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| Name | Class |
|---|---|
| KGK Science Inc. | INDUSTRY |
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This study will determine the quantity of almonds (1.5 oz or 2.5 oz) consumed as a snack that will provide optimal increases in HDL-C levels.
Elevated lipid levels are a major modifiable risk factor for cardiovascular disease (CVD), which is the leading cause of death worldwide, accounting for over 17.8 million deaths globally, equating to approximately 71 million Americans with the total annual cost associated with CVD approximating $351.3 billion USD. The National Cholesterol Education Program (NCEP) ATP III Guidelines and supporting literature recommend diet and lifestyle approaches for patients with elevated lipid levels prior to lipid lowering medication, as changing lifestyle and diet cost less than medications and does not lead to polypharmacy or unwanted side effects. Low nut and seed consumption has been identified as the leading dietary risk factor attributed to ischemic heart disease. Indeed, studies have demonstrated that almond consumption reduces total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels compared to no almond controls or substitutions. Additionally, emerging and predictive CVD risk factors such as abdominal obesity and concentrations of Apolipoprotein (ApoB), for which a dose-response effect may also be present, are also improved by almond consumption.
While the benefits of an almond-rich diet on TC, TG, and LDL-C are clear, the effects of almonds on high-density lipoprotein cholesterol (HDL-C) levels is less clear. In populations with hyperlipidemia, almond consumption appears to improve HDL-C, among other lipid markers. Yet, a recent systematic-review and meta-analysis reported a significant decrease in HDL-C compared to control across 12 studies. It is possible that a dose-response relationship exists for almond consumption and HDL-C levels. Almond consumption of ≤42.5 g/day significantly decreased LDL-C/HDL-C, TC/HDL-C and ApoB compared to control, however, significant reductions in TC, BP and body weight were only observed with >42.5 g of almonds/day. Sabate et al., found that the NCEP Step I Diet as well as a low almond diet (10% from calories) significantly reduced HDL-C by 3% and 4%, respectively. However, a high almond-diet (20% from calories) maintained HDL-C levels, while having favorable changes on LDL-C, LDL-C/HDL-C and ApoB/ApoA . Daily almond consumption between 37-73 g/day (~1.3-2.5 oz/day) resulted in significantly higher HDL-C levels compared to a muffin control, with the higher dose of almonds (73 g/day) resulting in a greater increase in HDL-C compared to a lower dose (37 g/day). Additionally, the majority of studies are of limited length and often less than 12 weeks long. A previous study on the long term effects of almonds and other lipid-modulating foods found the greatest reductions on LDL-C and TC/HDL-C were not observed until 12 weeks, and then maintained. Further, it has been suggested that other outcomes such as BP, body weight and abdominal obesity may require longer term consumption of almonds to show beneficial changes. Therefore, it is likely heterogeneity in the effect of HDL-C levels with almond consumption is due to inadequate study duration, background diet, population, control used or too low quantity of almonds.
The existing FDA health claim for almonds states: "scientific evidence suggests, but does not prove, that eating 1.5 ounces per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease". Despite the benefits of almonds on cardiometabolic health, clinical trials designed to determine the optimal dose of almonds on the improvement of lipid profile in a population at greater risk of CVD have not been conducted. This study will address this research gap and establish the optimal dose of almonds for improving HDL-C and other CVD markers and ultimately lowering risk in a population at increased risk of disease development. The specific aim of this study is to demonstrate the efficacy of consuming increasing quantities of almonds on blood lipid levels in adults with hypercholesterolemia. Two doses of almonds will be used, 1.5 oz and 2.5 oz, referred to the Almond-enriched Diet Dose 1 (AD1) and Almond-enriched Diet Dose 2 (AD2), respectively, compared to a Nut-Free Diet (NFD). This study will determine the optimal quantity of almonds consumed as a snack that will provide the most clinically relevant increase of HDL-C levels. Further, this study will investigate the dose-response of almonds on other lipid profile markers, blood pressure (BP), weight, and markers of abdominal obesity in a population with hypercholesterolemia. The hypothesis is that there will be an improvement in HDL-C in a dose-dependent manner with increased consumption of almonds for 16 weeks.
