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Nutrition attributes and health effects of pistachio nuts

  • M. Bulló (a1) (a2), M. Juanola-Falgarona (a1) (a2), P. Hernández-Alonso (a1) and J. Salas-Salvadó (a1) (a2)

Epidemiological and/or clinical trials have suggested that nut consumption has a beneficial impact on health outcomes such as hypertension, diabetes, CVD, cancer, other inflammatory conditions and total mortality. Nuts are nutrient-dense foods with a healthy fatty acid profile, as well as provide other bioactive compounds with recognised health benefits. Among nuts, pistachios have a lower fat and energy content and the highest levels of K, γ-tocopherol, vitamin K, phytosterols, xanthophyll carotenoids, certain minerals (Cu, Fe and Mg), vitamin B6 and thiamin. Pistachios have a high antioxidant and anti-inflammatory potential. The aforementioned characteristics and nutrient mix probably contribute to the growing body of evidence that consumption of pistachios improves health. The present review examines the potential health effects of nutrients and phytochemicals in pistachios, as well as epidemiological and clinical evidence supporting these health benefits.

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Corresponding author
*Corresponding authors: Dr M. Bulló, fax +34 977759322, email; Dr J. Salas-Salvadó, fax +34 977759322, E-mail:
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1Sabaté J & Ang Y (2009) Nuts and health outcomes: new epidemiologic evidence. Am J Clin Nutr 89, 1643S1648S.
2Estruch R, Ros E, Salas-Salvadó J, et al. (2013) Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 368, 12791290.
3Jenkins DJA, Kendall CWC, Banach MS, et al. (2011) Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care 34, 17061711.
4Lloyd-Jones DM, Hong Y, Labarthe D, et al. (2010) Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic impact goal through 2020 and beyond. Circulation 586613.
5Stone NJ, Robinson JG, Lichtenstein AH, et al. (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129, S1S45.
6Anderson TJ, Grégoire J, Hegele RA, et al. (2013) 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol 29, 151167.
7US Food and Drug Administration (2003)Qualified Health Claims: Letter of Enforcement Discretion – Nuts and Coronary Heart Disease. Rockville, MD: US Food and Drug Administration.
8Bao Y, Han J, Hu FB, et al. (2013) Association of nut consumption with total and cause-specific mortality. N Engl J Med 369, 20012011.
9Guasch-Ferré M, Bulló M, Martínez-González M, et al. (2013) Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial. BMC Med 11, 164.
10U.S. Department of Agriculture ARS (2013) USDA National Nutrient Database for Standard Reference, Release 26. Nutrient Data Laboratory Home Page. United States Department of Agriculture.
11Halvorsen BL, Carlsen MH, Phillips KM, et al. (2006) Content of redox-active compounds (i.e. antioxidants) in foods consumed in the United States. Am J Clin Nutr 84, 95135.
12Mandalari G, Bisignano C, Filocamo A, et al. (2013) Bioaccessibility of pistachio polyphenols, xanthophylls, and tocopherols during simulated human digestion. Nutrition 29, 338344.
13O'Neil CE, Keast DR, Fulgoni VL, et al. (2010) Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health and Nutrition Examination Survey (NHANES) 1999–2004. Asia Pac J Clin Nutr 19, 142150.
14O'Neil CE, Keast DR, Nicklas TA, et al. (2012) Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999–2004. Nutr Res 32, 185194.
15Tey SL, Brown R, Gray A, et al. (2011) Nuts improve diet quality compared to other energy-dense snacks while maintaining body weight. J Nutr Metab 2011, 357350.
16McManus K, Antinoro L & Sacks F (2001) A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord 25, 15031511.
17Gillingham LG, Harris-Janz S & Jones PJH (2011) Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors. Lipids 46, 209228.
18Covance Certificate of Analysis, Report # 709901-0. Iran (accessed 15 January 2013).
19Covance Certificate of Analysis, Report # 710331-0. Turkey (accessed 16 January 2013).
