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Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 80073

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Prof. Dr. Jordi Salas-Salvadó

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Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, University Hospital Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
Interests: nutritional epidemiology; clinical trials; obesity; diet and diabetes; effect of food and their components on health and disease; dietary patterns; diet and cardiovascular disease

Prof. Dr. Emilio Ros

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Guest Editor

1. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
2. Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain
Interests: nutrition in the prevention of cardiovascular diseases and cognitive decline with special interest in the Mediterranean diet and walnuts; plant sterols; blood membrane fatty acids; genetic dyslipidemias; cardiovascular risk assessment; and vascular imaging techniques, especially carotid ultrasound
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Prof. Dr. Joan Sabaté

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School of Public Health, Center for Nutrition, Lifestyle, and Disease Prevention, Loma Linda University, Loma Linda, CA, USA
Interests: health effects of plant foods; nuts and cognition; dietary assessment tools and methods; environmental nutrition and sustainable diets; plant-based dietary food patterns and health outcomes

Dr. Stephanie K. Nishi

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Guest Editor

1. Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain
2. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
3. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
4. Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
5. Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Unity Health Toronto, ON, Canada

Special Issue Information

Dear Colleagues,

NUTS2022 (https://nuts2022.com/) is an international scientific meeting that will take place in Reus (Spain) on 20–21 October 2022. We want to take advantage of the high quality of the Nutrients journal in order to publish the proceedings from this important meeting that will gather different worldwide experts in the nut/dried fruits–disease axis. We plan on publishing at least 10 manuscripts following these key topics: (1) nuts, energy balance, and body weight; (2) nuts, insulin resistance, and diabetes; (3) nuts, lipoproteins, and dyslipidemia; (4) nuts and the gastrointestinal system; (5) nuts, inflammation, and oxidation; (6) nuts and cardiovascular disease outcomes; (7) nut consumption, aging, and cognition; (8) nuts and cancer; (9) dried fruit and health; and (10) future lines of research.

Prof. Dr. Jordi Salas-Salvadó
Prof. Dr. Emilio Ros
Prof. Dr. Joan Sabaté
Dr. Stephanie K. Nishi
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

nuts
dried fruits
research
clinical trial
epidemiological
body weight
inflammation
oxidation
cardiovascular disease
insulin resistance
diabetes
dyslipidemia
aging
cancer
future

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Published Papers (11 papers)

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Editorial

Jump to: Research, Review

3 pages, 207 KiB

Open AccessEditorial

Where We Are and Where We Are Going in Nut Research

by Jordi Salas-Salvadó, Stephanie K. Nishi, Joan Sabaté and Emilio Ros

Nutrients 2023, 15(7), 1691; https://doi.org/10.3390/nu15071691 - 30 Mar 2023

Viewed by 1819

Abstract

Nuts have been part of the human diet for thousands of years [...] Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

Research

Jump to: Editorial, Review

16 pages, 792 KiB

Open AccessArticle

Effect of Nuts on Gastrointestinal Health

by Giuseppina Mandalari, Teresa Gervasi, Daniel W. Rosenberg, Karen G. Lapsley and David J. Baer

Nutrients 2023, 15(7), 1733; https://doi.org/10.3390/nu15071733 - 1 Apr 2023

Cited by 5 | Viewed by 5646

Abstract

Nuts are high nutrient-dense foods containing healthy lipids, dietary fiber, and bioactive phytochemicals, including vitamins and minerals. Although the beneficial effect of nut consumption on different chronic diseases has been well documented, especially in relation to their cardiometabolic benefits, less scientific evidence is available on their possible beneficial effects on gastrointestinal health. In this narrative review, we summarize the most important findings and new research perspectives in relation to the importance of nut consumption on gastrointestinal health. The integrity of the cell wall structure, cell size and particle size after mastication are known to play a crucial role in energy, nutrient and bioactive release from nuts during digestion, therefore affecting bioaccessibility. Other mechanisms, such as cell wall composition, thickness and porosity, as well as stability of the membranes surrounding the oil bodies within the cell, are also important for energy extraction. As the undigested nutrients and phytochemicals are delivered to the colon, effects on gut microbiota composition are predicted. Although the overall effect of nut consumption on microbial alpha- and beta-diversity has been inconsistent, some scientific evidence suggests an increase in fecal butyrate after almond consumption, and a beneficial role of walnuts on the prevention of ulcerative colitis and protection against the development of gastric mucosal lesions. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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Review