Participants in this study represent a target population that aligns with the goals of healthcare to provide lifestyle management prior to the introduction of prescription medication plans. The study is to be conducted in a population at risk of developing heart disease, who have hypercholesterolemia based on the NCEP definition (LDL-C levels >4.1 mmol/L (>160 mg/dL)). Currently, approximately 53% of the North American population is considered to have elevated LDL-C levels, yet less than half receive treatment. Participants aged 30 to 65 years will be considered for enrolment to avoid complications related to advanced age and a body mass index (BMI) of and up to 34.9 kg/m2 will eliminate confounders related to advanced obesity. Significant metabolic or physiological conditions that may affect lipid levels will be excluded and any participants on prescribed lipid lowering medication will be excluded to limit confounders. Current use of supplements known to affect blood lipid levels, vitamin E status or tree nuts that may impact study outcomes will be excluded unless participants undergo an appropriate washout period prior to enrollment. As well, an extensive list of exclusions in place will ensure that eligibility is based on establishing health and each participants' eligibility will be overseen by the Qualified Investigator (QI).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Almond-enriched diet dose 1 | Experimental | Participants will be instructed to ingest 1.5 oz of almonds daily for 16 weeks. The 1.5 oz of almonds can be split into a morning and afternoon snack. Participants will be advised not to exceed 2 doses of almonds daily. If a dose is missed, participants should take the missed dose as soon as the participants remember. |
|
| Almond-enriched diet dose 2 | Experimental | Participants will be instructed to ingest 2.5 oz of almonds daily for 16 weeks. The 2.5 oz of almonds can be split into a morning and afternoon snack. Participants will be advised not to exceed 2 doses of almonds daily. If a dose is missed, participants should take the missed dose as soon as the participants remember. |
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| Nut-free diet | Other | Participants will be instructed to ingest the control snack (Iso-caloric [to 1.5 oz of almonds] control snack of chocolate chip cookies or Oreo cookies) daily for 16 weeks. The control snack can be split into a morning and afternoon snack. Participants will be advised not to exceed 2 doses of snack daily. If a dose is missed, participants should take the missed dose as soon as the participants remember. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Almond-enriched diet - 1.5 oz | Other | Participants will receive 1.5 oz of almonds consumed as a snack daily for 16 weeks. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline to week 16 in HDL-C levels between the Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, and Nut-Free Diet | The change from baseline in HDL-C levels at week 16 between Almond-enriched Diet Dose 1 (AD1), Almond-Enriched Diet Dose 2 (AD2), and Nut-Free Diet (NFD) will be determined. | 16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline to week 4 in HDL-C levels between the Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, and Nut-Free Diet | The change from baseline in HDL-C levels at week 4 between Almond-enriched Diet Dose 1 (AD1), Almond-Enriched Diet Dose 2 (AD2), and Nut-Free Diet (NFD) will be determined. | 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of pre-emergent adverse events following 16-week ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Incidence of pre-emergent adverse events following 16-week ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks and at a 7-day follow-up at the end of the study |
Inclusion Criteria:
Males and Females between 30-65 years of age, inclusive
BMI between 25.0 - 34.9 kg/m2, inclusive
Individual is not of child-bearing potential, defined as those who have undergone a sterilization procedure (e.g. hysterectomy, bilateral oophorectomy, bilateral tubal ligation, complete endometrial ablation) or have been post-menopausal for at least 1 year prior to screening
Or,
Individuals of child-bearing potential must have a negative baseline urine pregnancy test and agree to use a medically approved method of birth control for the duration of the study. All hormonal birth control must have been in use for a minimum of three months. Acceptable methods of birth control include:
Individuals with hypercholesterolemia based on the NCEP definition (LDL-C levels >4.1 mmol/L (>160 mg/dL))
Motivated to comply with dietary guidelines as assessed by a motivation questionnaire at screening
Self-reported stable body weight for the past 3 months defined as not having gained or lost more than 5 kg of body weight throughout the 3 months prior to baseline
Agrees to adhere to dietary guidelines and to maintain current lifestyle habits as much as possible throughout the study depending on the participants' ability to maintain the following: medications, supplements, exercise, and sleep and avoid taking new supplements
Provided voluntary, written, informed consent to participate in the study
Healthy as determined by medical history, and laboratory results exam as assessed by Qualified Investigator (QI)
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David Crowley, MD | KGK Science Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| KGK Science Inc. | London | Ontario | N6A5R8 | Canada |
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The dietary interventions in this proposed study prevent blinding as it is impossible to mask the participant and investigators to whether the participants are consuming whole almonds or not. The requirements to report the quantity of almonds consumed also precludes blinding for both the participant and investigator. The statistician will be blinded for the duration of the study and throughout all analysis and reporting. The preclusion of blinding in this study is not a limitation given the objectivity of the primary and most secondary endpoints. This is a well-controlled study design that provides a "real-world" assessment of the dietary interventions that bolsters the resulting data to withstand scientific and regulatory scrutiny.
