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Hazelnut Heart Health

October 4, 2010 Written by JP       [Font too small?]

It’s a very common scenario that plays out in doctors’ offices around the world. A patient sits on an examination table and their physician sternly alerts them that their cholesterol level is slowly creeping upward and may soon need to be controlled with medication. From a natural health perspective, there are many options one can employ to lower LDL (“bad”) cholesterol. Eating a daily serving or two of nuts tops the list. The beauty of this strategy is that you don’t necessarily need to make other lifestyle changes to accomplish your objective. My Healthy Monday tip of the week is to consider adding a specific member of the tree nut family – hazelnuts or filberts – to your natural cholesterol-lowering regimen.

The September 29th edition of the European Journal of Clinical Nutrition reports that adding 30 grams of hazelnuts to one’s diet is likely to result in: a) an elevation of HDL (“good”) cholesterol and Vitamin E; b) a decline in LDL cholesterol and the total cholesterol-to-HDL ratio (TC:HDL-C); c) a reduction in a cardiovascular risk factor known as apo B100. These findings are based on a 4 week trial involving 48 mildly hypercholesterolemic patients. The inclusion of supplemental hazelnuts did not result in weight gain. (1)

Nutritionists and physicians are very hesitant to place too much importance on the outcome of a solitary study. They much prefer having corroborative evidence to support initial findings. As it turns out, there are several previous trials that help to make a fairly strong case for using hazelnuts to support cardiovascular health.

  • A study appearing in the February 2007 issue of the European Journal of Clinical Nutrition examined the effects of an 8-week intervention involving 15 hypercholesterolemic, middle-aged men who consumed 40 grams of hazelnuts daily. Once again, the weight of the participants remained stable although the hazelnuts accounted for 11.6% of total daily caloric intake. In addition, VLDL cholesterol declined by 29.5%, triglycerides by 31.8% and apolipoprotein B by 9.2%. The cardioprotective HDL cholesterol fraction increased by 12.6%. (2)
  • A trial published earlier this year goes on to document another positive attribute of hazelnut intake. It appears to shield against LDL cholesterol oxidation. This is a process that contributes to damage to the arteries and plaque build-up. The study in question lasted 4 weeks and employed 1 gram of hazelnuts per kilogram of weight as a therapeutic dosage. For a man or women weighing 150 lbs, this would translate into 68 grams or just over 2 ounces of hazelnuts daily. Another interesting finding of this study is that hazelnuts beneficially shifted the make-up of LDL cholesterol. The ratio of large-to-small LDL improved substantially. (3)
  • A study in the December 2009 issue of Nutrition, Metabolism and Cardiovascular Diseases found that providing high-risk patients with metabolic syndrome with 30 grams of mixed nuts daily effectively lowered abdominal obesity, blood pressure, body weight, insulin resistance, LDL cholesterol and an inflammatory marker (IL-6). The mixed nut blend consisted of 15 grams of walnuts, 7.5 grams of almonds and 7.5 grams of hazelnuts. (4)
Hazelnuts May Lower Various Cardiovascular Risk Markers
Source: Anadolu Kardiyol Derg. 2010 Feb;10(1):28-35. (link)

In my opinion, the best way to enjoy hazelnuts is in their raw form. Roasting decreases the levels of certain antioxidants naturally found in the skins, such as condensed tannins and gallic acid. But if you can’t find raw hazelnuts, don’t be too concerned. Fortunately, even roasted hazelnuts contain only small amounts of the suspected carcinogen, acrylamide. What’s more, many of the health benefits are still present after the roasting process. As is often the case, the skins contain the most abundant source of protective compounds. In the case of hazelnuts, this includes the health promoting phytochemicals caffeic acid, coumaric acid, ferulic acid and sinapic acid. On the other hand, the kernels tend to present more nutrient-based components, including choline, dietary fiber, folic acid, monounsaturated fats, potassium, protein, Vitamin E (tocopherols and tocotrienols) and Vitamin K. (5,6,7,8,9,10,11,12)