20Satil F, Azcan N & Baser KHC (2003) Fatty acid composition of pistachio nuts in Turkey. Chem Nat Compd 39, 322324.
21Ros E (2009) Nuts and novel biomarkers of cardiovascular disease. Am J Clin Nutr 89, 1649S1656S.
22Loscalzo J & Welch G (1995) Nitric oxide and its role in the cardiovascular system. Prog Cardiovasc Dis 38, 87104.
23Jaffrey SR & Snyder SH (1995) Nitric oxide: a neural messenger. Annu Rev Cell Dev Biol 11, 417440.
24Víteček J, Lojek A, Valacchi G, et al. (2012) Arginine-based inhibitors of nitric oxide synthase: therapeutic potential and challenges. Mediators Inflamm 2012, 318087.
25Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: The National Academies Press.
26Sathe SK, Monaghan EK, Kshiesagar HH, et al. (2008) Chemical composition of edible nut seeds and its implications in human health. In Tree Nuts Composition, Phytochemicals and Health Effects, pp. 1229 [Alsalvar C and Shahidi F, editors]. Florida, USA: Taylor & Francis Group.
27Ye EQ, Chacko SA, Chou EL, et al. (2012) Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr 142, 13041313.
28Kaczmarczyk MM, Miller MJ & Freund GG (2012) The health benefits of dietary fiber: beyond the usual suspects of type 2 diabetes mellitus, cardiovascular disease and colon cancer. Metabolism 61, 10581066.
29Anderson JW, Hanna TJ, Peng X, et al. (2000) Whole grain foods and heart disease risk. J Am Coll Nutr 19, 291S299S.
30Kendall CWC, West SG, Augustin LS, et al. (2014) Acute effects of pistachio consumption on glucose and insulin, satiety hormones and endothelial function in the metabolic syndrome. Eur J Clin Nutr 68, 370375.
31Gulati S, Misra A, Pandey RM, et al. (2014) Effects of pistachio nuts on body composition, metabolic, inflammatory and oxidative stress parameters in Asian Indians with metabolic syndrome: a 24-wk, randomized control trial. Nutrition 30, 192197.
32Rothwell JA, Urpi-Sarda M, Boto-Ordoñez M, et al. (2012) Phenol-Explorer 2·0: a major update of the Phenol-Explorer database integrating data on polyphenol metabolism and pharmacokinetics in humans and experimental animals. Database (Oxford) 2012:bas031, 18.
33Carlsson CM (2006) Homocysteine lowering with folic acid and vitamin B supplements: effects on cardiovascular disease in older adults. Drugs Aging 23, 491502.
34Bulló M, Estruch R & Salas-Salvadó J (2011) Dietary vitamin K intake is associated with bone quantitative ultrasound measurements but not with bone peripheral biochemical markers in elderly men and women. Bone 48, 13131318.
35Ibarrola-Jurado N, Salas-Salvadó J, Martínez-González MA, et al. (2012) Dietary phylloquinone intake and risk of type 2 diabetes in elderly subjects at high risk of cardiovascular disease. Am J Clin Nutr 96, 11131118.
36Juanola-Falgarona M, Salas-Salvadó J, Estruch R, et al. (2013) Association between dietary phylloquinone intake and peripheral metabolic risk markers related to insulin resistance and diabetes in elderly subjects at high cardiovascular risk. Cardiovasc Diabetol 12, 7.
37Nimptsch K, Rohrmann S, Kaaks R, et al. (2010) Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr 91, 13481358.
38Juanola-Falgarona M, Salas-Salvadó J, Martínez-González , et al. (2014) Dietary intake of vitamin K is inversely associated with mortality risk. J Nutr 144, 743750.
39Dietrich M, Traber MG, Jacques PF, et al. (2006) Does γ-tocopherol play a role in the primary prevention of heart disease and cancer? A review. J Am Coll Nutr 25, 292299.
40Huang H-Y, Caballero B, Chang S, et al. (2006) The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Ann Intern Med 145, 372385.
