Statins and almonds to lower lipoproteins (the STALL Study)

• Published in: Journal of clinical lipidology Vol. 9; no. 1; pp. 58 - 64
• Main Authors: Ruisinger, Janelle F., Gibson, Cheryl A., Backes, James M., Smith, Bryan K., Sullivan, Debra K., Moriarty, Patrick M., Kris-Etherton, Penny
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2015
• Subjects: Adolescent; Adult; Aged; Almonds; Body Weight; Cardiovascular; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Dietary Supplements; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - drug therapy; Life Style; Lipoprotein(a) - blood; Lipoproteins; Male; Middle Aged; Nuts; Prunus - chemistry; Statins; Treatment Outcome; Triglycerides - blood; Young Adult; Lipoproteins; Nuts; Almonds; Cholesterol; Statins
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2014.10.001

Dietary supplementation with almonds has demonstrated dose-dependent decreases in low-density lipoprotein cholesterol (LDL-C), likely because of their composition of beneficial nutrients including mono- and polyunsaturated fatty acids, fiber, and protein. The primary objective of this study was to determine the changes in the lipid profile (LDL-C, high-density lipoprotein cholesterol [HDL-C], triglycerides, total cholesterol, non–HDL-C), LDL-C particle size, and lipoprotein (a) when 100 g of almonds daily were added to background statin therapy for 4 weeks. Subjects (N = 48) receiving a consistent statin dose were randomized to 100 g of almonds daily and to The National Cholesterol Education Program Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (almond group; n = 22) or solely Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (non-almond group; n = 26), for 4 weeks. No significant changes in weight and weekly physical activity were noted between the 2 groups from baseline. However, the almond group consumed significantly more calories at 4 weeks compared with controls. The almond group experienced a 4.9% reduction in non–HDL-C compared with a 3.5% increase for the non-almond group (P = .02). Additionally, notable improvements were observed in LDL-C and triglycerides, but did not achieve statistical significance (P = .068 for both parameters). There was also a shift from LDL pattern A to pattern B particles (P = .003) in the almond group. No significant differences in total cholesterol (P = .1), HDL-C (P = .3), or lipoprotein (a) (P = .1) were observed. Adding 100 g of almonds daily to chronic statin therapy for 4 weeks significantly reduced non–HDL-C. Trial registration: clinicaltrials.gov Identifier: NCT00603876. ►One hundred grams of almonds daily added to statin therapy lowered non–HDL-C.►Subjects in the almond group did not gain weight compared with controls.►Subjects in the almond group experienced significant changes in LDL pattern type.