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Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial.

Journal of the American Heart Association
November 29, 2017
Yujin Lee et al. (9 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to examine the individual and combined effects of almonds, dark chocolate, and cocoa on markers of coronary heart disease risk in overweight and obese individuals.

Results Summary

Almond consumption alone reduced total cholesterol, non-HDL cholesterol, and LDL cholesterol by 4%, 5%, and 7%, respectively. Combined with dark chocolate, almonds also reduced apolipoprotein B by 5% and small dense LDL particles by 12.0 mg/dL compared to the average American diet.

Population

Overweight and obese individuals aged 30 to 70 years.

Effective Dosage

42.5 g/d of almonds.

Duration

4 weeks per diet period.

Interactions

None mentioned.

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
almond diet (ALD)
decrease
total cholesterol
overweight and obese individuals aged 30 to 70 years
4%
were lower
#1
almond diet (ALD)
decrease
non-high-density lipoprotein cholesterol
overweight and obese individuals aged 30 to 70 years
5%
were lower
#2
almond diet (ALD)
decrease
low-density lipoprotein cholesterol
overweight and obese individuals aged 30 to 70 years
7%
were lower
#3
CHOC+ALD diet
decrease
apolipoprotein B
overweight and obese individuals aged 30 to 70 years
5%
decreased
#4
almond diet (ALD)
decrease
large buoyant low-density lipoprotein particles
overweight and obese individuals aged 30 to 70 years
-5.7±2.3 versus -0.3±2.3 mg/dL
showed a greater reduction
#5
CHOC+ALD diet
decrease
small dense low-density lipoprotein particles
overweight and obese individuals aged 30 to 70 years
-12.0±2.8 versus -5.3±2.8 mg/dL
had a greater decrease
#6
almond diet (ALD), chocolate diet (CHOC), CHOC+ALD diet
no change
measures of vascular health
overweight and obese individuals aged 30 to 70 years
no significant change
There were no significant differences
#7
almond diet (ALD), chocolate diet (CHOC), CHOC+ALD diet
no change
measures of oxidative stress
overweight and obese individuals aged 30 to 70 years
no significant change
There were no significant differences
#8
almonds alone
increase
lipid profiles
overweight and obese individuals aged 30 to 70 years
-
improves
#9
almonds combined with dark chocolate
increase
lipid profiles
overweight and obese individuals aged 30 to 70 years
-
improves
#10
Abstract

BACKGROUND: Consumption of almonds or dark chocolate and cocoa has favorable effects on markers of coronary heart disease; however, the combined effects have not been evaluated in a well-controlled feeding study. The aim of this study was to examine the individual and combined effects of consumption of dark chocolate and cocoa and almonds on markers of coronary heart disease risk. METHODS AND RESULTS: A randomized controlled, 4-period, crossover, feeding trial was conducted in overweight and obese individuals aged 30 to 70 years. Forty-eight participants were randomized, and 31 participants completed the entire study. Each diet period was 4 weeks long, followed by a 2-week compliance break. Participants consumed each of 4 isocaloric, weight maintenance diets: (1) no treatment foods (average American diet), (2) 42.5 g/d of almonds (almond diet [ALD]), (3) 18 g/d of cocoa powder and 43 g/d of dark chocolate (chocolate diet [CHOC]), or (4) all 3 foods (CHOC+ALD). Compared with the average American diet, total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after the ALD were lower by 4%, 5%, and 7%, respectively (P<0.05). The CHOC+ALD decreased apolipoprotein B by 5% compared with the average American diet. For low-density lipoprotein subclasses, compared with the average American diet, the ALD showed a greater reduction in large buoyant low-density lipoprotein particles (-5.7±2.3 versus -0.3±2.3 mg/dL; P=0.04), whereas the CHOC+ALD had a greater decrease in small dense low-density lipoprotein particles (-12.0±2.8 versus -5.3±2.8 mg/dL; P=0.04). There were no significant differences between diets for measures of vascular health and oxidative stress. CONCLUSIONS: Our results demonstrate that consumption of almonds alone or combined with dark chocolate under controlled-feeding conditions improves lipid profiles. Incorporating almonds, dark chocolate, and cocoa into a typical American diet without exceeding energy needs may reduce the risk of coronary heart disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01882881.

Medical Subject Headings (MeSH)
AdultAgedBody Mass IndexCardiovascular DiseasesChocolateCholesterol, HDLCross-Over StudiesFemaleHumansIncidenceMaleMiddle AgedObesityOverweightPennsylvaniaPrognosisPrunus dulcisRisk AssessmentRisk Factors
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations45
Citations/Year5.6
Relative Citation Ratio2.30
NIH Percentile78.6%
Research Impact Scores
APT Score0.75
Weight Score2.11
Normalized Score0.86
Related Supplements
Effects of Dark Chocolate and Almonds on Cardiovascular Risk... | Panacea Index