Impact of Cashew Nuts in the Human Diet: Measured Energy Value and Effects on Cardiovascular Disease Risk Factors

The cardioprotective effects of nuts have been well documented in the scientific literature;
however, most of the research has been done with almonds, walnuts, and pistachios, while
studies with cashew nuts are lacking. In addition to the cardiovascular literature, our
recent studies measuring the metabolizable energy of nuts have demonstrated that the
measured energy value of almonds, pistachios, and walnuts is lower than that predicted using
the Atwater factors. However, the measured energy value of cashew nuts is unknown. There are
two distinct aims of this study - determining the effects of cashew nut consumption on risk
factors of CVD, and determining the energy value of cashew nuts in the human diet. The
cardiovascular effects of cashew nuts will be determined by measuring both traditional and
emerging risk factors. The metabolizable energy value of cashew nuts will be calculated
based on the chemical composition and energy content of the consumed diet and excreta. This
will provide a better estimate of the energy value than simply calculating energy value
based on Atwater factors.

Inclusion Criteria:

- BMI between 20 and 38 kg/m2

- Fasting glucose ≤ 126 mg/dL

- Blood pressure ≤ 160/100 mm Hg

Exclusion Criteria:

- Presence of kidney disease, liver disease, gout, hyperthyroidism, untreated or
unstable hypothyroidism, certain cancers, gastrointestinal disease, pancreatic
disease, other metabolic diseases, or malabsorption syndromes

- Use of cholesterol lowering medication

- Use of medication to treat hypertension for less than 6 months

- Active cardiovascular disease (such as a heart attack or procedure within the past
six months or participation in a cardiac rehabilitation program within the last six
months, stroke, or history/treatment for transient ischemic attacks in the past six
months, or documented history of pulmonary embolus in the past six months)

- Women who have given birth during the previous 12 months

- Pregnant women or women who plan to become pregnant or become pregnant during the
study

- Lactating women

- Type 2 diabetes

- Use of prescription or over-the-counter antiobesity medications or supplements (e.g.,
phenylpropanolamine, ephedrine, caffeine, during and for at least 6 months prior to
the start of the study) or history of a surgical intervention for obesity

- Smokers or other tobacco users (during 6 months prior to the start of the study)

- History of eating disorders or other dietary patterns which are not consistent with
the dietary intervention (e.g., vegetarians, very low fat diets, high protein diets)

- Known (self-reported) allergy or adverse reaction to cashew nuts or other nuts

- Unable or unwilling to give informed consent or communicate with study staff

- Self-report of alcohol or substance abuse within the past 12 months and/or current
acute treatment or rehabilitation program for these problems (long-term participation
in Alcoholics Anonymous is not an exclusion)

- Other medical, psychiatric, or behavioral factors that in the judgment of the
Principal Investigator may interfere with study participation or the ability to
follow the intervention protocol