A randomized, controlled trial on the effects of almonds on lipoprotein response to a higher carbohydrate, lower fat diet in men and women with abdominal adiposity

BACKGROUND: Almonds have been shown to lower LDL cholesterol but there is limited information regarding their effects on the dyslipidemia characterized by increased levels of very low density lipoproteins (VLDL) and small, dense low-density lipoprotein (LDL) particles that is associated with abdominal adiposity and high carbohydrate intake. The objective of the present study was to test whether substitution of almonds for other foods attenuates carbohydrate-induced increases in small, dense LDL in individuals with increased abdominal adiposity. METHODS: This was a randomized cross-over study of three 3wk diets, separated by 2wk washouts: a higher-carbohydrate (CHO) reference diet (CHO(high)), a higher-CHO diet with isocaloric substitution of 20% kcal (E) from almonds (CHO(high + almonds)), and a lower-CHO reference diet (CHO(low)) in 9 men and 15 women who were overweight or obese. The two CHO(high) diets contained 50% carbohydrate, 15% protein, 35% fat (6% saturated, 21% monounsaturated, 8% polyunsaturated), while the CHO(low) diet contained 25% carbohydrate, 28% protein, 47% fat (8% saturated, 28% monounsaturated, 8% polyunsaturated). Lipoprotein subfraction concentrations were measured by ion mobility. RESULTS: Relative to the CHO(low) diet: 1) the CHO(high + almonds) diet significantly increased small, dense LDLIIIa (mean difference ± SE: 28.6 ± 10.4 nmol/L, P = 0.008), and reduced LDL-peak diameter (− 1.7 ± 0.6 Å, P = 0.008); 2) the CHO(high) diet significantly increased medium-sized LDLIIb (24.8 ± 11.4 nmol/L, P = 0.04) and large VLDL (3.7 ± 1.8 nmol/L, P = 0.05). Relative to CHO(low), the effects of CHO(high) on LDLIIIa (17.7 ± 10.6 nmol/L) and LDL-peak diameter (− 1.1 ± 0.6 Å) were consistent with those of CHO(high + almonds), and the effects of CHO(high + almonds) on LDLIIb (21.0 ± 11.2 nmol/L) and large VLDL (2.8 ± 1.8 nmol/L) were consistent with those of CHO(high), but did not achieve statistical significance (P > 0.05). None of the variables examined showed a significant difference between the CHO(high + almonds) and CHO(high) diets (P > 0.05). CONCLUSION: Our analyses provided no evidence that deriving 20% E from almonds significantly modifies increases in levels of small, dense LDL or other plasma lipoprotein changes induced by a higher carbohydrate low saturated fat diet in individuals with increased abdominal adiposity. TRIAL REGISTRATION: Clinicaltrials.gov NCT01792648. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12944-019-1025-4) contains supplementary material, which is available to authorized users.