Tricia L Hart, Penny M Kris-Etherton, Kristina S Petersen
Journal: The Journal of nutrition 2025;155(5):1459-1465
PMID: 40113170
Cardiometabolic diseases, such as heart disease and type 2 diabetes, are major health concerns worldwide. These conditions are often linked to unhealthy blood lipid levels (fats in the blood) and insulin resistance, where the body does not respond properly to insulin. Nuts, including pecans, contain healthy fats, fibre, and plant compounds that may improve heart and metabolic health. However, more research is needed to understand how pecans affect detailed markers of cardiovascular risk. This 12-week randomised controlled trial was conducted to examine whether replacing usual snack foods with pecans would improve blood fat particles and early markers of insulin resistance in adults at increased risk of cardiometabolic diseases.
The results showed that participants who consumed pecans had improvements in lipids compared to those who continued their usual snacks. Specifically, changes were seen in those linked to cardiovascular risk. Markers related to insulin resistance also improved in the pecan group.
In conclusion, daily pecan consumption for 12 weeks improved blood lipid profiles and markers associated with insulin resistance in adults at increased cardiometabolic risk. Healthcare professionals may use this evidence to support dietary recommendations that encourage replacing less healthy snack options with nutrient-dense foods such as nuts to improve cardiometabolic health.
BACKGROUND
Pecan consumption consistently improves lipoproteins, but less research has investigated the effect of pecans on lipoprotein subfractions.
OBJECTIVES
The aim was to investigate the effect of substitution of usual snack foods with 57 g/d of pecans on lipoprotein particle subfractions and apolipoproteins compared with continuing usual intake after 12 wk. Exploratory analyses evaluated effects on early markers of insulin resistance including the Lipoprotein Insulin Resistance Index (LP-IR), Diabetes Risk Index, and GlycA.
METHODS
A 12-wk, randomized, 2-armed parallel trial in adults at risk of cardiometabolic disease was conducted. Participants were instructed to either consume 57 g/d of pecans in place of usual snacks or to continue their usual intake. Plasma samples collected at baseline and 12 wk were analyzed for lipoproteins, apolipoproteins, and GlycA by proton nuclear magnetic resonance spectroscopy. Between-group differences in the change from baseline were evaluated with linear regression.
RESULTS
In total, 138 participants were randomly assigned (n = 69 per group) and 130 participants (pecan group n = 62; usual diet group n = 68) completed the trial. The pecan group had a greater reduction from baseline in the concentrations of apolipoprotein B (apoB) [-4.38 mg/dL; 95% confidence interval (CI): -8.02, -0.73], total low-density lipoprotein particles (-75.3 nmol/L; 95% CI: -144, -6.93), total triglyceride-rich lipoprotein particles (TRL-P) (-20.4 nmol/L; 95% CI: -33.8, -7.03), large (-1.47 nmol/L; 95% CI: -2.69, -0.26) and small (-11.3 nmol/L; 95% CI: -22.4, -0.27) TRL-P and the LP-IR (-4.42 points; 95% CI: -8.14, -0.69), and greater increases from baseline in the concentration of large high-density lipoprotein particles (0.35 μmol/L; 95% CI: 0.07, 0.63) compared with the usual diet group.
CONCLUSIONS
Incorporating 57 g/d of pecans into the diet in place of usual snacks for 12 wk improved apoB, atherogenic lipoprotein subfractions, and the LP-IR in adults at risk of cardiometabolic diseases. This trial was registered at clinicaltrials.gov as NCT05071807.
Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.
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