| Almond-enriched diet - 2.5 oz | Other | Participants will receive 2.5 oz of almonds consumed as a snack daily for 16 weeks. |
|
| Control snack | Other | Participants will receive a control snack daily for 16 weeks. |
|
| Change from baseline to week 8 in HDL-C levels between the Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, and Nut-Free Diet |
The change from baseline in HDL-C levels at week 8 between Almond-enriched Diet Dose 1 (AD1), Almond-Enriched Diet Dose 2 (AD2), and Nut-Free Diet (NFD) will be determined. |
| 8 weeks |
| Change from baseline to week 12 in HDL-C levels between the Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, and Nut-Free Diet | The change from baseline in HDL-C levels at week 12 between Almond-enriched Diet Dose 1 (AD1), Almond-Enriched Diet Dose 2 (AD2), and Nut-Free Diet (NFD) will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a clinically relevant increase in HDL-C levels | The difference in the proportion of participants from baseline to 4 weeks achieving a clinically relevant increase in HDL-C levels defined as an increase of at least 1 mg/dL (0.026 mmol/L) will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a clinically relevant increase in HDL-C levels | The difference in the proportion of participants from baseline to 8 weeks achieving a clinically relevant increase in HDL-C levels defined as an increase of at least 1 mg/dL (0.026 mmol/L) will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a clinically relevant increase in HDL-C levels | The difference in the proportion of participants from baseline to 12 weeks achieving a clinically relevant increase in HDL-C levels defined as an increase of at least 1 mg/dL (0.026 mmol/L) will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a clinically relevant increase in HDL-C levels | The difference in the proportion of participants from baseline to 16 weeks achieving a clinically relevant increase in HDL-C levels defined as an increase of at least 1 mg/dL (0.026 mmol/L) will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving no change or an increase in HDL-C levels | The difference in the proportion of participants from baseline to 16 weeks achieving no change or an increase in HDL-C levels based on expected effects through almond intervention will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving no change or an increase in HDL-C levels | The difference in the proportion of participants from baseline to 4 weeks achieving no change or an increase in HDL-C levels based on expected effects through almond intervention will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving no change or an increase in HDL-C levels | The difference in the proportion of participants from baseline to 8 weeks achieving no change or an increase in HDL-C levels based on expected effects through almond intervention will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving no change or an increase in HDL-C levels | The difference in the proportion of participants from baseline to 12 weeks achieving no change or an increase in HDL-C levels based on expected effects through almond intervention will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving movement from HDL-C categories | The difference in the proportion of participants from baseline to 4 weeks achieving movement from HDL-C categories defined by NCEP guidelines (those with HDL-C levels <40 mg/dL (1.04 mmol/L) and ≥40 mg/dL) will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving movement from HDL-C categories | The difference in the proportion of participants from baseline to 8 weeks achieving movement from HDL-C categories defined by NCEP guidelines (those with HDL-C levels <40 mg/dL (1.04 mmol/L) and ≥40 mg/dL) will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving movement from HDL-C categories | The difference in the proportion of participants from baseline to 12 weeks achieving movement from HDL-C categories defined by NCEP guidelines (those with HDL-C levels <40 mg/dL (1.04 mmol/L) and ≥40 mg/dL) will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving movement from HDL-C categories | The difference in the proportion of participants from baseline to 16 weeks achieving movement from HDL-C categories defined by NCEP guidelines (those with HDL-C levels <40 mg/dL (1.04 mmol/L) and ≥40 mg/dL) will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in total cholesterol levels | The difference in the proportion of participants from baseline to 16 weeks achieving a change in total cholesterol levels will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in total cholesterol levels | The difference in the proportion of participants from baseline to 4 weeks achieving a change in total cholesterol levels will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in total cholesterol levels | The difference in the proportion of participants from baseline to 8 weeks achieving a change in total cholesterol levels will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in total cholesterol levels | The difference in the proportion of participants from baseline to 12 weeks achieving a change in total cholesterol levels will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in LDL-C levels | The difference in the proportion of participants from baseline to 4 weeks achieving a change in LDL-C levels will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in LDL-C levels | The difference in the proportion of participants from baseline to 12 weeks achieving a change in LDL-C levels will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in LDL-C levels | The difference in the proportion of participants from baseline to 16 weeks achieving a change in LDL-C levels will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in LDL-C levels | The difference in the proportion of participants from baseline to 8 weeks achieving a change in LDL-C levels will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in triglyceride levels | The difference in the proportion of participants from baseline to 4 weeks achieving a change in triglyceride levels will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in triglyceride levels | The difference in the proportion of participants from baseline to 8 weeks achieving a change in triglyceride levels will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in triglyceride levels | The difference in the proportion of participants from baseline to 12 weeks achieving a change in triglyceride levels will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in