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Other relevant components of nuts: phytosterols, folate and minerals

  • Ramon Segura (a1), Casimiro Javierre (a1), M Antonia Lizarraga (a1) and Emilio Ros (a2)

Nuts contain significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. Nuts do not contain cholesterol, but they are rich in chemically related phytosterols, a class of compounds that interfere with intestinal cholesterol absorption and thus help lower blood cholesterol. Nuts also contain folate, a B-vitamin necessary for normal cellular function that plays an important role in detoxifying homocysteine, a sulphur-containing amino acid with atherothrombotic properties that accumulates in plasma when folate status is subnormal. Compared to other common foodstuffs, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium and potassium. Like that of most vegetables, the sodium content of nuts is very low. A high intake of calcium, magnesium and potassium, together with a low sodium intake, is associated with protection against bone demineralisation, arterial hypertension, insulin resistance, and overall cardiovascular risk. Phytosterols might justify part of the cholesterol-lowering effect of nut intake beyond that attributable to fatty acid exchange, while the mineral richness of nuts probably contributes to the prevention of diabetes and coronary heart disease observed in epidemiological studies in association with frequent nut consumption.

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*Corresponding author: R. Segura, fax + 34 93 402 4268, email
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Altmann SW, Davis HR Jr, Zhu LJ, Yao X, Hoos LM & Tetzloff G (2004) Niemann-Pick C1 like protein is critical for intestinal cholesterol absorption. Science 303, 12021204.
Andersson SW, Skinner J, Ellegard L, Welch AA, Bingham S, Mulligan A, Andersson H & Khaw K-T (2004) Intake of dietary plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study. Eur J Clin Nutr 58, 13781385.
Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FMAmerican Heart Association. (2006) Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47, 296308.
Bailey LB & Berry RJ (2005) Folic acid supplementation and the occurrence of congenital heart defects, orofacial clefts, multiple births, and miscarriage. Am J Clin Nutr 81, suppl, 1213S1217S.
Baron JA, Beach M & Mandel JS (1999) Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study Group. N Engl J Med 340, 101107.
Barr SI (2003) Increased dairy product or calcium intake: is body weight or composition affected in humans?. J Nutr 133, 245S248S.
Berge KE, Tian H, Graf GA, Yu L, Grishin NV, Schultz J, Kwiterovich P, Shan B, Barnes R & Hobbs HH (2000) Accumulation of dietary cholesterol in sitosterolemia caused by mutations in adjacent ABC transporters. Science 290, 17711775.
Birkett NJ (1998) Comments on a meta-analysis of the relation between dietary calcium intake and blood pressure. Am J Epidemiol 14, 223228.
Bollheimer LC, Buettner R, Kullmann A & Kullmann F (2005) Folate and its preventive potential in colorectal carcinogenesis. How strong is the biological and epidemiological evidence?. Crit Rev Oncol Hematol 55, 1336.
Bosner MS, Lange LG, Stenson WF & Ostlund RE (1999) Percent cholesterol absorption in normal women and men quantified by dual stable isotopic tracers and negative ions mass spectrometry. J Lipid Res 40, 302308.
Bryant RJ, Cadogan J & Weaver CM (1999) The new dietary reference intakes for calcium: implications for osteoporosis. J Am Coll Nutr 18, 406S412S.
Choi SW & Mason JB (2000) Folate and carcinogenesis: An integrated scheme. J Nutr 130, 129132.
Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH & Brand-Miller J (2005) Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 81, 341354.
Czeizel AE & Dudas I (1992) Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 327, 18321835.
de Vries JHM, Jansen A, Kromhout D, van de Bovenkamp P, van Staveren WA, Mensink RP & Katan MB (1997) The fatty acid and sterol content of food composites of middle-aged men in seven countries. J Food Comp Anal 19, 115141.
Denke MA (1995) Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia. Am J Clin Nutr 61, 392396.