41Hercberg S, Kesse-Guyot E, Druesne-Pecollo N, et al. (2010) Incidence of cancers, ischemic cardiovascular diseases and mortality during 5-year follow-up after stopping antioxidant vitamins and minerals supplements: a postintervention follow-up in the SU.VI.MAX Study. Int J Cancer 127, 18751881.
42Bulló M, Lamuela-Raventós R & Salas-Salvadó J (2011) Mediterranean diet and oxidation: nuts and olive oil as important sources of fat and antioxidants. Curr Top Med Chem 11, 17971810.
43Bolling BW, Chen C-YO, McKay DL, et al. (2011) Tree nut phytochemicals: composition, antioxidant capacity, bioactivity, impact factors. A systematic review of almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts. Nutr Res Rev 24, 244275.
44Hassellund SS, Flaa A, Kjeldsen SE, et al. (2013) Effects of anthocyanins on cardiovascular risk factors and inflammation in pre-hypertensive men: a double-blind randomized placebo-controlled crossover study. J Hum Hypertens 27, 100106.
45Gentile C, Tesoriere L, Butera D, et al. (2007) Antioxidant activity of Sicilian pistachio (Pistacia vera L. var. Bronte) nut extract and its bioactive components. J Agric Food Chem 55, 643648.
46Tomaino A, Martorana M, Arcoraci T, et al. (2010) Antioxidant activity and phenolic profile of pistachio (Pistacia vera L., variety Bronte) seeds and skins. Biochimie 92, 11151122.
47Dixon RA, Xie D-Y & Sharma SB (2005) Proanthocyanidins – a final frontier in flavonoid research? New Phytol 165, 928.
48Nikzadeh V & Sedaghat N (2008) Physical and sensory changes in pistachio nuts as affected by roasting temperature and storage. Am-Euras J Agric Environ Sci 4, 478483.
49Van het Hof KH, West CE, Weststrate JA, et al. (2000) Dietary factors that affect the bioavailability of carotenoids. J Nutr 130, 503506.
50Carpentier S, Knaus M & Suh M (2009) Associations between lutein, zeaxanthin, and age-related macular degeneration: an overview. Crit Rev Food Sci Nutr 49, 313326.
51SanGiovanni JP & Neuringer M (2012) The putative role of lutein and zeaxanthin as protective agents against age-related macular degeneration: promise of molecular genetics for guiding mechanistic and translational research in the field. Am J Clin Nutr 96, 1223S1233S.
52Ostlund RE, Racette SB & Stenson WF (2002) Effects of trace components of dietary fat on cholesterol metabolism: phytosterols, oxysterols, and squalene. Nutr Rev 60, 349359.
53Lessin WJ & Schwartz SJ (1997) Quantification of cis-trans isomers of provitamin A carotenoids in fresh and processed fruits and vegetables. J Agric Food Chem 45, 37283732.
54Updike AA & Schwartz SJ (2003) Thermal processing of vegetables increases cis isomers of lutein and zeaxanthin. J Agric Food Chem 51, 61846190.
55Fernández C, Fiandor A, Martinez-Garate A, et al. (1995) Allergy to pistachio: crossreactivity between pistachio nut and other Anacardiaceae. Clin Exp Allergy 25, 12541259.
56Noorbakhsh R, Mortazavi SA, Sankian M, et al. (2010) Influence of processing on the allergenic properties of pistachio nut assessed in vitro. J Agric Food Chem 58, 1023110235.
57Haila KM, Lievonen SM & Heinonen MI (1996) Effects of lutein, lycopene, annatto, and γ-tocopherol on autoxidation of triglycerides. J Agric Food Chem 44, 20962100.
58Subagio A & Morita N (2001) Instability of carotenoids is a reason for their promotion on lipid oxidation. Food Res Int 34, 183188.
59Bellomo MG, Fallico B & Muratore G (2009) Stability of pigments and oil in pistachio kernels during storage. Int J Food Sci Technol 44, 23582364.
