***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE We evaluated the effects of peanut consumption on lipid profiles , atherogenic index of plasma ( AIP ) and CHD risk in hypercholesterolaemic men . DESIGN R and omised crossover clinical trial . SETTING Participants were r and omly assigned to two groups . They were asked to consume peanut supplements ( about 77 g ) with their habitual diet for 4 weeks . SUBJECTS Fifty-four hypercholesterolaemic men with total cholesterol ( TC ) concentrations between 200 and 350 mg/dl . RESULTS Compared with the habitual diet , peanut supplementation of the habitual diet significantly reduced TC/HDL cholesterol ( HDL-C ) ratio ( mean 1 ( se 0.3 ) P = 0.001 ) and LDL cholesterol (LDL-C)/HDL-C ratio ( mean 0.7 ( se 0.2 ) ; P = 0.001 ) . Peanut consumption increased HDL-C ( mean 6.1 ( se 1.5 ) mg/dl ; P < 0.001 ) and total antioxidant capacity ( TAC ) ( mean 1.2 ( se 0.6 ) U/mL P = 0.04 ) . In addition , peanut consumption significantly reduced the AIP ( mean 0.1 ( se 0.03 ) P = 0.01 ) and CHD estimated risk over 10 years based on systolic and diastolic blood pressures ( mean 1.4 % ( se 0.5 % ) P = 0.004 and mean 2.2 % ( se 0.5 % ) P < 0.001 , respectively ) . CONCLUSIONS Short-term peanut consumption might improve lipid profiles , the AIP and CHD risk in free-living hypercholesterolaemic men Small changes of diet may reduce CVD risk . One example is the inclusion of nuts . They are rich in fibre , unsaturated fatty acids and phytonutrients . However , their fat content and energy density raise concerns that chronic consumption will promote weight gain . R and omised intervention studies are required to evaluate whether this concern is well founded . This study 's aim was to determine if the inclusion of a 1440 kJ serving of almonds in the daily diet results in positive energy balance , and body composition change . During a 23-week cross-over design study , participants were required to consume almonds for 10 weeks and were provided no advice on how to include them in their diet . For another 10 weeks ( order counter-balanced ) , participants followed their customary diet and there was a 3-week washout between . The study group consisted of twenty women . Potential mechanisms of energy dissipation were measured . Ten weeks of daily almond consumption did not cause a change in body weight . This was predominantly due to compensation for the energy contained in the almonds through reduced food intake from other sources . Moreover , inefficiency in the absorption of energy from almonds was documented ( P < 0.05 ) . No changes in resting metabolic rate , thermic effect of food or total energy expenditure were noted . A daily 1440 kJ serving of almonds , sufficient to provide beneficial effects on cardiovascular risk factors , may be included in the diet with limited risk of weight gain . Whether this can be generalised to other high-fat energy dense foods warrants evaluation In a r and omized , cross-over feeding trial involving 10 men with polygenic hypercholesterolemia , a control , Mediterranean-type cholesterol-lowering diet , and a diet of similar composition in which walnuts replaced approximately 35 % of energy from unsaturated fat , were given for 6 weeks each . Compared with the control diet , the walnut diet reduced serum total and LDL cholesterol by 4.2 % ( P = 0.176 ) , and 6.0 % ( P = 0.087 ) , respectively . No changes were observed in HDL cholesterol , triglycerides , and apolipoprotein A-I levels or in the relative proportion of protein , triglycerides , phospholipids , and cholesteryl esters in LDL particles . The apolipoprotein B level declined in parallel with LDL cholesterol ( 6.0 % reduction ) . Whole LDL , particularly the triglyceride fraction , was enriched in polyunsaturated fatty acids from walnuts ( linoleic and alpha-linolenic acids ) . In comparison with LDL obtained during the control diet , LDL obtained during the walnut diet showed a 50 % increase in association rates to the LDL receptor in human hepatoma HepG2 cells . LDL uptake by HepG2 cells was correlated with alpha-linolenic acid content of the triglyceride plus cholesteryl ester fractions of LDL particles ( r(2 ) = 0.42 , P < 0.05 ) . Changes in the quantity and quality of LDL lipid fatty acids after a walnut-enriched diet facilitate receptor-mediated LDL clearance and may contribute to the cholesterol-lowering effect of walnut consumption BACKGROUND Elevated serum cholesterol levels play an important role in the development of coronary artery disease . Previous studies have suggested that nut consumption benefits lipid profile .  