Pistachio Prediabetes Research Helps Explain Mechanism of Protection from Heart Disease by Nuts

Test diet reduced small and non-high-density LDL levels in those with pre diabetes

FRESNO, Calif., June 2, 2015 - A study conducted by Spanish researchers and published in the journal Nutrition, Metabolism and Cardiovascular Diseases discovered that regular pistachio consumption shifts the particle size of lipoprotein subclasses which has a beneficial effect on cardiovascular risk factors in prediabetic subjects.

Researchers have been seeking to understand the mechanisms that explain how eating nuts benefit cardiovascular health and affect the lipid profile of those with prediabetes, a significant health issue which affects approximately 86 million Americans.

Lipid profiles are made up of lipoprotein particles in the bloodstream and carry cholesterol and triglycerides through the body and vary in size and chemical structure representing subclasses. Affecting the size and density of these particles can reduce cardiovascular risk. Researchers studied if eating pistachios shifted these lipoprotein subclasses to a healthier profile among people with prediabetes. This, the authors suggested, may explain the lower risk of cardiovascular disease associated with regular nut consumption. They noted that the effect of dietary fatty acids on size and distribution of lipoprotein subclasses has not, before now, been well investigated.

The controlled, clinical study consisted of 54 adults with prediabetes between 25 and 65 and without other medical, dietary or social conditions that would hinder compliance. Participants were randomly assigned to one of two, four-month sequences: starting with a control diet followed by a pistachio diet or starting with the pistachio diet followed by a control diet. The pistachio diet participants consumed two ounces (57 grams) of pistachios a day, one half roasted and one half roasted and salted. The control diet provided the same amount of calories as the pistachio diet by adjusting the amount of other foods and olive oil.

While total low density lipoprotein particles (LDL-P) was not significantly lowered in the pistachio diet than in the control diet, small low-density lipoprotein particles (sLDL-P) significantly decreased after pistachio consumption compared to the nut-free control diet. Also, the non-high-density lipoprotein particles (non-HDL-P, very-low-density lipoprotein VLPL-P and low-density lipoprotein LDL-P) significantly decreased under the pistachio diet compared to the control diet.

According to the research team, “chronic pistachio consumption could modify the lipoprotein particle size and subclass concentrations independently of changes in total plasma lipid profile” and may further explain the lower rates of cardiovascular diseases and lower mortality associated with nut consumption.

“This study suggests that eating pistachios regularly may protect from heart disease by shifting the lipoprotein subclass particle profile to a healthier pattern,” says Dr. Arianna Carughi, nutrition consultant to American Pistachio Growers. Dr. Carughi continues, “This is particularly important for those with prediabetes and type 2 diabetes as they are at higher risk of heart disease. This is one of only a few studies that looks at how diet can affect lipoprotein subtractions, an emerging marker of heart disease risk.”

This research adds to previous studies that showed beneficial effects of adding pistachios to the diet on fasting blood sugar levels, insulin levels following a meal and blood pressure response to stress.

This recent study was supported in part by American Pistachio Growers, and was conducted by researchers with the Universitat Rovira i Virgili, Reus and Instituto de Salud Carlos III, both in Spain. None of the funding sources played a role in the design, collection, analysis or interpretation of the data.


Hernández-Alonso P, Salas-Salvadó J, Baldrich-Mora M, Mallol R, Correig X, Bulló M, Effect of pistachio consumption on plasma lipoprotein subclasses in prediabetic subjects, Nutrition, Metabolism and Cardiovascular Diseases (2015), doi: 10.1016/j.numecd.2015.01.013.

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