60Gentile C, Allegra M, Angileri F, et al. (2012) Polymeric proanthocyanidins from Sicilian pistachio (Pistacia vera L.) nut extract inhibit lipopolysaccharide-induced inflammatory response in RAW 264.7 cells. Eur J Nutr 51, 353363.
61Zhang J, Kris-Etherton PM, Thompson JT, et al. (2010) Effect of pistachio oil on gene expression of IFN-induced protein with tetratricopeptide repeats 2: a biomarker of inflammatory response. Mol Nutr Food Res 54, Suppl. 1, S83S92.
62Aksoy N, Aksoy M, Bagci C, et al. (2007) Pistachio intake increases high density lipoprotein levels and inhibits low-density lipoprotein oxidation in rats. Tohoku J Exp Med 212, 4348.
63Alturfan AA, Emekli-Alturfan E & Uslu E (2009) Consumption of pistachio nuts beneficially affected blood lipids and total antioxidant activity in rats fed a high-cholesterol diet. Folia Biol (Praha) 55, 132136.
64Poulose SM, Bielinski DF & Shukitt-Hale B (2013) Walnut diet reduces accumulation of polyubiquitinated proteins and inflammation in the brain of aged rats. J Nutr Biochem 24, 912919.
65Bes-Rastrollo M, Sabaté J, Gómez-Gracia E, et al. (2007) Nut consumption and weight gain in a Mediterranean cohort: the SUN study. Obesity (Silver Spring) 15, 107116.
66Bes-Rastrollo M, Wedick NM, Martinez-Gonzalez MA, et al. (2009) Prospective study of nut consumption, long-term weight change, and obesity risk in women. Am J Clin Nutr 89, 19131919.
67Casas-Agustench P, Bulló M, Ros E, et al. (2011) Cross-sectional association of nut intake with adiposity in a Mediterranean population. Nutr Metab Cardiovasc Dis 21, 518525.
68Sabaté J, Cordero-MacIntyre Z, Siapco G, et al. (2005) Does regular walnut consumption lead to weight gain? Br J Nutr 94, 859864.
69Foster GD, Shantz KL, Vander Veur SS, et al. (2012) A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity. Am J Clin Nutr 96, 249254.
70Tapsell LC, Gillen LJ, Patch CS, et al. (2004) Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. Diabetes Care 27, 27772783.
71Casas-Agustench P, López-Uriarte P, Bulló M, et al. (2011) Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis 21, 126135.
72Rajaram S & Sabaté J (2006) Nuts, body weight and insulin resistance. Br J Nutr 96, Suppl. 2, S79S86.
73Li Z, Song R, Nguyen C, et al. (2010) Pistachio nuts reduce triglycerides and body weight by comparison to refined carbohydrate snack in obese subjects on a 12-week weight loss program. J Am Coll Nutr 29, 198203.
74Martínez-González MA & Bes-Rastrollo M (2011) Nut consumption, weight gain and obesity: epidemiological evidence. Nutr Metab Cardiovasc Dis 21, Suppl. 1, S40S45.
75Vadivel V, Kunyanga CN & Biesalski HK (2012) Health benefits of nut consumption with special reference to body weight control. Nutrition 28, 10891097.
76Wang X, Li Z, Liu Y, et al. (2012) Effects of pistachios on body weight in Chinese subjects with metabolic syndrome. Nutr J 11, 20.
77Salas-Salvadó J, Fernández-Ballart J, Ros E, et al. (2008) Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med 168, 24492458.
78Flores-mateo G, Rojas-rueda D, Basora J, et al. (2013) Nut intake and adiposity: meta-analysis of clinical trials. Am J Clin Nutr 97, 13461355.
79Edwards K, Kwaw I, Matud J, et al. (1999) Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr 18, 229232.
80Kocyigit A, Koylu AA & Keles H (2006) Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutr Metab Cardiovasc Dis 16, 202209.