Dietschy JM, Turley SD & Spady DK (1993) Role of the liver in the maintenance of cholesterol and low density lipoprotein homeostasis in different animal species, including humans. J Lipid Res 34, 16371659.
Estruch R, Martínez-González MA & Corella D (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors. A randomized trial. Ann Intern Med.
Food and Drug Administration (1996) Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Final rule. 21 CFR Parts 136, 137, and 139. Fed Regist 61, 87818807.
Freisleben A, Schieberle P & Rychlik M (2003) Specific and sensitive quantification of folate vitamers in foods by stable isotope dilution assays using high-performance liquid chromatography–tandem mass spectrometry. Anal Bioanal Chem 376, 149156.
Griel AE & Kris-Etherton PM (2006) Tree Nuts and the Lipid Profile: A Review of Clinical Studies. Br J Nutr 96, S68S78.
Hartmann MA (1998) Plant sterols and the membrane environmentTrends Plant Sci 3, 170175.
He FJ & MacGregor GA (2001) Fortnightly review. Beneficial effects of potassium. Br Med J 323, 497501.
Homocysteine Lowering Trialists' Collaboration (2005) Dose-dependent effects of folic acid on blood concentrations of homocysteine: a metaanalysis of the randomized trials. Am J Clin Nutr 82, 806812.
Hu FB (2003) Plant-based foods and prevention of cardiovascular disease: an overviewAm J Clin Nutr 78, suppl, 544S551S.
Jacques PF, Selhub J, Bostom AG, Wilson PWF & Rosenberg IH (1999) The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 340, 14491454.
Jenkins DJ, Kendall CW & Marchie A (2002) Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation 106, 13271332.
Jiang R, Manson JE, Stampfer MJ, Liu S, Willett WC & Hu FB (2002) Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 288, 25542560.
Jones PJH, MacDougall DE, Nitanios FY & Vanstone CA (1997) Dietary phytosterols as cholesterol-lowering agents in humans. Can J Physiol Pharmacol 75, 217227.
Kao WH, Folsom AR, Nieto FJ, Mo JP, Watson RL & Brancati FL (1999) Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the Atherosclerosis Risk in Communities Study. Arch Intern Med 15, 21512159.
Katan MB, Grundy SM, Jones P, Law M, Miettinen T & Paoletti R (2003) Efficay and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clinic Proc 78, 965978.
Kesäniemi YA & Miettinen TA (1987) Cholesterol absorption efficiency regulates plasma cholesterol levels in the Finnish population. Eur J Clin Invest 17, 391395.
Kim YI (1999) Folate and carcinogenesis: Evidence, mechanisms, and implications. J Nutr Biochem 10, 6688.
Law M (2000) Plant sterol and stanol margarines and health. BMJ 320, 861864.
Lee MH, Lu K, Hazard S, Yu H et al. (2001) Identification of a gene, ABCG5, important in the regulation of dietary cholesterol absorption. Nat Genet 27, 7983.
Liu S, Song Y, Ford ES, Manson JAE, Buring JE & Ridker PM (2005) Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care 28, 29262932.
Lopez-Ridaura R, Willett WC, Rimm EB, Liu S, Stampfer MJ, Manson JE & Hu FB (2004) Magnesium intake and risk of type 2 diabetes in men and women. Diabetes Care 27, 134140.
Luchsinger JA & Mayeux R (2004) Dietary factors and Alzheimer's disease. Lancet Neurol 3, 79587.
Mason JB (2003) Biomarkers of nutrient exposure and status in one-carbon (methyl) metabolism. J Nutr 133, Suppl 3941S947S.
McNulty H & Pentieva K (2004) Folate bioavailability. Proc Nutr Soc 63, 529536.
Meneton P, Jeunemaitre X, de Wardener HE & MacGregor GA (2005) Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases. Physiol Rev 85, 679715.
Miller GD & Anderson JJ (1999) The role of calcium in prevention of chronic diseases. J Am Coll Nutr 18, 371S372S.
