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Pistachio Nut Consumption and Serum Lipid Levels

Department of Medicine, Inova Fairfax Hospital, Falls Church, VA

Address reprint requests to: Michael J. Sheridan, Sc.D., Director, Epidemiology & Biostatistics, Department of Medicine, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042-3300. E-mail: michael.sheridan{at}inova.com

Objective: Clinical and epidemiological studies have reported the beneficial effects of tree nuts and peanuts on serum lipid levels. We studied the effects of consuming 15% of the daily caloric intake in the form of pistachio nuts on the lipid profiles of free-living human subjects with primary, moderate hypercholesterolemia (serum cholesterol greater than 210 mg/dL).

Methods: Design: Randomized crossover trial. Setting: Outpatient dietary counseling and blood analysis. Subjects: 15 subjects with moderate hypercholesterolemia. Intervention: Fours weeks of dietary modification with 15% caloric intake from pistachio nuts. Measures of Outcome: Endpoints were serum lipid levels of total cholesterol, HDL-C, LDL-C, VLDL-C, triglycerides and apolipoproteins A-1 and B-100. BMI, blood pressure, and nutrient intake (total energy, fat, protein, and fiber) were also measured at baseline, during, and after dietary intervention.

Results: No statistically significant differences were observed for total energy or percent of energy from protein, carbohydrate or fat. On the pistachio nut diet, a statistically significant decrease was seen for percent energy from saturated fat (mean difference, –2.7%; 95% CI, –5.4% to –0.08%; p = 0.04). On the pistachio nut diet, statistically significant increases were seen for percent energy from polyunsaturated fat (mean difference, 6.5%; 95% CI, 4.2% to 8.9%; p<.0001) and fiber intake (mean difference, 15g; 95% CI, 8.4g to 22g; p = 0.0003). On the pistachio diet, statistically significant reductions were seen in TC/HDL-C (mean difference, –0.38; 95% CI, –0.57 to –0.19; p = 0.001), LDL-C/HDL-C (mean difference, –0.40; 95% CI, –0.66 to –0.15; p = 0.004), B-100/A-1 (mean difference, –0.11; 95% CI, –0.19 to –0.03; p = 0.009) and a statistically significant increase was seen in HDL-C (mean difference, 2.3; 95% CI, 0.48 to 4.0; p = 0.02). No statistically significant differences were seen for total cholesterol, triglycerides, LDL-C, VLDL-C, apolipoprotein A-1 or apolipoprotein B-100. No changes were observed in BMI or blood pressure.

Conclusion: A diet consisting of 15% of calories as pistachio nuts (about 2–3 ounces per day) over a four week period can favorably improve some lipid profiles in subjects with moderate hypercholesterolemia and may reduce risk of coronary disease.

Key words: pistachio nuts, cholesterol, lipoprotein, diet, coronary heart disease

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