You might be wondering why I’m recommending hazelnuts today instead of almonds, pecans or walnuts. Eating a variety of nuts and seeds is highly advisable. Nutritional variety is a principle with which most people are familiar when it comes to selecting produce. As healthy as broccoli or spinach is, you wouldn’t want to eat it as your only source of vegetables. Eating a spectrum of vegetables ensures that you’ll take in a comprehensive mix of nutrients and phytochemicals. The key is to devise a list of the most nutrient dense foods in any given category, then pick and choose within that grouping without frequent repetition. The side benefit of doing so is that you’re much less likely to get bored with your food choices.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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16 Comments & Updates to “Hazelnut Heart Health”

  1. Pat Says:

    I love this, since I love nuts, but have stayed away from them because of their high calories. Everything in moderation, I am assuming! Can you give us an estimate of how many hazelnuts are in 30 grams? Ounces and grams don’t translate well into how many it takes.

  2. JP Says:

    Thank you, Pat.

    According to the Cleveland Clinic:

    The following equal one ounce: 24 almonds, 18 medium cashews, 12 hazelnuts or filberts, 8 medium Brazil nuts, 12 macadamia nuts, 35 peanuts, 15 pecan halves and 14 English walnut halves”

    http://my.clevelandclinic.org/heart/prevention/nutrition/nuts.aspx

    Be well!

    JP

  3. vincent Says:

    I love this, since I love nuts, but have stayed away from them because of their high calories.

  4. Pat Says:

    Thank you!

  5. Rose Says:

    Thanks for keeping up with and sorting through all the jumbled info that is out there about nutrition. I have read about the benefits of walnuts, almonds and brazil nuts but I’m especially pleased with this study on filbers because it is one my very favorite flavors. I always keep a small bowl of nuts out and many of our friends have taken up the practice so now I can tell them to add the hazelnuts to the mix.

  6. JP Says:

    Thank you, Rose. I’m always happy to share some welcome news! Enjoy the filberts! :)

    Be well!

    JP

  7. David Says:

    I LOVE hazelnuts! They (along with other omega-3 fatty acid foods such as fish and olive oil) are great not only for lowering LDL, but also for fiber needed in our typical “white bread” diets.

  8. Dave Says:

    Did not know that about Hazelnuts. As always. Superb article. What is your take on Krill oil?

    Dave

  9. JP Says:

    Thank you, Dave. :)

    Here’s a column I wrote about krill oil awhile back:

    http://www.healthyfellow.com/283/krill-oil-research/

    And a few updates:

    http://www.healthyfellow.com/388/natural-liver-protection/

    http://www.healthyfellow.com/586/natural-pain-relievers/

    In general, I think krill oil shows great promise. However, more research is clearly needed. Many issues remain to be clarified, IMO – best dosage, concentration of ingredients, quality control issues, etc.

    Be well!

    JP

  10. Alex Says:

    Many nuts have undesirable ratios of Omega 6 PUFAs to Omega 3 PUFAs. Do you know the amounts of Omega 6s and Omega 3s in a serving of Hazelnuts?

  11. JP Says:

    Hello, Alex. Hazelnuts don’t have a great omega-6/omega-3 ratio. This link (below) gives a detailed breakdown of the fatty acids present in hazelnuts:

    http://nutritiondata.self.com/facts/nut-and-seed-products/3116/2

    Be well!

    JP

  12. JP Says:

    Updated 11/03/15:

    http://link.springer.com/article/10.1007%2Fs00394-015-1038-3

    Eur J Nutr. 2015 Sep 10.

    Nut-enriched bread is an effective and acceptable vehicle to improve regular nut consumption.

    PURPOSE: Consuming 30 g of nuts/day is recommended to reduce chronic disease. However, nut consumption appears far from ideal among several populations. A potential strategy to increase consumption is to add nuts to a staple, for example, bread. Whether the health benefits and acceptability of nuts persist in this form is currently unknown. Thus, we examined the effects of consuming three nut-enriched breads on postprandial glycaemia, satiety, gastrointestinal tolerance, dietary intakes, and acceptance.