81Sheridan MJ, Cooper JN, Erario M, et al. (2007) Pistachio nut consumption and serum lipid levels. J Am Coll Nutr 26, 141148.
82Gebauer SK, West SG, Kay CD, et al. (2008) Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose–response study. Am J Clin Nutr 88, 651659.
83Sari I, Baltaci Y, Bagci C, et al. (2010) Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: a prospective study. Nutrition 26, 399404.
84Reaven PD & Witztum JL (1996) Oxidized low density lipoproteins in atherogenesis: role of dietary modification. Annu Rev Nutr 16, 5171.
85Alper CM & Mattes RD (2002) Effects of chronic peanut consumption on energy balance and hedonics. Int J Obes Relat Metab Disord 26, 11291137.
86Burton-Freeman B (2000) Dietary fiber and energy regulation. J Nutr 130, 272S275S.
87Astrup A (2005) The satiating power of protein – a key to obesity prevention? Am J Clin Nutr 82, 12.
88Hu FB (2005) Protein, body weight, and cardiovascular health. Am J Clin Nutr 82, 242S247S.
89Honselman CS, Painter JE, Kennedy-Hagan KJ, et al. (2011) In-shell pistachio nuts reduce caloric intake compared to shelled nuts. Appetite 57, 414417.
90Kennedy-Hagan K, Painter JE, Honselman C, et al. (2011) The effect of pistachio shells as a visual cue in reducing caloric consumption. Appetite 57, 418420.
91Cassady BA, Hollis JH, Fulford AD, et al. (2009) Mastication of almonds: effects of lipid bioaccessibility, appetite, and hormone response. Am J Clin Nutr 89, 794800.
92Ellis PR, Kendall CWC, Ren Y, et al. (2004) Role of cell walls in the bioaccessibility of lipids in almond seeds. Am J Clin Nutr 80, 604613.
93Baer DJ, Gebauer SK & Novotny JA (2012) Measured energy value of pistachios in the human diet. Br J Nutr 107, 120125.
94Sabaté J, Oda K & Ros E (2010) Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med 170, 821827.
95Aldemir M, Okulu E, Neşelioğlu S, et al. (2011) Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res 23, 3238.
96West SG, Gebauer SK, Kay CD, et al. (2012) Diets containing pistachios reduce systolic blood pressure and peripheral vascular responses to stress in adults with dyslipidemia. Hypertension 60, 5863.
97Kay CD, Gebauer SK, West SG, et al. (2010) Pistachios increase serum antioxidants and lower serum oxidized-LDL in hypercholesterolemic adults. J Nutr 140, 10931098.
98Sarwar N, Gao P, Seshasai SRK, et al. (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375, 22152222.
99Shaw JE, Sicree RA & Zimmet PZ (2010) Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 87, 414.
100Jenkins DJA, Hu FB, Tapsell LC, et al. (2008) Possible benefit of nuts in type 2 diabetes. J Nutr 138, 1752S1756S.
101Ros E (2010) Health benefits of nut consumption. Nutrients 2, 652682.
102Damavandi RD, Eghtesadi S, Shidfar F, et al. (2013) Effects of hazelnuts consumption on fasting blood sugar and lipoproteins in patients with type 2 diabetes. J Res Med Sci 18, 314321.
103Kochar J, Gaziano JM & Djoussé L (2010) Nut consumption and risk of type II diabetes in the Physicians' Health Study. Eur J Clin Nutr 64, 7579.
104Pan A, Sun Q, Manson JE, et al. (2013) Walnut consumption is associated with lower risk of type 2 diabetes in women. J Nutr 143, 512518.
105Kendall CWC, Josse AR, Esfahani A, et al. (2011) The impact of pistachio intake alone or in combination with high-carbohydrate foods on post-prandial glycemia. Eur J Clin Nutr 65, 696702.
106Akbaraly TN, Fontbonne A, Favier A, et al. (2008) Plasma carotenoids and onset of dysglycemia in an elderly population: results of the Epidemiology of Vascular Ageing Study. Diabetes Care 31, 13551359.
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