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Review
. 2024 Sep 23;13(18):3008.
doi: 10.3390/foods13183008.

Effect of Nuts Combined with Energy Restriction on the Obesity Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Darlene Larissa de Souza Vilela  1   2 , Alessandra da Silva  3   4 , Ana Claudia Pelissari Kravchychyn  1   2 , Josefina Bressan  1   2 , Helen Hermana Miranda Hermsdorff  1   2
Affiliations
Review

Effect of Nuts Combined with Energy Restriction on the Obesity Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Darlene Larissa de Souza Vilela et al. Foods. .

Abstract

Obesity is a multifactorial disease that is difficult to control worldwide. Although nuts are recognized health foods, the application of food in obesity management is unclear. We systematically reviewed the literature and performed a meta-analysis to evaluate if nut consumption favors people on energy restriction (ER) dietary interventions. Four databases were used to search for eligible articles in May 2024. This review was conducted according to the PRISMA guide, and the bias risk of papers was evaluated. For the meta-analysis, we extracted the endpoint values of the group's variables and estimated the effect sizes by the random-effects model. Sixteen and ten articles were included in the systematic review and meta-analysis, respectively. Almonds were evaluated in the majority of studies (n = 6). The consumption of nuts (28 to 84 g/d, 4 to 72 months) included in ER (-250 to 1000 kcal/d) did not differently affect anthropometry (weight loss, BMI, waist and hip circumferences), body composition (fat mass, fat-free mass, or lean mass), markers of glucose (glycemia and insulinemia), lipid metabolism (total cholesterol, HDL-c, LDL-c, LDL-c/HDL-c, or triglycerides), and systolic and diastolic blood pressure. In most analyses, stratifying studies by type of nut or intervention time did not present different results in the meta-analysis. As there are few studies, in addition to great methodological variability, more high-quality trials are needed to confirm these results. The PROSPERO registration number is CRD42023444878.

Keywords: cardiometabolic diseases; energy restriction; obesity; oilseeds; overweight; weight loss.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for new systematic reviews, which included searches of databases and registers only [29].
Figure 2
Figure 2
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diets on weight loss [25,28,37,38,39,42,44,46,47]. Squares represent the weight of studies in meta-analysis, and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; CV, conventional peanuts group; HOP, high-oleic peanuts group; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 3
Figure 3
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on body mass index [25,28,37,38,39,42,44,46,47] Squares represent the weight of studies in meta-analysis, and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; CV, conventional peanuts group; HOP, high-oleic peanuts group; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 4
Figure 4
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on waist circumference [25,28,37,39,41,42,44,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; CV, conventional peanuts group; HOP, high-oleic peanuts group; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 5
Figure 5
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on hip circumference [25,44,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. CV, conventional peanuts group; HOP, high-oleic peanuts group.
Figure 6
Figure 6
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on fat mass [28,42,44,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; CV, conventional peanuts group; HOP, high-oleic peanuts group; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 7
Figure 7
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on fat-free mass or lean mass [28,41,42,44,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; CV, conventional peanuts group; HOP, high-oleic peanuts group; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 8
Figure 8
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on total cholesterol [25,28,37,38,39,43,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 9
Figure 9
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on low-density lipoprotein cholesterol [25,28,37,38,39,41,43,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 10
Figure 10
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on high-density lipoprotein cholesterol [25,28,37,38,39,41,43,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 11
Figure 11
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-c/HDL-c ratio) [28,43,46,47]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 12
Figure 12
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on triglyceride levels [25,28,37,38,39,41,43,46,47] Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 13
Figure 13
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on glycaemia [25,28,38,39,41,46,47,48]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 14
Figure 14
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on insulinemia [28,38,39,46,47,48]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 15
Figure 15
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on homeostatic model assessment for insulin resistance (HOMA-IR) [28,39,46,47,48]. Squares represent the weight of studies in meta-analysis and horizontal lines their 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 16
Figure 16
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on systolic blood pressure [25,28,37,39,41,46,47,48]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
Figure 17
Figure 17
Forest plot of randomized controlled trials investigating the effects of nut consumption combined with energy-restricted diet on diastolic blood pressure [25,28,37,39,41,46,47,48]. Squares represent the weight of studies in meta-analysis and horizontal lines, the 95% CI; diamond’s center represents the combined treatment effect and horizontal tips represent the 95% CI. CI: confidence interval; SMD: standard mean difference. T1, first assessment after intervention; T2, second assessment after intervention; WP, whole roasted peanuts group; SP, skinned peanuts group.
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