Jump to: Editorial, Research

19 pages, 1652 KiB

Open AccessReview

Dried Fruits: Bioactives, Effects on Gut Microbiota, and Possible Health Benefits—An Update

by Cesarettin Alasalvar, Sui Kiat Chang, Penny M. Kris-Etherton, Valerie K. Sullivan, Kristina S. Petersen, Marta Guasch-Ferré and David J. A. Jenkins

Nutrients 2023, 15(7), 1611; https://doi.org/10.3390/nu15071611 - 26 Mar 2023

Cited by 18 | Viewed by 8002

Abstract

Dried fruits contain many bioactive compounds broadly classified as phytochemicals including phenolics, flavonoids, carotenoids, proanthocyanidins, stilbenes, chalcones/dihydrochalcones, and phytoestrogens. These compounds have antioxidant effects that may benefit health. Dried fruits are also a diverse group of foods with varying fibre contents. The evaluation of the biological activity of these bioactive compounds, including their bioaccessibility and bioavailability, may contribute to the understanding of the health effects of dried fruits. Limited evidence suggests that dried fruits (raisins, cranberries, dates, and prunes) affect human gut microbiota composition in a potentially beneficial manner (in terms of effects on Bifidobacteria, Faecalibacterium prausnitzii, Lactobacillus, Ruminococcaceae, Klebsiella spp., and Prevotella spp.). There is little epidemiological evidence about the association of dried fruit consumption with cardiovascular disease incidence and mortality, as well as the risk of type 2 diabetes or obesity. Clinical trial evidence for the effects of dried fruit consumption on cardiovascular risk factors, including glycaemic control, is mixed. Clinical trial evidence suggests prunes might preserve bone mineral density in postmenopausal women. Consumption of dried fruits is associated with higher-quality diets. Studies are needed to increase our understanding of the health effects of dried fruits and the underlying biological mechanisms. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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18 pages, 1108 KiB

Open AccessReview

Dried Fruits, Nuts, and Cancer Risk and Survival: A Review of the Evidence and Future Research Directions

by Bradley W. Bolling, Dagfinn Aune, Hwayoung Noh, Kristina S. Petersen and Heinz Freisling

Nutrients 2023, 15(6), 1443; https://doi.org/10.3390/nu15061443 - 16 Mar 2023

Cited by 8 | Viewed by 8981

Abstract

Dried fruits and nuts contain high amounts of nutrients and phytochemicals—all of which may have anticarcinogenic, anti-inflammatory, and antioxidant properties. This narrative review summarizes the evidence for dried fruits and nuts and cancer incidence, mortality, and survival and their potential anticancer properties. The evidence for dried fruits in cancer outcomes is limited, but existing studies have suggested an inverse relationship between total dried fruit consumption and cancer risk. A higher consumption of nuts has been associated with a reduced risk of several site-specific cancers in prospective cohort studies, including cancers of the colon, lung, and pancreas, with relative risks per 5 g/day increment equal to 0.75 (95% CI 0.60, 0.94), 0.97 (95% CI 0.95, 0.98), and 0.94 (95% CI 0.89, 0.99), respectively. A daily intake of total nuts of 28 g/day has also been associated with a 21% reduction in the rate of cancer mortality. There is also some evidence that frequent nut consumption is associated with improved survival outcomes among patients with colorectal, breast, and prostate cancer; however, further studies are needed. Future research directions include the investigation of additional cancer types, including rare types of cancer. For cancer prognosis, additional studies with pre- and postdiagnosis dietary assessment are warranted. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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17 pages, 1618 KiB

