Replacing Saturated Fat With Walnuts or Vegetable Oils Improves Central Blood Pressure and Serum Lipids in Adults at Risk for Cardiovascular Disease

A Randomized Controlled-Feeding Trial

Alyssa M. Tindall, Kristina Petersen, Ann C. Skulas-Ray, Chesney K. Richter, David Nathan Proctor, Penny Margaret Kris-Etherton

Research output: Contribution to journalArticle

Abstract

Background: Walnuts have beneficial effects on cardiovascular risk factors, but it is unclear whether these effects are attributable to the fatty acid (FA) content, including α-linolenic acid (ALA), and/or bioactives. Methods and Results: A randomized, controlled, 3-period, crossover, feeding trial was conducted in individuals at risk for cardiovascular disease (n=45). Following a 2-week standard Western diet run-in (12% saturated FAs [SFA], 7% polyunsaturated FAs, 12% monounsaturated FAs), participants consumed 3 isocaloric weight-maintenance diets for 6 weeks each: a walnut diet (WD; 7% SFA, 16% polyunsaturated FAs, 3% ALA, 9% monounsaturated FAs); a walnut FA-matched diet; and an oleic acid–replaced-ALA diet (7% SFA, 14% polyunsaturated FAs, 0.5% ALA, 12% monounsaturated FAs), which substituted the amount of ALA from walnuts in the WD with oleic acid. This design enabled evaluation of the effects of whole walnuts versus constituent components. The primary end point, central systolic blood pressure, was unchanged, and there were no significant changes in arterial stiffness. There was a treatment effect (P=0.04) for central diastolic blood pressure; there was a greater change following the WD versus the oleic acid–replaced-ALA diet (−1.78±1.0 versus 0.15±0.7 mm Hg, P=0.04). There were no differences between the WD and the walnut fatty acid-matched diet (−0.22±0.8 mm Hg, P=0.20) or the walnut FA-matched and oleic acid–replaced-ALA diets (P=0.74). The WD significantly lowered brachial and central mean arterial pressure. All diets lowered total cholesterol, LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and non-HDL cholesterol. Conclusions: Cardiovascular benefits occurred with all moderate-fat, high-unsaturated-fat diets. As part of a low-SFA diet, the greater improvement in central diastolic blood pressure following the WD versus the oleic acid–replaced-ALA diet indicates benefits of walnuts as a whole-food replacement for SFA. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02210767.

Original languageEnglish (US)
Article numbere011512
JournalJournal of the American Heart Association
Volume8
Issue number9
DOIs
StatePublished - May 7 2019

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Juglans
Plant Oils
Cardiovascular Diseases
Randomized Controlled Trials
Fats
Diet
Blood Pressure
Lipids
Serum
Fatty Acids
Unsaturated Fats
Vascular Stiffness
alpha-Linolenic Acid
High Fat Diet
Oleic Acid
LDL Cholesterol
Cross-Over Studies
HDL Cholesterol
Arterial Pressure
Arm

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{786a3597c79f48edadc60b493761f216,
title = "Replacing Saturated Fat With Walnuts or Vegetable Oils Improves Central Blood Pressure and Serum Lipids in Adults at Risk for Cardiovascular Disease: A Randomized Controlled-Feeding Trial",
abstract = "Background: Walnuts have beneficial effects on cardiovascular risk factors, but it is unclear whether these effects are attributable to the fatty acid (FA) content, including α-linolenic acid (ALA), and/or bioactives. Methods and Results: A randomized, controlled, 3-period, crossover, feeding trial was conducted in individuals at risk for cardiovascular disease (n=45). Following a 2-week standard Western diet run-in (12{\%} saturated FAs [SFA], 7{\%} polyunsaturated FAs, 12{\%} monounsaturated FAs), participants consumed 3 isocaloric weight-maintenance diets for 6 weeks each: a walnut diet (WD; 7{\%} SFA, 16{\%} polyunsaturated FAs, 3{\%} ALA, 9{\%} monounsaturated FAs); a walnut FA-matched diet; and an oleic acid–replaced-ALA diet (7{\%} SFA, 14{\%} polyunsaturated FAs, 0.5{\%} ALA, 12{\%} monounsaturated FAs), which substituted the amount of ALA from walnuts in the WD with oleic acid. This design enabled evaluation of the effects of whole walnuts versus constituent components. The primary end point, central systolic blood pressure, was unchanged, and there were no significant changes in arterial stiffness. There was a treatment effect (P=0.04) for central diastolic blood pressure; there was a greater change following the WD versus the oleic acid–replaced-ALA diet (−1.78±1.0 versus 0.15±0.7 mm Hg, P=0.04). There were no differences between the WD and the walnut fatty acid-matched diet (−0.22±0.8 mm Hg, P=0.20) or the walnut FA-matched and oleic acid–replaced-ALA diets (P=0.74). The WD significantly lowered brachial and central mean arterial pressure. All diets lowered total cholesterol, LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and non-HDL cholesterol. Conclusions: Cardiovascular benefits occurred with all moderate-fat, high-unsaturated-fat diets. As part of a low-SFA diet, the greater improvement in central diastolic blood pressure following the WD versus the oleic acid–replaced-ALA diet indicates benefits of walnuts as a whole-food replacement for SFA. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02210767.",
author = "Tindall, {Alyssa M.} and Kristina Petersen and Skulas-Ray, {Ann C.} and Richter, {Chesney K.} and Proctor, {David Nathan} and Kris-Etherton, {Penny Margaret}",
year = "2019",
month = "5",
day = "7",
doi = "10.1161/JAHA.118.011512",
language = "English (US)",
volume = "8",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Replacing Saturated Fat With Walnuts or Vegetable Oils Improves Central Blood Pressure and Serum Lipids in Adults at Risk for Cardiovascular Disease

