Musa-Veloso Kathy, Gauntlett Caroline, Geronimo Katrina, Vicente Isabella, Ho Samuel Pak Lam
Intertek Health Sciences Inc., 2233 Argentia Road, Suite 201, Mississauga, ON L5N 2X7, Canada.
Nutrients. 2025 Aug 28;17(17):2791. doi: 10.3390/nu17172791.
BACKGROUND/OBJECTIVES: While the benefits of almond consumption in reducing levels of TC and LDL-C are well established, the effects on additional lipids that have emerged as important predictors of cardiovascular disease, such as ApoB and the ratio of ApoB:ApoA, are not well characterized. In this systematic review and meta-analysis, the effects of almond consumption on blood lipids were comprehensively assessed.
On 12 May 2025, ProQuest Dialog™ was used to search ten literature databases (AdisInsight: Trials; Allied & Complementary Medicine™; BIOSIS Previews; CAB ABSTRACTS; Embase; Embase Preprints; Foodline: SCIENCE; FSTA; MEDLINE; National Technical Information Service). Randomized controlled trials at least 4 weeks in duration were included if the investigational product was almonds; the control was void of nuts/tree nuts; the subjects were adults without CVD; and blood lipid levels were assessed. Health Canada's Quality Appraisal Tool for Intervention Studies was used to assess each study's risk of bias. The mean difference in the effect for each parameter was pooled across studies in a random effects model, using the inverse of the variance as the weighting factor.
36 publications (48 almond-control datasets) representing 2485 participants were included. Almond consumption significantly reduced LDL-C (-0.132 mmol/L; 95% CI: -0.190, -0.075 mmol/L; < 0.001), TC (-0.160 mmol/L; 95% CI: -0.218, -0.101 mmol/L; < 0.001), non-HDL-C (-0.204 mmol/L; 95% CI: -0.281, -0.127 mmol/L; < 0.001), TC:HDL-C (-0.154; 95% CI: -0.246, -0.063; = 0.001), LDL-C:HDL-C (-0.112; 95% CI: -0.199, -0.026; = 0.011), ApoB (-4.552 mg/dL; 95% CI: -6.460, -2.645 mg/dL; < 0.001), and ApoB:ApoA (-0.027; 95% CI: -0.046, -0.008; = 0.006), with a borderline significant reduction in TG (-0.037 mmol/L; 95% CI: -0.079, 0.005; = 0.085) and no effects on HDL-C, ApoA, or Lp[a]. The effects persisted when the analyses were limited to higher quality studies, except for the reduction in TG.
Almond consumption improves levels of LDL-C, TC, non-HDL-C, TC:HDL-C, LDL-C:HDL-C, ApoB, and ApoB:ApoA, though dedicated clinical trials are needed to better understand effects on TG levels.
背景/目的：虽然食用杏仁在降低总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平方面的益处已得到充分证实，但对于已成为心血管疾病重要预测指标的其他血脂指标，如载脂蛋白B（ApoB）以及ApoB与载脂蛋白A（ApoA）的比值，其影响尚不明确。在本系统评价和荟萃分析中，全面评估了食用杏仁对血脂的影响。
于2025年5月12日，使用ProQuest Dialog™检索了10个文献数据库（阿迪斯洞察：试验；联合与补充医学™；生物学文摘数据库；CAB文摘；Embase；Embase预印本；食品线：科学；食品科学与技术文摘；医学索引；国家技术信息服务处）。纳入持续时间至少4周的随机对照试验，条件为研究产品为杏仁；对照不含坚果/树坚果；受试者为无心血管疾病的成年人；且评估了血脂水平。使用加拿大卫生部干预研究质量评估工具评估每项研究的偏倚风险。采用随机效应模型，以方差的倒数作为权重因子，汇总各研究中每个参数效应的平均差异。
纳入了36篇文献（48个杏仁-对照数据集），共2485名参与者。食用杏仁显著降低了LDL-C（-0.132 mmol/L；95%置信区间：-0.190，-0.075 mmol/L；P<0.001）、TC（-0.160 mmol/L；95%置信区间：-0.218，-0.101 mmol/L；P<0.001）、非HDL-C（-0.204 mmol/L；95%置信区间：-0.281，-0.127 mmol/L；P<0.001）、TC:HDL-C（-0.154；95%置信区间：-0.246，-0.063；P = 0.001）、LDL-C:HDL-C（-0.112；95%置信区间：-0.199，-0.026；P = 0.011）、ApoB（-4.552 mg/dL；95%置信区间：-6.460，-2.645 mg/dL；P<0.001）以及ApoB:ApoA（-0.027；95%置信区间：-0.046，-0.008；P = 0.006），甘油三酯（TG）有边缘性显著降低（-0.037 mmol/L；95%置信区间：-0.079，0.005；P = 0.085），对HDL-C、ApoA或脂蛋白[a]（Lp[a]）无影响。当分析仅限于高质量研究时，除TG降低外，其他影响仍然存在。
食用杏仁可改善LDL-C、TC、非HDL-C、TC:HDL-C、LDL-C:HDL-C、ApoB和ApoB:ApoA的水平，不过需要专门的临床试验来更好地了解对TG水平的影响。