Open AccessEditor’s ChoiceReview

Nuts, Energy Balance and Body Weight

by David J. Baer, Michelle Dalton, John Blundell, Graham Finlayson and Frank B. Hu

Nutrients 2023, 15(5), 1162; https://doi.org/10.3390/nu15051162 - 25 Feb 2023

Cited by 10 | Viewed by 5531

Abstract

Over several decades, the health benefits of consuming nuts have been investigated, resulting in a large body of evidence that nuts can reduce the risk of chronic diseases. The consumption of nuts, being a higher-fat plant food, is restricted by some in order to minimize weight gain. In this review, we discuss several factors related to energy intake from nuts, including food matrix and its impact on digestibility, and the role of nuts in regulating appetite. We review the data from randomized controlled trials and observational studies conducted to examine the relationship between nut intake and body weight or body mass index. Consistently, the evidence from RCTs and observational cohorts indicates that higher nut consumption does not cause greater weight gain; rather, nuts may be beneficial for weight control and prevention of long-term weight gain. Multiple mechanisms likely contribute to these findings, including aspects of nut composition which affect nutrient and energy availability as well as satiety signaling. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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14 pages, 598 KiB

Open AccessReview

Effect of Nuts on Markers of Inflammation and Oxidative Stress: A Narrative Review

by Sujatha Rajaram, Nagila Raquel Teixeira Damasceno, Ribanna Aparecida Marques Braga, Raquel Martinez, Penny Kris-Etherton and Aleix Sala-Vila

Nutrients 2023, 15(5), 1099; https://doi.org/10.3390/nu15051099 - 22 Feb 2023

Cited by 11 | Viewed by 6021

Abstract

Oxidative stress and inflammation are mediators in the pathophysiology of several non-communicable diseases (NCDs). Tree nuts and peanuts lower risk factors of cardiometabolic disease, including blood lipids, blood pressure and insulin resistance, among others. Given their strong antioxidant/anti-inflammatory potential, it is plausible that nuts may also exert a favorable effect on inflammation and oxidative stress. Evidence from systematic reviews and meta-analyses of cohort studies and randomized controlled trials (RCTs) suggest a modest protective effect of total nuts; however, the evidence is inconsistent for specific nut types. In this narrative review, the state of evidence to date is summarized for the effect of nut intake on biomarkers of inflammation and oxidative stress, and an attempt is made to define the gaps in research while providing a framework for future research. Overall, it appears that some nuts, such as almonds and walnuts, may favorably modify inflammation, and others, such as Brazil nuts, may favorably influence oxidative stress. There is a pressing need for large RCTs with an adequate sample size that consider different nut types, and the dose and duration of nut intervention, while evaluating a robust set of biomarkers for inflammation and oxidative stress. Building a stronger evidence base is important, especially since oxidative stress and inflammation are mediators of many NCDs and can benefit both personalized and public health nutrition. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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20 pages, 781 KiB