triglyceride levels | The difference in the proportion of participants from baseline to 16 weeks achieving a change in triglyceride levels will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in non-HDL-C levels | The difference in the proportion of participants from baseline to 4 weeks achieving a change in non-HDL-C levels will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in non-HDL-C levels | The difference in the proportion of participants from baseline to 8 weeks achieving a change in non-HDL-C levels will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in non-HDL-C levels | The difference in the proportion of participants from baseline to 12 weeks achieving a change in non-HDL-C levels will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in non-HDL-C levels | The difference in the proportion of participants from baseline to 16 weeks achieving a change in non-HDL-C levels will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in the Triglyceride/HDL-C ratio | The difference in the proportion of participants from baseline to 4 weeks achieving a change in the Triglyceride/HDL-C ratio will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in the Triglyceride/HDL-C ratio | The difference in the proportion of participants from baseline to 8 weeks achieving a change in the Triglyceride/HDL-C ratio will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in the Triglyceride/HDL-C ratio | The difference in the proportion of participants from baseline to 12 weeks achieving a change in the Triglyceride/HDL-C ratio will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in the Triglyceride/HDL-C ratio | The difference in the proportion of participants from baseline to 16 weeks achieving a change in the Triglyceride/HDL-C ratio will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in the Total Cholesterol/HDL-C ratio | The difference in the proportion of participants from baseline to 4 weeks achieving a change in the Total Cholesterol/HDL-C ratio will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in the Total Cholesterol/HDL-C ratio | The difference in the proportion of participants from baseline to 8 weeks achieving a change in the Total Cholesterol/HDL-C ratio will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in the Total Cholesterol/HDL-C ratio | The difference in the proportion of participants from baseline to 12 weeks achieving a change in the Total Cholesterol/HDL-C ratio will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in the Total Cholesterol/HDL-C ratio | The difference in the proportion of participants from baseline to 16 weeks achieving a change in the Total Cholesterol/HDL-C ratio will be determined. | 16 weeks |
| The difference in the proportion of participants from baseline to 4 weeks achieving a change in the LDL-C/HDL-C ratio | The difference in the proportion of participants from baseline to 4 weeks achieving a change in the LDL-C/HDL-C ratio will be determined. | 4 weeks |
| The difference in the proportion of participants from baseline to 8 weeks achieving a change in the LDL-C/HDL-C ratio | The difference in the proportion of participants from baseline to 8 weeks achieving a change in the LDL-C/HDL-C ratio will be determined. | 8 weeks |
| The difference in the proportion of participants from baseline to 12 weeks achieving a change in the LDL-C/HDL-C ratio | The difference in the proportion of participants from baseline to 12 weeks achieving a change in the LDL-C/HDL-C ratio will be determined. | 12 weeks |
| The difference in the proportion of participants from baseline to 16 weeks achieving a change in the LDL-C/HDL-C ratio | The difference in the proportion of participants from baseline to 16 weeks achieving a change in the LDL-C/HDL-C ratio will be determined. | 16 weeks |
| The difference in change in ApoB48 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks | The difference in change in ApoB48 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks will be determined. | 8 weeks |
| The difference in change in ApoB48 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks | The difference in change in ApoB48 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks will be determined. | 16 weeks |
| The difference in change in ApoB100 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks | The difference in change in ApoB100 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks will be determined. | 16 weeks |
| The difference in change in ApoB100 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks | The difference in change in ApoB100 concentration between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks will be determined. | 8 weeks |
| The difference in change in cardiovascular disease risk between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks | The difference in change in cardiovascular disease (CVD) risk between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 8 weeks will be determined. Cardiovascular disease risk scores will be assessed by Framingham CVD Risk Scores, which is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. | 8 weeks |
| The difference in change in cardiovascular disease risk between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks | The difference in change in cardiovascular disease (CVD) risk between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet from baseline to 16 weeks will be determined. Cardiovascular disease risk scores will be assessed by Framingham CVD Risk Scores, which is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. | 16 weeks |
| The change in weight from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in weight from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 4 weeks |
| The change in weight from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in weight from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 8 weeks |
| The change in weight from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in weight from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 12 weeks |
| The change in weight from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in weight from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 16 weeks |
| The change in Body Mass Index from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Body Mass Index from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 4 weeks |
| The change in Body Mass Index from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Body Mass Index from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 8 weeks |