    METHODS: In this controlled, crossover study, 32 participants were randomly allocated to receive one of four breads for 8 days each. Three breads contained either 30 g of finely sliced hazelnuts, 30 g semi-defatted hazelnut flour, or 15 g of each (amounts per 120 g bread) and were compared with a control nut-free bread. Blood glucose response was measured over 120 min, along with ratings of gastrointestinal discomfort. Appetite ratings and diet diaries were completed during each treatment period.

    RESULTS: Area under the blood glucose curve was significantly lower for the nut breads compared to the control bread (all P < 0.001), with no significant differences between the nut breads (all P ≥ 0.130). There were no significant differences in satiety (all P ≥ 0.135) or gastrointestinal symptoms (all P ≥ 0.102) between the breads. Acceptance was highest for the finely sliced hazelnut bread. Furthermore, consuming hazelnut-enriched bread improved diet quality, increasing monounsaturated fat, vitamin E, and dietary fibre intakes.

    CONCLUSION: Bread appears to be an effective and acceptable vehicle for increasing nut consumption, resulting in improved postprandial glycaemia and diet profiles. Long-term studies are now required.

    Be well!

    JP

  13. JP Says:

    Updated 11/03/15:

    http://econtent.hogrefe.com/doi/abs/10.1024/0300-9831/a000168?

    Int J Vitam Nutr Res. 2013;83(5):263-70.

    Phytosterol content and fatty acid pattern of ten different nut types.

    Ten different nut kinds (almonds, Brazil nuts, cashews, hazelnuts, macadamias, peanuts, pecans, pine nuts, pistachios, and walnuts) were evaluated for their total oil and phytosterol content as well as their fatty acid composition. The total oil content was the predominant component; mean values oscillated between 45.2 % (cashews) and 74.7 % (macadamias). Mean total phytosterol content ranged from 71.7 mg (Brazil nuts) to 271.9 mg (pistachios) per 100 g oil. ß-sitosterol was the major sterol (mean >71.7 mg/100 g oil) followed by minor contents of campesterol, ergosterol, and stigmasterol. Almonds, cashews, hazelnuts, macadamias, and pistachios were high in monounsaturated fatty acids (MUFA; > 55 %). MUFA- and polyunsaturated fatty acid (PUFA)-rich nuts were peanuts and pecans, whereas Brazil nuts, pine nuts, and walnuts had the highest PUFA content (> 50 %); the high unsaturated/saturated fatty acid ratio ranged from 4.5 to 11.8. However, the fatty acid pattern of every nut is unique.

    Be well!

    JP

  14. JP Says:

    Updated 1/13/16:

    http://link.springer.com/article/10.1007%2Fs00394-015-1150-4

    Eur J Nutr. 2016 Jan 8.

    Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?

    PURPOSE: Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observed with raw nuts. This study aimed to compare the effects of consuming two different forms of hazelnuts on cardiovascular risk factors and acceptance.

    METHODS: Using a randomised crossover design, 72 participants were asked to consume 30 g/day of either raw or dry roasted, lightly salted hazelnuts for 28 days each. CVD risk factors were measured at the beginning and end of each treatment period. “Desire to consume” and “overall liking” for both forms of hazelnuts were assessed daily using a 150-mm visual analogue scale.

    RESULTS: Body composition, blood pressure, plasma total and low-density lipoprotein-cholesterol, apolipoprotein A1 and B100, glucose and α-tocopherol concentrations did not differ between forms of hazelnuts (all P ≥ 0.054). High-density lipoprotein (HDL)-cholesterol (P = 0.037) and triacylglycerol (P < 0.001) concentrations were significantly lower following the consumption of dry roasted, lightly salted hazelnuts when compared to the raw hazelnuts. Compared with baseline, consuming both forms of hazelnuts significantly improved HDL-cholesterol and apolipoprotein A1 concentrations, total-C/HDL-C ratio, and systolic blood pressure without significantly changing body composition. Acceptance ratings did not differ between forms of hazelnuts and remained high throughout the study.

