Hazelnut-enriched diet improves cardiovascular risk biomarkers beyond a lipid-lowering effect in hypercholesterolemic subjects

J Clin Lipidol. 2013 Mar-Apr;7(2):123-31. doi: 10.1016/j.jacl.2012.10.005. Epub 2012 Oct 26.


Background: Tree nuts, particularly almonds, walnuts, and pistachios, have been shown to possess cardioprotective effects. However, there is little information on the effects of hazelnut consumption on cardiovascular risk markers.

Methods: The antiatherogenic effect of hazelnut before and after consumption in hypercholesterolemic subjects was investigated. Twenty-one hypercholesterolemic volunteers (18 men and 3 women) were recruited in a double control sandwich model intervention study with a single group and three isoenergetic diet periods. These were control diet I (4 weeks), hazelnut-enriched diet (4 weeks; hazelnut contributing 18%-20% of the total daily energy intake), and control diet period II (4 weeks). The cardiovascular risk biomarkers such as endothelial function, using flow-mediated dilation (FMD) technique, low-density lipoprotein (LDL) oxidation products and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule-1 (sVCAM-1) as well as lipids and lipoprotein levels were monitored.

Results: Consumption of a hazelnut-enriched diet significantly improved FMD (56.6%), total cholesterol (-7.8%), triacylglycerol (-7.3%), LDL-cholesterol (-6.17%), and high-density lipoprotein cholesterol (6.07%) compared with the control diet I. Oxidized-LDL, hs-CRP, and sVCAM-1 levels were significantly lower in the group ingesting a hazelnut-enriched diet compared with the control diets I and II. Modest correlations between sVCAM-1 and FMD and between sVCAM-1 and hs-CRP were observed (r = -0.49, P < .025; r = 0.66, P < .001, respectively).

Conclusion: Hazelnut-enriched diets may exert antiatherogenic effect by improving endothelial function, preventing LDL oxidation, and inflammatory markers, in addition to their lipid and lipoprotein-lowering effects. These beneficial effects appeared to be reversible after 4 weeks on a hazelnut-free diet. Therefore, hazelnut may be incorporated into daily diet without change in total caloric intake for sustained health benefit.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Corylus
  • Diet*
  • Fatty Acids / analysis
  • Female
  • Humans
  • Hypercholesterolemia / diet therapy*
  • Hypoglycemic Agents / therapeutic use*
  • Intercellular Adhesion Molecule-1 / blood
  • Lipoproteins, LDL / blood
  • Male
  • Middle Aged
  • Risk Factors
  • Triglycerides / blood
  • Vascular Cell Adhesion Molecule-1 / blood


  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Fatty Acids
  • Hypoglycemic Agents
  • Lipoproteins, LDL
  • Triglycerides
  • Vascular Cell Adhesion Molecule-1
  • oxidized low density lipoprotein
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein
  • Cholesterol