Mooijaart SP, Gussekloo J, Frölich M, Jolles J, Stott DJ, Westendorp RGJ & de Craen AJM (2005) Homocysteine, vitamin B-12, and folic acid and the risk of cognitive decline in old age: the Leiden 85-Plus Study. Am J Clin Nutr 82, 866871.
Moreau RA, Whitakerb BD & Hicksa KB (2002) Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Progr Lipid Res 41, 457500.
MRC Vitamin Study Research Group (1991) Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 338, 131137.
Nieves JW (2005) Osteoporosis: the role of micronutrients. Am J Clin Nutr 81, 1232S1239S.
Northfield TC & Hoffmann AF (1975) Biliary lipid output during three meals and an overnight fast. I. Relationship to bile acid pool size and cholesterol saturation in gallstone and control subjects. Gut 16, 111.
O'Neill FH, Sanders TAB & Thompson GR (2005) Comparison of efficacy of plant stanol ester and sterol ester: short-term and longer-term studies. Am J Cardiol 96, suppl, 29D36D.
Ostlund RE Jr (2002) Phytosterols in human nutrition. Annu Rev Nutr 22, 533549.
Ostlund RE Jr, Racette SB, Okeke A & Stenson WF (2002) Phytosterols that are naturally present in commercial corn oil significantly reduce cholesterol absorption in humans. Am J Clin Nutr 75, 10001004.
Ostlund RE Jr, Racette SB & Stenson WF (2003) Inhibition of cholesterol absorption by phytosterol-replete wheat germ compared with phytosterol-depleted wheat germ. Am J Clin Nutr 77, 13851389.
Ostlund RE Jr (2004) Phytosterols and cholesterol metabolism. Curr Opin Lipidol 15, 3741.
Phillips KM, Ruggio DM & Ashraf-Khorassani M (2005) Phytosterol composition of nuts and seeds commonly consumed in the United States. J Agric Food Chem 53, 94369445.
Piironen V, Lindsay DG, Miettinen TA, Toivo J & Lampi A-M (2000) Plant sterols: biosynthesis, biological function and their importance to human nutrition. J Sci Food Agric 80, 939966.
Pintó X, Vilaseca MA, Balcells S, Artuch R, Corbella E, Meco JF, Vila R, Pujol R & Grinberg D (2005) A folate-rich diet is as effective as folic acid supplements in decreasing plasma homocysteine concentrations. Int J Med Sci 2, 5863.
Plat J & Mensink RP (2005) Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 96, suppl, 15D22D.
Prins ND, den Heijer T, Hofman A, Koudstaal PJ, Jolles J, Clarke R, Breteler MMRotterdam Scan Study. (2002) Homocysteine and cognitive function in the elderly. The Rotterdam Study. Neurology 59, 13751380.
Reid IR, Mason B, Horne A, Ames R, Clearwater J, Bava U, Orr-Walker B, Wu F, Evans MC & Gamble GD (2002) Effects of calcium supplementation on serum lipid concentrations in normal older women: a randomized controlled trial. Am J Med 112, 343347.
Ros E (2000) Intestinal absorption of triglyceride and cholesterol. Dietary and pharmacological inhibition to reduce cardiovascular risk. Atherosclerosis 151, 357379.
Ros E, Núñez I, Pérez-Heras A, Serra M, Gilabert R, Casals E & Deulofeu R (2004) A walnut diet improves endothelial function in hypercholesterolemic subjects. Circulation 109, 16091614.
Said HM (2004) Recent advances in carrier-mediated intestinal absorption of water-soluble vitamins. Annu Rev Physiol 66, 419446.
Sanderson P, McNulty H, Mastroiacovo P, McDowell IFW, Melse-Boonstra A, Finglas PM & Gregory JF III (2003) Folate bioavailability: UK Food Standards Agency workshop report. Br J Nutr 90, 473479.
