LAUSR

Background: Nut intake is associated with lower risk of cardiometabolic diseases through reductions in low density lipoprotein cholesterol (LDL-C) and triglycerides and improvements in measures of glycemic control. The cardiometabolic effects of pecan consumption have been less studied in comparison with other nuts. Objectives: The aim of this trial was to examine how substitution of usual snack foods with 57 g/day of pecans affects lipids and lipoproteins and measures of glycemic control compared to continuing usual dietary intake after 12-weeks in individuals at increased risk for cardiometabolic diseases. Methods: A 12-week single-blinded, parallel, randomized controlled trial was conducted. Adults with overweight or obesity and with ≥1 criterion for metabolic syndrome who were free from cardiovascular disease and type 2 diabetes were included. Participants were provided with 57 g/day of pecans and instructed to replace the snacks usually consumed with the provided pecans. The control group was instructed to continue consuming their usual intake. Lipids/lipoproteins and glycemic outcomes (i.e., fasting plasma glucose, hemoglobin A1C and insulin) were measured over two days approximately 24 hours apart at baseline and after 12 weeks. The between-group difference in the change from baseline for each outcome was evaluated by linear regression with adjustment for the baseline value, age, sex and body mass index. Results: In total, 138 participants (46 ± 13 years, 29.8 ± 3.7 kg/m 2 ; 59% female) were randomized. Both groups had 69 participants. Compared to the usual diet group, pecan intake reduced total cholesterol (-8.1 mg/dL; 95% CI -14.5, -1.7), LDL-C (-7.2 mg/dL; 95% CI -12.3, -2.1), non-HDL-C (-9.5 mg/dL; 95% CI -15.3, -3.7), and triglycerides (-16.4 mg/dL; 95% CI -30.0, -2.9) from baseline to 12 weeks. No between-group differences were observed for high-density lipoprotein cholesterol (HDL-C) or measures of glycemic control. Conclusions: Replacing usual snacks with 57 g/day of pecans for 12 weeks improved lipids and lipoproteins in adults at increased risk for cardiometabolic diseases.