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CHAPTER OUTLINE
Introduction 161 Botanical Description 162 Historical Cultivation and Usage 162 Present-Day Cultivation and Usage 162 Applications to Health Promotion and Disease Prevention 163 Adverse Effects and Reactions (Allergies and Toxicity) 165 Summary Points 165 References 165
LIST OF ABBREVIATIONS
BMI, body mass index CHD, coronary heart disease CVD, cardiovascular disease LDL, low-density lipoprotein MUFA, monounsaturated fatty acid ROS, reactive oxidative species
INTRODUCTION
The word almond, sometimes used to dene the shape of objects, comes from the Greek amygdala, which literally refers to the well known seed. Though the commonly used term nut
Nuts & Seeds in Health and Disease Prevention. DOI: 10.1016/B978-0-12-375688-6.10018-0 Copyright 2011 Elsevier Inc. All rights reserved.
refers to a wide range of seeds, based on botanical denitions almonds are not actually true nuts (Rushforth, 1999). While hazelnuts meet the botanical denition of nuts, almonds (along with pistachios and walnuts) are seeds of drupe fruits. Despite this inconsistency, these variable seeds have been clustered together under the collective term tree nuts. Almonds have historically and culturally been associated with good health, in India with good brain health, and in China with female beauty. Years of research have come to validate some of the age-old beliefs about these seeds. The various bioactive components and the unique macronutrient prole of nuts have been linked to lowering oxidative stress and inammation, improving lipid proles (Sabate et al., 2003), endothelial function (Ros, 2009), and blood pressure (Estruch et al., 2006). The ability of these seeds to improve the blood lipid prole and assist in diabetes management (Kris-Etherton et al., 2001; Lovejoy et al., 2002; Josse et al., 2007; Kendall et al., 2010), as well as reducing coronary heart disease (CHD) risk, has progressively become more established and considered as therapeutic (Ternus et al., 2006). Furthermore, with increasing rates of chronic diseases (including diabetes and cancer), known for causing greater levels of oxidative stress, the antioxidant effects of almonds are, now more than ever, of particular interest.
BOTANICAL DESCRIPTION
The almond is the seed of Prunus Dulcis, a small deciduous species of tree (4e10 m tall). The Prunus Dulcis drupe consists of an outer hull (exocarp) and a hard shell (endocarp) with the seed inside. Almond trees are not immediately productive, and only bear fruit after 5 years. It is in autumn, 7 to 8 months after owering, that the fruit becomes mature (Grifths & Anthony, 1992; Rushforth, 1999).
(1 million beehives) are trucked in to the almond groves in February for this task. Pollination of almonds has been heavily impacted by the colony collapse disorder affecting the bee population globally. In 2006, because of two cases of Salmonella traced to almonds, the Almond Board of California proposed pasteurization of almonds available to the public; the USDA has approved this as part of the almond distribution process. Almonds continue to be used in various foods, but they have now become of particular interest in nutraceuticals as a means of therapy. They have been linked to disease prevention and management in numerous studies. An example of almond incorporation into present-day diets is the use of almond milk. Almond milk, a dairy milk substitute, is processed from almonds, and makes an efcient and well-liked soy-free choice analog for lactose-intolerant people and for vegans. More innovative methods of incorporating almonds in diets as healthy alternatives continue to be explored and developed. Recently, a low carbohydrate nut-bread recipe was conceived at the St Michaels Hospital Clinical Nutrition and Risk Factor Modication Center in Toronto, and this, due to its high palatability and benecial nutrient prole, was used in the successful EcoAtkins weight loss and cholesterol lowering trial (see Table 18.1 for the recipe) (Jenkins et al., 2009).
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Ideally, all ingredients should be weighed, but if you dont have a scale, approximate volumes are provided.
*Estimates are based on United States Department of Agriculture (USDA) National Nutrient Database standard references; values
are given per 100 grams. All approximations are based on different numbers of data points.