Pistachio nuts are widely available , inexpensive and frequently consumed by the general population . OBJECTIVE To determine whether substituting 20 % of the daily caloric intake in the form of pistachio nuts will improve the lipid profiles of humans with primary , moderate hypercholesterolemia . DESIGN Controlled , r and omized crossover design . SETTING Outpatient dietary modification , counseling and blood analysis . PATIENTS Ten patients with moderate hypercholesterolemia . INTERVENTION Three weeks of dietary modification with 20 % caloric intake from pistachio nuts . MEASUREMENTS Body weight , blood pressure , total cholesterol , LDL , HDL , and triglycerides were monitored . Lipid profiles were analyzed prior to , during and after dietary modification . RESULTS After three weeks , there was a decrease in total cholesterol ( p<0.04 ) , an increase in HDL ( p<0.09 ) , a decrease in the total cholesterol/HDL ratio ( p<0.01 ) and a decrease in the LDL/HDL ratio ( p<0.02 ) . Triglycerides and LDL levels decreased , but not significantly . Body weight and blood pressure remained constant throughout the study . CONCLUSIONS Results suggest that eating pistachio nuts instead of other dietary fat calories can improve lipid profiles , thereby decreasing coronary risk . Further studies will be required to confirm these results and to determine the mechanism of this effect Pistachios are high in lutein , beta-carotene , and gamma-tocopherol relative to other nuts ; however , studies of the effects of pistachios on oxidative status are lacking . We conducted a r and omized , crossover controlled-feeding study to evaluate 2 doses of pistachios on serum antioxidants and biomarkers of oxidative status in 28 hypercholesterolemic adults ( LDL-cholesterol > or=2.86 mmol/L ) . Participants consumed 3 isoenergetic diets for 4 wk each after a 2-wk baseline Western diet . Experimental diets included a lower-fat control diet without pistachios ( 25 % total fat ) with 1 serving/d ( i.e. 32 - 63 g/d ; energy adjusted ) of pistachios ( 1 PD ; 10 % energy from pistachios ; 30 % total fat ) or with 2 servings/d ( 63 - 126 g/d ; energy adjusted ) of pistachios ( 2 PD ; 20 % energy from pistachios ; 34 % total fat ) . When participants consumed the pistachio-enriched diets , they had higher plasma lutein ( P < 0.0001 ) , alpha-carotene , and beta-carotene ( P < 0.01 ) concentrations than after the baseline diet . After consuming the pistachio diets , participants had greater plasma lutein ( P < 0.001 ) and gamma-tocopherol ( P < 0.05 ; 2 PD only ) relative to the lower-fat control diet . After the 2 PD diet period , participants also had lower serum oxidized-LDL concentrations than following the baseline diet period ( P < 0.05 ) . After both the 1 PD and 2 PD diet periods , they had lower serum oxidized-LDL concentrations than after the control diet period ( P < 0.05 ) . The change in oxidized-LDL from baseline correlated positively with the change in LDL-cholesterol across all treatments ( r = 0.42 ; P < 0.005 ) . After controlling for the change in serum LDL-cholesterol as a covariate , increases in serum lutein and gamma-tocopherol following the 2 PD period were still modestly associated with decreases in oxidized-LDL ( r = -0.36 , P = 0.06 and r = -0.35 , P = 0.08 , respectively ) . This suggests that a heart-healthy diet including pistachios contributes to the decrease in the serum oxidized-LDL concentration through cholesterol-lowering and may provide an added benefit as a result of the antioxidants the pistachios contain Nut consumption reduces