currently recommended.
This hypothesis will be tested by comparing the lipoprotein effects of an almond-supplemented
diet (20%E) with those of two reference diets that do not contain almond products: one with
similar content of carbohydrate, protein, and fat (standard reference), and the other in
which carbohydrate content is reduced by substitution of protein and monounsaturated fat
(low-carbohydrate reference).
We will provide the diets for 3 weeks each in a randomized 3-period crossover design to 40
individuals with increased abdominal adiposity. We will test whether the almond supplemented
diet will result in lower levels of lipoprotein measures of CVD risk, specifically LDL-C and
small and medium LDL particles, compared to either the standard or low-carbohydrate reference
diets.
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