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Almonds have also been linked to the risk of developing type 2 diabetes. According to the American Diabetes Association, glycemic control is of crucial importance for the prevention and management of diabetes (American Diabetes Association, 2007). Evidence suggests that when eaten alone or in combination with mixed meals, the low available carbohydrate content of nuts can help lower the postprandial glucose and insulin responses, and, as such, play a benecial role in glycemic control (Josse et al., 2007; Kendall et al., 2010). Moreover, it has been suggested that high MUFA consumption can also improve glycemic control (Kendall et al., 2010), possibly by displacing the carbohydrates and effectively decreasing the glycemic load. Since hyperglycemia is a major cause of oxidative stress in diabetic patients (Brownlee, 2001), these benets of almond consumption may have considerable potential in reducing reactive oxidative species (ROS) through reducing the glycemic excursions of foods consumed with almonds (Monnier et al., 2006; Kendall et al., 2010). ROS have been associated with multiple disease states, including CVD and cancer (Mercuri et al., 2000). Almonds and other nuts contain a multitude of antioxidants (Table 18.2) that may prove to reduce the extent of oxidative damage incurred to cells through metabolism (Chen et al., 2005). A recent study examined the acute effects of nut consumption in healthy human subjects. The investigators found that both almonds and walnuts (in the form of smoothies) led to signicant increases in the plasma polyphenol concentration following the nut meals (Torabian et al., 2009). The same study showed that the susceptibility of plasma lipids to peroxidation decreased after 90 minutes on both nut treatments, but not on the control. Similar results have been noted in a trial of 60 male smokers, where almonds were shown to decrease lipid peroxidation and reduce oxidative damage to DNA (Li et al., 2007). Moreover, avonoids found in the skin of almonds may further contribute to oxidative protective benets. Flavonoids are considered to possess a variety of biological activities, including antioxidant and anti-inammatory capability. The antioxidant properties of almond avonoid were recently shown to be highly biologically available and work synergistically with other
antioxidants (Vitamins C and E) to protect against LDL oxidation in vitro, as well as enhancing resistance to Cu2 induced oxidation of LDL ex vivo (Chen et al., 2005). These data suggest that almonds are a rich source of bioactive compounds and antioxidants that can prevent lipid, DNA, and protein peroxidation. In conclusion, through the many macro- and micronutrients that almond seeds contain (Table 18.2), they may contribute to lowering oxidative damage in both healthy individuals and patients with chronic disease. These effects may be achieved either indirectly, via lowering the overall glycemic load and the glycemic index of meals consumed concomitantly (Brownlee, 2001; Monnier et al., 2006; Kendall et al., 2010), or more directly through their intrinsic polyphenols and avonoids. Therefore, it is not surprising that almond seeds and other nuts have been so prevalently associated with signicant reductions in risk factors for developing CHD, CVD, diabetes, and other chronic diseases (Ros, 2009; Kendall et al., 2010).
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SUMMARY POINTS
l l
The high levels of MUFAs in almond (Prunus Dulcis) have been shown to improve glycemic control; hence the management of type 2 diabetes. The low carbohydrate content of nuts results in a low glycemic index and a moderate postprandial serum glucose excursion. The highly bioavailable avonoids and polyphenols that almonds contain help to reduce lipid, protein, and DNA peroxidation. Through reduction of postprandial glycemia, almonds have been shown to reduce oxidative stress, and therefore to decrease the risks of CHD and cancer. Nut consumption has been indicated for weight loss, and as a part of a weight-maintaining diet.
References
American Diabetes Association. (2007). Nutrition Recommendations and Interventions for Diabetes: a position statement of the American Diabetes Association. Diabetes Care, 30(Suppl. 1), S48eS65. Bes-Rastrollo, M., Wedick, N. M., Martinez-Gonzalez, M. A., Li, T. Y., Sampson, L., & Hu, F. B. (2009). Prospective study of nut consumption, long-term weight change, and obesity risk in women. The American Journal of Clinical Nutrition, 89, 1913e1919. Brownlee, M. (2001). Biochemistry and molecular cell biology of diabetic complications. Nature, 414, 813e820. Chen, C. Y., Milbury, P. E., Lapsley, K., & Blumberg, J. B. (2005). Flavonoids from almond skins are bioavailable and act synergistically with vitamins C and E to enhance hamster and human LDL resistance to oxidation. Journal of Nutrition, 135, 1366e1373.