| The change in Body Mass Index from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Body Mass Index from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 12 weeks |
| The change in Body Mass Index from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Body Mass Index from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 16 weeks |
| The change in Sagittal Abdominal Diameter from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Sagittal Abdominal Diameter from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Also known as abdominal height, Sagittal Abdominal Diameter will be measured with the participant in a supine position with straight legs after normal expiration. At the level of the iliac crest, Sagittal Abdominal Diameter is the distance between the examination table to the horizontal level using abdominal calipers. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 0.5 cm, a third measurement is to be taken and the two closest values will be averaged for final measurement. | 4 weeks |
| The change in Sagittal Abdominal Diameter from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Sagittal Abdominal Diameter from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Also known as abdominal height, Sagittal Abdominal Diameter will be measured with the participant in a supine position with straight legs after normal expiration. At the level of the iliac crest, Sagittal Abdominal Diameter is the distance between the examination table to the horizontal level using abdominal calipers. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 0.5 cm, a third measurement is to be taken and the two closest values will be averaged for final measurement. | 8 weeks |
| The change in Sagittal Abdominal Diameter from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Sagittal Abdominal Diameter from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Also known as abdominal height, Sagittal Abdominal Diameter will be measured with the participant in a supine position with straight legs after normal expiration. At the level of the iliac crest, Sagittal Abdominal Diameter is the distance between the examination table to the horizontal level using abdominal calipers. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 0.5 cm, a third measurement is to be taken and the two closest values will be averaged for final measurement. | 16 weeks |
| The change in Sagittal Abdominal Diameter from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Sagittal Abdominal Diameter from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Also known as abdominal height, Sagittal Abdominal Diameter will be measured with the participant in a supine position with straight legs after normal expiration. At the level of the iliac crest, Sagittal Abdominal Diameter is the distance between the examination table to the horizontal level using abdominal calipers. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 0.5 cm, a third measurement is to be taken and the two closest values will be averaged for final measurement. | 12 weeks |
| The change in Waist Circumference from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist Circumference from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Measurements will be performed when standing at the part of the trunk located midway between the lower costal margin and the iliac crest. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 10%, a third measurement is to be taken and the two closest values will be averaged for final measurement. The height of the waist will be also recorded at baseline, and then used to determine the waist throughout the study in order to ensure a consistent measurement at all visits. | 4 weeks |
| The change in Waist Circumference from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist Circumference from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Measurements will be performed when standing at the part of the trunk located midway between the lower costal margin and the iliac crest. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 10%, a third measurement is to be taken and the two closest values will be averaged for final measurement. The height of the waist will be also recorded at baseline, and then used to determine the waist throughout the study in order to ensure a consistent measurement at all visits. | 8 weeks |
| The change in Waist Circumference from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist Circumference from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Measurements will be performed when standing at the part of the trunk located midway between the lower costal margin and the iliac crest. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 10%, a third measurement is to be taken and the two closest values will be averaged for final measurement. The height of the waist will be also recorded at baseline, and then used to determine the waist throughout the study in order to ensure a consistent measurement at all visits. | 12 weeks |
| The change in Waist Circumference from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist Circumference from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. Measurements will be performed when standing at the part of the trunk located midway between the lower costal margin and the iliac crest. At least two separate measurements are to be taken at each visit. If the two measurements differ by more than 10%, a third measurement is to be taken and the two closest values will be averaged for final measurement. The height of the waist will be also recorded at baseline, and then used to determine the waist throughout the study in order to ensure a consistent measurement at all visits. | 16 weeks |
| The change in Waist to Hip Ratio from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist to Hip Ratio from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 16 weeks |
| The change in Waist to Hip Ratio from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist to Hip Ratio from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 12 weeks |
| The change in Waist to Hip Ratio from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist to Hip Ratio from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 8 weeks |
| The change in Waist to Hip Ratio from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in Waist to Hip Ratio from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 4 weeks |
| The change in blood pressure from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in blood pressure from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 4 weeks |