Saris NE, Mervaala E, Karppanen H, Khawaja JA & Lewenstam A (2000) Magnesium. An update on physiological, clinical and analytical aspects. Clin Chim Acta 29, 126.
Sehayek E (2004) Genetic regulation of cholesterol absorption and plasma plant sterol levels: commonalities and differences. J Lipid Res 44, 20302038.
Sehayek E, Nath C, Heinemann T, McGee M, Seidman CE, Samuel P & Breslow JL (1998) U-shape relationship between change in dietary cholesterol absorption and plasma lipoprotein responsiveness and evidence for extreme interindividual variation in dietary cholesterol absorption in humans. J Lipid Res 39, 24152422.
Selhub J, Jacques PF, Wilson PW, Rush D & Rosenberg IH (1993) Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 270, 26932698.
Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, Wilson PW & Wolf PA (2002) Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. N Engl J Med 346, 476483.
Shane B (1995) Folate chemistry and metabolism Folate in Health and Disease [Bailey LB editor] New York, NY: Marcel Dekker.
Shin MJ, Lee JH, Jang Y, Lee-Kim YC, Park E, Kim KM, Chung BC & Chung N (2005) Micellar phytosterols effectively reduce cholesterol absorption at low doses. Ann Nutr Metab 49, 346351.
St-Onge MP (2005) Dietary fats, teas, dairy, and nuts: potential functional foods for weight control?. Am J Clin Nutr 81, 715.
Stover PJ (2004) Physiology of folate and vitamin B12 in health and disease. Nutr Rev 62, S3S12.
Strain JJ, Dowey L, Ward M, Pentieva K & McNulty H (2004) B-vitamins, homocysteine metabolism and CVD. Proc Nutr Soc 63, 597603.
Sudhop T & von Bergmann K (2002) Cholesterol absorption inhibitors for the treatment of hypercholesterolaemia. Drugs 62, 23332347.
Taylor MJ, Carney SM, Goodwin GM & Geddes JR (2004) Folate for depressive disorders: systematic review and meta-analysis of randomized controlled trials. J Psychopharmacol 18, 251256.
The Homocysteine Studies Collaboration (2002) Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA 288, 20152022.
Thompson GR & Grundy SM (2005) History and development of plant sterol and stanol esters for cholesterol-lowering purposes. Am J Cardiol 96, suppl, 3D9D.
Touyz RM (2004) Magnesium in clinical medicine. Front Biosci 9, 12781293.
Turley SD & Dietschy JM (2003) Sterol absorption by the small intestine. Curr Opin Lipidol 14, 233240.
Vahouny GV, Borja CR & Treadwell CR (1964) Absorption and esterification of micellar free and esterified cholesterol. Arch Biochem Biophys 106, 440446.
Vanstone CA, Raeini-Sarjaz M, Parsons WE & Jones PJ (2002) Unesterified plant sterols and stanols lower LDL-cholesterol concentrations in hypercholesterolemic persons. Am J Clin Nutr 76, 12721278.
Vaskonen T (2003) Dietary minerals and modification of cardiovascular risk factors. J Nutr Biochem 14, 492506.
von Bergmann K, Sudhop T & Lütjohann D (2005) Cholesterol and plant sterol absorption: recent insights. Am J Cardiol 96, suppl, 10D14D.
Vuoristo M & Miettinen TA (1985) Increased biliary lipid secretion in coeliac disease. Gastroenterology 88, 134142.
Vuoristo M & Miettinen TA (1994) Absorption, metabolism, and serum concentrations of cholesterol in vegetarians: effects of cholesterol feeding. Am J Clin Nutr 59, 13251331.
Wald DS, Law M & Morris JK (2002) Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 325, 17.
Welch GN & Loscalzo J (1998) Homocysteine and atherothrombosis. N Engl J Med 338, 10421050.
Zemel MB (2002) Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implications. J Am Coll Nutr 21, 146S151S
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