Effects of mixed nuts as part of a Brazilian Cardioprotective diet on LDL-cholesterol in adult patients after myocardial infarction: a multicenter randomized controlled clinical trial.
Study Goal
The researchers aimed to evaluate whether adding 30 g/day of mixed nuts to a cardioprotective diet improved cardiometabolic features in post-myocardial infarction patients.
Results Summary
The study found no significant differences in low-density lipoprotein cholesterol, other lipid biomarkers, glycemic profile, or anthropometric data between the nuts-supplemented group and the control group after 16 weeks. Both groups improved diet quality similarly, with no additional benefit from nuts.
Population
Males and females over 40 years old with a previous myocardial infarction diagnosed within the last 2 to 6 months.
Effective Dosage
30 g/day (10 g peanuts, 10 g cashew, 10 g Brazil nuts).
Duration
16 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) | no change | low-density lipoprotein cholesterol concentrations | patients with previous myocardial infarction | intervention-control difference: 3.48 mg/dL [-3.45 to 10.41], P = 0.32 | no significant difference was found | #1 |
Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) | increase | overall diet quality | patients with previous myocardial infarction | intervention-control difference: 1.05 (-0.9 to 2.99); P = 0.29 | improved | #2 |
Brazilian Cardioprotective diet (DICA Br) prescription | increase | overall diet quality | patients with previous myocardial infarction | - | improved | #3 |
Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) | no change | other lipids, glycemic profile and anthropometrics | patients with previous myocardial infarction | - | were also not different | #4 |
Adding 30 g/day of mixed nuts to the DICA Br for 16 weeks | no change | lipid, glycemic and anthropometric features | patients in the post-myocardial infarction setting | - | did not change | #5 |
BACKGROUND: Nuts consumption is related to cardioprotective effects on primary cardiovascular prevention, but studies conducted in secondary prevention are small, scarce and controversial. The objective of this trial was to evaluate the effects of a regional and sustainable cardioprotective diet added or not with an affordable mixed nuts on cardiometabolic features in patients with previous myocardial infarction. METHODS: DICA-NUTS study is a national, multi-center, and superiority-parallel randomized clinical trial. Males and females over 40 years old diagnosed with previous myocardial infarction in the last 2 to 6 months were included. Patients were allocated into two groups: the Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) (intervention group, n = 193); or only DICA Br prescription (control group, n = 195). The primary outcome was low-density lipoprotein cholesterol means (in mg/dL) after 16 weeks. Secondary outcomes were other lipid biomarkers, glycemic and anthropometric data and diet quality. RESULTS: After adjustment for baseline values, participating study site, time since myocardial infarction and statin treatment regimen (high potency, moderate and low potency/no statins), no significant difference was found between the groups in low-density lipoprotein cholesterol concentrations (intervention-control difference: 3.48 mg/dL [-3.45 to 10.41], P = 0.32). Both groups improved their overall diet quality at the end of the study without differences between them after 16 weeks (intervention-control difference: 1.05 (-0.9 to 2.99); P = 0.29). Other lipids, glycemic profile and anthropometrics were also not different between study groups at the end of the study. CONCLUSION: Adding 30 g/day of mixed nuts to the DICA Br for 16 weeks did not change lipid, glycemic and anthropometric features in the post-myocardial infarction setting. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov website under number NCT03728127 and its World Health Organization Universal Trial Number (WHO-UTN) is U1111-1259-8105.