A calorie-restricted diet with nuts favourably raises plasma high-density lipoprotein-cholesterol in overweight and obese patients with stable coronary heart disease: A randomised controlled trial.

ABSTRACT

BACKGROUND: Weight loss and consumption of nuts may both improve plasma lipids and lipoproteins. However, their effects in patients with coronary artery disease (CAD) who are under treatment with statins remain unclear. This study was conducted to determine plasma lipid and lipoprotein responses to a low-calorie (25% of energy deficit) nuts containing diet (NELCD) compared with a nut-free energy-restricted diet (NFLCD) in stable CAD patients who were overweight or obese (n = 67). METHODS: Plasma lipids and lipoproteins and ATP-binding cassette (ABC) A1 and ABCG1 mRNA expressions in peripheral blood mononuclear cells (PBMCs) isolated from patients were assessed at baseline and after 8 weeks. RESULTS: Plasma high-density lipoprotein (HDL) cholesterol and apoA1 increased significantly in the NELCD group at the end of Week 8 compared with those in NFLCD group (in NELCD group, mean change and 95% confidence interval (CI) were 1.17 [-1.31, 3.66] mg/dL, P = 0.012, and 2.55 [-2.10, 7.20] mg/dL, P = 0.011, for HDL cholesterol and apoA1, respectively). In both groups, the concentrations of total cholesterol, low-density lipoprotein cholesterol and triglyceride reduced significantly at Week 8 compared with those in baseline with no significant difference between the two groups. ABCA1 and ABCG1 mRNA expressions non-significantly decreased in both groups. CONCLUSION: This study indicates that inclusion of nuts as part of a calorie-restricted diet improves the concentrations of HDL cholesterol and apoA-1 in patients with stable, established CHD receiving statins.