    CONCLUSION: Dry roasting and lightly salting nuts do not appear to negate the cardioprotective effects observed with raw nut consumption, and both forms of nuts are resistant to monotony. Public health messages could be extended to include dry roasted and lightly salted nuts as part of a heart healthy diet.

    Be well!

    JP

  15. JP Says:

    Updated 04/24/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28429343

    Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1610-1626.

    Post-prandial effects of hazelnut-enriched high fat meal on LDL oxidative status, oxidative and inflammatory gene expression of healthy subjects: a randomized trial.

    OBJECTIVE: Postprandial oxidative stress is characterized by an increased susceptibility of the organism towards oxidative damage after consumption of a meal rich in lipids and/or carbohydrates. Micronutrients modulate the immune system and exert a protective action by reducing low-density lipoproteins oxidation (ox-LDL) via induction of antioxidant enzymes.

    SUBJECTS AND METHODS: The clinical study was a randomized and cross-over trial, conducted through the CONSORT flowchart. We evaluated the gene expression of 103 genes related to oxidative stress (HOSp) and human inflammasome pathways (HIp), and ox-LDL level at fasting and after 40 g raw “Tonda Gentile delle Langhe” hazelnut consumption, in association with a McDonald’s® Meal (McDM) in 22 healthy human volunteers.

    RESULTS: Ox-LDL levels significantly increased comparing no dietary treatment (NDT) vs. McDM, and decreased comparing McDM vs. McDM + H (p<0.05). Percentage of significant genes expressed after each dietary treatment were the follows: (A) NDT vs. McDM: 3.88% HIp and 17.48% HOSp; (B) NDT vs. McDM + H: 17.48% HIp and 23.30% HOSp; (C) McDM vs. McDM + H: 17.48% HIp and 33.98% HOSp.

    CONCLUSIONS: Hazelnut consumption reduced post prandial risk factors of atherosclerosis, such as ox-LDL, and the expression of inflammation and oxidative stress related genes. Chronic studies on larger population are necessary before definitive conclusions.

    Be well!

    JP

  16. JP Says:

    Updated 06/14/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28606702

    Clin Nutr. 2017 May 27.

    Effect of hazelnut on serum lipid profile and fatty acid composition of erythrocyte phospholipids in children and adolescents with primary hyperlipidemia: A randomized controlled trial.

    BACKGROUND & AIM: Regular intake of nuts improves lipid profile and thus reduces the cardiovascular (CV) risk associated with hyperlipidemia. The aim of the study was to investigate the effect of a dietary intervention with hazelnuts (HZNs, 15-30 g/day, depending on patient weight) on serum lipid profile, anthropometric parameters and fatty acids (FAs) composition of erythrocyte phospholipids in children and adolescents with primary hyperlipidemia.

    METHODS: Eight-week randomized, single blind, controlled, three-arm, parallel-group study. Sixty-six subjects were enrolled and randomized in 3 groups receiving: 1) hazelnuts with skin (HZN+S); 2) hazelnuts without skin (HZN-S); 3) dietary advices for hyperlipidemia only (controls). Before and after intervention, clinical parameters were measured and blood samples were collected for the evaluation of serum lipid levels and phospholipid FA composition of erythrocytes.

    RESULTS: Two-way ANOVA showed a significant effect of time on serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)/LDL-C ratio and non-HDL-C (p ≤ 0.001), but not of treatment and time × treatment interaction. In particular, HZN+S and HZN-S significantly reduced the concentrations of LDL-C and increased HDL-C/LDL-C ratio. HZNs also had a favorable impact on FAs composition of erythrocyte phospholipids, as demonstrated by time × treatment interaction, with a significant increase of monounsaturated fatty acids (MUFAs) (p = 0.008) and MUFAs/saturated fatty acids (SFAs) ratio (p = 0.002) with respect to the control group.

    CONCLUSIONS: For the first time, we documented a positive effect of HZN consumption on lipid profile and FA composition of erythrocyte phospholipids in children with primary hyperlipidemia. Further studies are encouraged to better define HZN impact on the markers of CV risk in this population.

    Be well!

    JP

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