Open AccessReview

Impact of Nut Consumption on Cognition across the Lifespan

by Stephanie K. Nishi, Aleix Sala-Vila, Jordi Julvez, Joan Sabaté and Emilio Ros

Nutrients 2023, 15(4), 1000; https://doi.org/10.3390/nu15041000 - 16 Feb 2023

Cited by 6 | Viewed by 8318

Abstract

Cognitive health is a life-long concern affected by modifiable risk factors, including lifestyle choices, such as dietary intake, with serious implications for quality of life, morbidity, and mortality worldwide. In addition, nuts are a nutrient-dense food that contain a number of potentially neuroprotective components, including monounsaturated and polyunsaturated fatty acids, fiber, B-vitamins, non-sodium minerals, and highly bioactive polyphenols. However, increased nut consumption relates to a lower cardiovascular risk and a lower burden of cardiovascular risk factors that are shared with neurodegenerative disorders, which is why nuts have been hypothesized to be beneficial for brain health. The present narrative review discusses up-to-date epidemiological, clinical trial, and mechanistic evidence of the effect of exposure to nuts on cognitive performance. While limited and inconclusive, available evidence suggests a possible role for nuts in the maintenance of cognitive health and prevention of cognitive decline in individuals across the lifespan, particularly in older adults and those at higher risk. Walnuts, as a rich source of the plant-based polyunsaturated omega-3 fatty acid alpha-linolenic acid, are the nut type most promising for cognitive health. Given the limited definitive evidence available to date, especially regarding cognitive health biomarkers and hard outcomes, future studies are needed to better elucidate the impact of nuts on the maintenance of cognitive health, as well as the prevention and management of cognitive decline and dementia, including Alzheimer disease. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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17 pages, 1202 KiB

Open AccessReview

Novel Lines of Research on the Environmental and Human Health Impacts of Nut Consumption

by Linda Tapsell, Joan Sabaté, Raquel Martínez, Marc Llavanera, Elizabeth Neale and Albert Salas-Huetos

Nutrients 2023, 15(4), 955; https://doi.org/10.3390/nu15040955 - 14 Feb 2023

Cited by 7 | Viewed by 4475

Abstract

Nuts have formed part of human diets throughout the ages. In recent decades, research has shown they are key foods in dietary patterns associated with lower chronic disease risk. The current state of climate change, however, has introduced an imperative to review the impact of dietary patterns on the environment with a shift to plant-based diets. Nuts emerge as a significant source of protein in plant-based diets and are a minimally processed and sustainable food. Research in this area is evolving to drive better production methods in varying climate conditions. Nevertheless, nut consumption remains an important contributor to human health. The mechanisms of action can be explained in terms of the nutrients they deliver. Studies of nut consumption have linked components such as monounsaturated fatty acids, plant omega-3 fatty acids, antioxidants, and plant sterols to improved lipoprotein profiles, lower blood pressure, and reduced cardiovascular disease risk. Preliminary research also indicates possible beneficial effects of nut consumption on reproductive health. In any case, the ultimate effects of foods on health are the results of multiple interactive factors, so where nuts fit within dietary patterns is a significant consideration for research translation. This has implications for research methodologies, including categorization within food groups and inclusion in Healthy Dietary Indices. The aim of this narrative review is to outline new focal points for investigation that examine the environmental and some novel human health impacts of nut consumption and discuss future directions for research. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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16 pages, 719 KiB

Open AccessReview

Nuts and Cardiovascular Disease Outcomes: A Review of the Evidence and Future Directions

by Andrea J. Glenn, Dagfinn Aune, Heinz Freisling, Noushin Mohammadifard, Cyril W. C. Kendall, Jordi Salas-Salvadó, David J. A. Jenkins, Frank B. Hu and John L. Sievenpiper

Nutrients 2023, 15(4), 911; https://doi.org/10.3390/nu15040911 - 11 Feb 2023

Cited by 12 | Viewed by 9140

Abstract

Nuts are nutrient-rich foods that contain many bioactive compounds that are beneficial for cardiovascular health. Higher consumption of nuts has been associated with a reduced risk of several cardiovascular diseases (CVD) in prospective cohort studies, including a 19% and 25% lower risk of CVD incidence and mortality, respectively, and a 24% and 27% lower risk of coronary heart disease incidence and mortality, respectively. An 18% lower risk of stroke mortality, a 15% lower risk of atrial fibrillation, and a 19% lower risk of total mortality have also been observed. The role of nuts in stroke incidence, stroke subtypes, peripheral arterial disease and heart failure has been less consistent. This narrative review summarizes recommendations for nuts by clinical practice guidelines and governmental organizations, epidemiological evidence for nuts and CVD outcomes, nut-containing dietary patterns, potential mechanisms of nuts and CVD risk reduction, and future research directions, such as the use of biomarkers to help better assess nut intake. Although there are still some uncertainties around nuts and CVD prevention which require further research, as summarized in this review, there is a substantial amount of evidence that supports that consuming nuts will have a positive impact on primary and secondary prevention of CVD. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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22 pages, 636 KiB