cardiovascular risk , and reductions in blood pressure and peripheral vascular resistance may be important mediators of this relationship . We evaluated effects of pistachios on flow-mediated dilation and blood pressure response to acute stress . Twenty-eight adults with dyslipidemia completed a r and omized , crossover , controlled-feeding study . All of the meals were provided and calories were controlled . After 2 weeks on a typical Western diet ( 35 % total fat and 11 % saturated fat ) , test diets were presented in counterbalanced order for 4 weeks each , a low-fat control diet ( 25 % total fat and 8 % saturated fat ) , a diet containing 10 % of energy from pistachios ( on average , 1 serving per day ; 30 % total fat and 8 % saturated fat ) , and a diet containing 20 % of energy from pistachios ( on average , 2 servings per day , 34 % total fat and 8 % saturated fat ) . None of the resting hemodynamic measures significantly differed from pretreatment values . When resting and stress levels were included in the repeated- measures analysis , average reductions in systolic blood pressure were greater after the diet containing 1 serving per day versus 2 servings per day of pistachios ( mean change in systolic blood pressure , −4.8 vs −2.4 mm Hg , respectively ; P<0.05 ) . After the higher dose , there were significant reductions in peripheral resistance ( −62.1 dyne·s × cm−5 ) and heart rate ( −3 bpm ) versus the control diet ( P<0.0001 ) . These changes were partially offset by increases in cardiac output . There was no effect of diet on fasting flow-mediated dilation . Reductions in peripheral vascular constriction and the result ing decrease in hemodynamic load may be important contributors to lower risk in nut consumers BACKGROUND Walnut consumption is associated with reduced risk of coronary heart disease ( CHD ) . OBJECTIVE We assessed the effect of walnuts on lipid and glucose metabolism , adipokines , inflammation and endothelial function in healthy Caucasian men and postmenopausal women ≥50years old . DESIGN Forty subjects ( mean±SEM : age 60±1years , BMI 24.9±0.6kg/m(2 ) ; 30 females ) were included in a controlled , cross-over study and r and omized to receive first a walnut-enriched ( 43g/d ) and then a Western-type ( control ) diet or vice-versa , with each lasting 8weeks and separated by a 2-week wash-out . At the beginning and end of each diet phase , measurements of fasting values  , a  mixed meal test  and an assessment of postpr and ial endothelial function ( determination of microcirculation by peripheral artery tonometry ) were conducted . Area under the curve ( AUC ) , incremental AUC ( iAUC ) and treatment × time interaction ( shape of the curve ) were evaluated for postpr and ial triglycerides , VLDL-triglycerides , chylomicron-triglycerides , glucose and insulin . RESULTS Compared with the control diet , the walnut diet significantly reduced non-HDL-cholesterol ( walnut vs. control : -10±3 vs. -3±2mg/dL ; p=0.025 ) and apolipoprotein-B ( -5.0±1.3 vs. -0.2±1.1mg/dL ; p=0.009 ) after adjusting for age , gender , BMI and diet sequence . Total cholesterol showed a trend toward reduction ( p=0.073 ) . Fasting VLDL-cholesterol , LDL-cholesterol , HDL-cholesterol , triglycerides and glucose , insulin , HOMA-IR , and HbA1c did not change significantly . Similarly , fasting adipokines , C-reactive protein , biomarkers of endothelial dysfunction , postpr and ial lipid and glucose metabolism and endothelial function were unaffected . CONCLUSION Daily consumption of 43 g of walnuts for 8weeks significantly reduced non-HDL-ch 
    Output:
    
There were variable and inconsistent effects of nut consumption on CVD risk factors ( lipid levels and blood pressure ) .
None of the included trials reported on other secondary outcomes , occurrence of type 2 diabetes as a major risk factor for CVD , health-related quality of life and costs .
AUTHORS ' CONCLUSIONS Currently there is a lack of evidence for the effects of nut consumption on CVD clinical events in primary prevention and very limited evidence for the effects on CVD risk factors .