T2 - A Randomized Controlled-Feeding Trial

AU - Tindall, Alyssa M.

AU - Petersen, Kristina

AU - Skulas-Ray, Ann C.

AU - Richter, Chesney K.

AU - Proctor, David Nathan

AU - Kris-Etherton, Penny Margaret

PY - 2019/5/7

Y1 - 2019/5/7

N2 - Background: Walnuts have beneficial effects on cardiovascular risk factors, but it is unclear whether these effects are attributable to the fatty acid (FA) content, including α-linolenic acid (ALA), and/or bioactives. Methods and Results: A randomized, controlled, 3-period, crossover, feeding trial was conducted in individuals at risk for cardiovascular disease (n=45). Following a 2-week standard Western diet run-in (12% saturated FAs [SFA], 7% polyunsaturated FAs, 12% monounsaturated FAs), participants consumed 3 isocaloric weight-maintenance diets for 6 weeks each: a walnut diet (WD; 7% SFA, 16% polyunsaturated FAs, 3% ALA, 9% monounsaturated FAs); a walnut FA-matched diet; and an oleic acid–replaced-ALA diet (7% SFA, 14% polyunsaturated FAs, 0.5% ALA, 12% monounsaturated FAs), which substituted the amount of ALA from walnuts in the WD with oleic acid. This design enabled evaluation of the effects of whole walnuts versus constituent components. The primary end point, central systolic blood pressure, was unchanged, and there were no significant changes in arterial stiffness. There was a treatment effect (P=0.04) for central diastolic blood pressure; there was a greater change following the WD versus the oleic acid–replaced-ALA diet (−1.78±1.0 versus 0.15±0.7 mm Hg, P=0.04). There were no differences between the WD and the walnut fatty acid-matched diet (−0.22±0.8 mm Hg, P=0.20) or the walnut FA-matched and oleic acid–replaced-ALA diets (P=0.74). The WD significantly lowered brachial and central mean arterial pressure. All diets lowered total cholesterol, LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and non-HDL cholesterol. Conclusions: Cardiovascular benefits occurred with all moderate-fat, high-unsaturated-fat diets. As part of a low-SFA diet, the greater improvement in central diastolic blood pressure following the WD versus the oleic acid–replaced-ALA diet indicates benefits of walnuts as a whole-food replacement for SFA. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02210767.

AB - Background: Walnuts have beneficial effects on cardiovascular risk factors, but it is unclear whether these effects are attributable to the fatty acid (FA) content, including α-linolenic acid (ALA), and/or bioactives. Methods and Results: A randomized, controlled, 3-period, crossover, feeding trial was conducted in individuals at risk for cardiovascular disease (n=45). Following a 2-week standard Western diet run-in (12% saturated FAs [SFA], 7% polyunsaturated FAs, 12% monounsaturated FAs), participants consumed 3 isocaloric weight-maintenance diets for 6 weeks each: a walnut diet (WD; 7% SFA, 16% polyunsaturated FAs, 3% ALA, 9% monounsaturated FAs); a walnut FA-matched diet; and an oleic acid–replaced-ALA diet (7% SFA, 14% polyunsaturated FAs, 0.5% ALA, 12% monounsaturated FAs), which substituted the amount of ALA from walnuts in the WD with oleic acid. This design enabled evaluation of the effects of whole walnuts versus constituent components. The primary end point, central systolic blood pressure, was unchanged, and there were no significant changes in arterial stiffness. There was a treatment effect (P=0.04) for central diastolic blood pressure; there was a greater change following the WD versus the oleic acid–replaced-ALA diet (−1.78±1.0 versus 0.15±0.7 mm Hg, P=0.04). There were no differences between the WD and the walnut fatty acid-matched diet (−0.22±0.8 mm Hg, P=0.20) or the walnut FA-matched and oleic acid–replaced-ALA diets (P=0.74). The WD significantly lowered brachial and central mean arterial pressure. All diets lowered total cholesterol, LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and non-HDL cholesterol. Conclusions: Cardiovascular benefits occurred with all moderate-fat, high-unsaturated-fat diets. As part of a low-SFA diet, the greater improvement in central diastolic blood pressure following the WD versus the oleic acid–replaced-ALA diet indicates benefits of walnuts as a whole-food replacement for SFA. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02210767.

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U2 - 10.1161/JAHA.118.011512

DO - 10.1161/JAHA.118.011512

M3 - Article

VL - 8

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 9

M1 - e011512

ER -