Open AccessReview

Nuts in the Prevention and Management of Type 2 Diabetes

by Stephanie K. Nishi, Effie Viguiliouk, Cyril W. C. Kendall, David J. A. Jenkins, Frank B. Hu, John L. Sievenpiper, Alessandro Atzeni, Anoop Misra and Jordi Salas-Salvadó

Nutrients 2023, 15(4), 878; https://doi.org/10.3390/nu15040878 - 9 Feb 2023

Cited by 14 | Viewed by 10326

Abstract

Diabetes is a continuously growing global concern affecting >10% of adults, which may be mitigated by modifiable lifestyle factors. Consumption of nuts and their inclusion in dietary patterns has been associated with a range of beneficial health outcomes. Diabetes guidelines recommend dietary patterns that incorporate nuts; however, specific recommendations related to nuts have been limited. This review considers the epidemiological and clinical evidence to date for the role of nut consumption as a dietary strategy for the prevention and management of type 2 diabetes (T2D) and related complications. Findings suggest nut consumption may have a potential role in the prevention and management of T2D, with mechanistic studies assessing nuts and individual nut-related nutritional constituents supporting this possibility. However, limited definitive evidence is available to date, and future studies are needed to elucidate better the impact of nuts on the prevention and management of T2D. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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20 pages, 605 KiB

Open AccessReview

Effects of Nut Consumption on Blood Lipids and Lipoproteins: A Comprehensive Literature Update

by Marta Guasch-Ferré, Anne-Julie Tessier, Kristina S. Petersen, Philip A. Sapp, Linda C. Tapsell, Jordi Salas-Salvadó, Emilio Ros and Penny M. Kris-Etherton

Nutrients 2023, 15(3), 596; https://doi.org/10.3390/nu15030596 - 23 Jan 2023

Cited by 9 | Viewed by 8557

Abstract

In the present review, we provide a comprehensive narrative overview of the current knowledge on the effects of total and specific types of nut consumption (excluding nut oil) on blood lipids and lipoproteins. We identified a total of 19 systematic reviews and meta-analyses of randomized controlled trials (RCTs) that were available in PubMed from the inception date to November 2022. A consistent beneficial effect of most nuts, namely total nuts and tree nuts, including walnuts, almonds, cashews, peanuts, and pistachios, has been reported across meta-analyses in decreasing total cholesterol (mean difference, MD, −0.09 to −0.28 mmol/L), LDL-cholesterol (MD, −0.09 to −0.26 mmol/L), and triglycerides (MD, −0.05 to −0.17 mmol/L). However, no effects on HDL-cholesterol have been uncovered. Preliminary evidence indicates that adding nuts into the regular diet reduces blood levels of apolipoprotein B and improves HDL function. There is also evidence that nuts dose-dependently improve lipids and lipoproteins. Sex, age, or nut processing are not effect modifiers, while a lower BMI and higher baseline lipid concentrations enhance blood lipid/lipoprotein responses. While research is still emerging, the evidence thus far indicates that nut-enriched diets are associated with a reduced number of total LDL particles and small, dense LDL particles. In conclusion, evidence from clinical trials has shown that the consumption of total and specific nuts improves blood lipid profiles by multiple mechanisms. Future directions in this field should include more lipoprotein particle, apolipoprotein B, and HDL function studies. Full article

(This article belongs to the Special Issue Nuts: Where We Are and Where We Are Going in Research. Proceedings from the NUTS 2022 International Conference)

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