Effects of energy restriction with and without almonds on weight and cardiometabolic risk factors

Despite evidence of an inverse association between nut consumption and body mass index,⁽¹⁾ the role of nuts in weight loss and weight maintenance is limited. In a parallel study design, it was evaluated whether the inclusion of 15% of energy from almonds [almond-enriched diet (AED)] compared to carbohydrate-rich snacks in an otherwise nut-free energy-restricted diet [nut-free control diet (NFD)] would improve weight loss during 3 months of dietary energy restriction (−30%E, phase 1) and limit weight regain during 6 months of weight maintenance (phase 2).⁽²⁾ Outcomes were measured at baseline and the end of each phase. One hundred and forty adults (aged 25–65 years) with overweight or obesity (body mass index [BMI]: 27.5–34.9 kg/m²) were recruited and randomly allocated to the AED (n = 68) or the NFD (n = 72). There was a significant reduction in weight during phase 1 (p < 0.001) of −6.9 ± 0.5 kg in the AED and −7.0 ± 0.5 kg in the NFD, with no difference between groups (p = 0.858). There was a small amount of additional weight loss in both groups during phase 2 (−1.2 ± 0.4 kg, p = 0.009), but again with no significant difference between the groups (p = 0.756). There was a significant reduction in fat mass (−7.3 ± 0.4 kg, p < 0.001) and a small but significant reduction in lean mass (−0.9 ± 0.1 kg, p < 0.001), resulting in a significant increase in percent lean mass over the duration of the study (4.8 ± 0.3%, p < 0.001). HbA1c increased (0.1 ± 0.04%, p = 0.020) and fasting insulin decreased (−9.3 ± 3.8 pmol/L, p = 0.049) in phase 1 only for both groups and there was a reduction in fasting glucose at end of phase 2 (−0.2 ± 0.07 mmol/L, p = 0.002). Blood pressure fell over the duration of the study for both groups (−4.9 ± 0.8 mm/Hg systolic and −5.0 ± 0.5 mm/Hg diastolic, p < 0.001). Total cholesterol, LDL-C, VLDL-C and triglycerides significantly decreased over time for both groups (−0.3 ± 0.07 mmol/L, −0.2 ± 0.06 mmol/L, −0.1 ± 0.03 mmol/L, −0.3 ± 0.06 mmol/L, respectively, all p < 0.001) and HDL-C significantly increased for both groups (0.065 ± 0.02 mmol/L, p = 0.011). No group x time interactions were observed for any outcome measures. These findings provide further evidence that an almond-enriched energy-restricted diet can promote weight loss and weight maintenance comparable to a nut-free energy-restricted diet and that both diets support cardiometabolic health.