| The change in blood pressure from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in blood pressure from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 8 weeks |
| The change in blood pressure from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in blood pressure from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 12 weeks |
| The change in blood pressure from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet | The change in blood pressure from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 16 weeks |
| The difference in change in serum α-tocopherol concentrations from baseline to 16 weeks between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet | The difference in change in serum α-tocopherol concentrations from baseline to 16 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 16 weeks |
| The difference in change in serum α-tocopherol concentrations from baseline to 12 weeks between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet | The difference in change in serum α-tocopherol concentrations from baseline to 12 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 12 weeks |
| The difference in change in serum α-tocopherol concentrations from baseline to 8 weeks between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet | The difference in change in serum α-tocopherol concentrations from baseline to 8 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 8 weeks |
| The difference in change in serum α-tocopherol concentrations from baseline to 4 weeks between Almond-enriched Diet Dose 1 and Almond-Enriched Diet Dose 2 compared to the Nut-Free Diet | The difference in change in serum α-tocopherol concentrations from baseline to 4 weeks between Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2 and the Nut-Free Diet will be determined. | 4 weeks |
| Incidence of post-emergent adverse events following 16-week ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Incidence of post-emergent adverse events following 16-week ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks and at a 7-day follow-up at the end of the study |
| Change in Aspartate Aminotransferase levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in Aspartate Aminotransferase levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in alanine aminotransferase levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in alanine aminotransferase levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in alkaline phosphatase from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in alkaline phosphatase from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in total bilirubin levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in total bilirubin levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in creatinine from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in creatinine from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in potassium levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in potassium levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in sodium levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in sodium levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in chloride levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in chloride levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in glucose levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in glucose levels from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in estimated glomerular filtration rate (eGFR) from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in estimated glomerular filtration rate (eGFR) from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in white blood cell count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in white blood cell count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of neutrophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of neutrophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of lymphocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of lymphocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of monocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of monocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of eosinophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of eosinophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of basophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of basophils from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of hemoglobin from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of hemoglobin from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of hematocrit from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of hematocrit from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in Red Blood Cell (RBC) Count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in Red Blood Cell (RBC) Count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in platelet count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in platelet count from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of immature granulocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of immature granulocytes from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in levels of nucleated red blood cells from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in levels of nucleated red blood cells from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in mean corpuscular volume from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in mean corpuscular volume from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in mean corpuscular hemoglobin from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in mean corpuscular hemoglobin from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in mean corpuscular hemoglobin concentration from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in mean corpuscular hemoglobin concentration from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. | 16 weeks |
| Change in red cell distribution width from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet | Change in red cell distribution width from baseline to 16 weeks following daily ingestion of Almond-enriched Diet Dose 1, Almond-Enriched Diet Dose 2, or Nut-Free Diet will be determined. Red cell distribution width is expressed as a percentage of variation. | 16 weeks |
| ID | Term |
|---|---|
| D006937 | Hypercholesterolemia |
| ID | Term |
|---|---|
| D006949 | Hyperlipidemias |
| D050171 | Dyslipidemias |
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
Not provided
Not provided