Estruch, R., Martinez-Gonzalez, M. A., Corella, D., Salas-Salvado, J., Ruiz-Gutierrez, V., Covas, M. I., et al. (2006). Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Annals of Internal Medicine, 145, 1e11. Grifths, M. D., & Anthony, J. H. (1992). The New Royal Horticultural Society dictionary of gardening. London, UK: Macmillan Press. Jenkins, D. J., Wong, J. M., Kendall, C. W., Esfahani, A., Ng, V. W., Leong, T. C., et al. (2009). The effect of a plantbased low-carbohydrate ("Eco-Atkins") diet on body weight and blood lipid concentrations in hyperlipidemic subjects. Archives of Internal Medicine, 169, 1046e1054. Josse, A. R., Kendall, C. W., Augustin, L. S., Ellis, P. R., & Jenkins, D. J. (2007). Almonds and postprandial glycemia e a doseeresponse study. Metabolism, 56, 400e404. Kendall, C. W., Esfahani, A., Truan, J., Srichaikul, K., & Jenkins, D. J. (2010). Health benets of nuts in prevention and management of diabetes. Asia Pacic Journal of Clinical Nutrition, 19, 110e116. Kris-Etherton, P. M., Zhao, G., Binkoski, A. E., Coval, S. M., & Etherton, T. D. (2001). The effects of nuts on coronary heart disease risk. Nutrition Reviews, 59, 103e111. Li, N., Jia, X., Chen, C. Y., Blumberg, J. B., Song, Y., Zhang, W., et al. (2007). Almond consumption reduces oxidative DNA damage and lipid peroxidation in male smokers. Journal of Nutrition, 137, 2717e2722. Lovejoy, J. C., Most, M. M., Lefevre, M., Greenway, F. L., & Rood, J. C. (2002). Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. The American Journal of Clinical Nutrition, 76, 1000e1006. Matasar, M. J., & Neugut, A. I. (2003). Epidemiology of anaphylaxis in the United States. Current Allergy and Asthma Reports, 3, 30e35. Mercuri, F., Quagliaro, L., & Ceriello, A. (2000). Oxidative stress evaluation in diabetes. Diabetes Technology & Therapeutics, 2, 589e600. Monnier, L., Mas, E., Ginet, C., Michel, F., Villon, L., Cristol, J. P., et al. (2006). Activation of oxidative stress by acute glucose uctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. The Journal of the American Medical Association, 295, 1681e1687. Rieger, M. (2006). Introduction to fruit crops. New York, NY: Food Products Press. Ros, E. (2009). Nuts and novel biomarkers of cardiovascular disease. The American Journal of Clinical Nutrition, 89, 1649Se1656S.
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Roux, K. H., Teuber, S. S., & Sathe, S. K. (2003). Tree nut allergens. International Archives of Allergy and Immunology, 131, 234e244. Rushforth, K. (1999). Collins Wildlife Trust guide to trees: a photographic guide to the trees of Britain and Europe. London, UK: Harper Collins. Sabate, J., Haddad, E., Tanzman, J. S., Jambazian, P., & Rajaram, S. (2003). Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feeding trial. The American Journal of Clinical Nutrition, 77, 1379e1384. Ternus, M., McMahon, K., Lapsley, K., & Johnson, G. (2006). Qualied health claim for nuts and heart disease prevention: development of consumer-friendly language. Nutrition Today, 41, 62e66. The Food Standards Agency. (2010). The Food Standards Agency Aatoxins in Nuts Survey. London, UK: FSA. Torabian, S., Haddad, E., Rajaram, S., Banta, J., & Sabate, J. (2009). Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation. Journal of Human Nutrition and Dietetics, 22, 64e71. Zohary, D., & Maria, H. (2000). Domestication of plants in the old world: the origin and spread of cultivated plants in West Asia, Europe, and the Nile Valley. Oxford, UK: Oxford University Press.