Background: We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and blood pressure levels in adults, with and without comorbidities. Methods: The databases used were MEDLINE (PubMed), EMBASE, Web of Science, Cochrane, LILACS, and SciELO. The eligible studies were randomized clinical trials (RCTs) involving adults undergoing cocoa consumption (cocoa extract or ≥70% cocoa dark chocolate) for ≥4 weeks that evaluated at least one of the following markers: body weight, body mass index (BMI), waist/abdominal circumference, total cholesterol, LDL-c, triglycerides, HDL-c, blood glucose, glycated hemoglobin (HbA1c), and systolic and diastolic blood pressure (SBP/DBP). Results: Thirty-one studies were included, totaling 1986 participants. Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c. Yet, there was a reduction in total cholesterol (−8.35 mg/dL, 95% CI −14.01; −2.69 mg/dL), LDL-c (−9.47 mg/dL, 95% CI −13.75; −5.20 mg/dL), fasting blood glucose (−4.91 mg/dL, 95% CI −8.29; −1.52 mg/dL), SBP (−2.52 mmHg, 95% CI −4.17; −0.88 mmHg), and DBP (−1.58 mmHg, 95% CI −2.54; −0.62 mmHg). Conclusions: The consumption of cocoa showed protective effects on major cardiometabolic risk markers that have a clinical impact in terms of cardiovascular risk reduction.

Coronary artery disease (CAD) remains the leading cause of death worldwide and has a multifactorial etiology involving genetic, metabolic, and behavioral factors. Hypertension and dyslipidemia contribute significantly to atherosclerosis progression, and these conditions may be influenced by microRNAs (miRNAs), which act as post-transcriptional gene expression regulators. In turn, miRNA expression can be modulated by nutrient-dense dietary patterns or cardioprotective foods, such as nuts. Despite growing interest in miRNAs and cardiovascular disease (CVD) risk, few reviews have specifically addressed the unique role of nuts in modulating miRNA expression, particularly regarding gaps in secondary prevention of CAD. This study summarizes the main miRNAs associated with blood pressure, lipid metabolism, and atherosclerotic disease, as well as the current evidence on how nut consumption influences their expression. Several miRNAs, including miR-1, miR-21, the miR-29 family, miR-30a/b, miR-133, miR-143, miR-145, and miR-221/222, are dysregulated in hypertension and associated with circadian blood pressure patterns, left ventricular hypertrophy, and antihypertensive response. Others, such as miR-122, miR-33a/b, miR-148a, miR-483-5p, and miR-145, are linked to lipid metabolism, plaque instability, and ischemic outcomes. Nut-rich diets, particularly the Mediterranean diet, seem to modulate miRNAs associated with pathways involved in lipid homeostasis, endothelial function, and inflammation. Data from clinical trials conducted in primary CVD prevention setting have shown changes in circulating miRNAs in response to diets rich in nuts. Additional studies with Brazil nuts, pistachios, almonds, and walnuts supplementation also reported modulation of miRNAs involved in lipid homeostasis, inflammation, and insulin resistance, including significant changes in expression of miR-15a, miR-21, miR-328, miR-454-3p, miR-29a-3p, miR-192, miR-330-3p, miR-32-5p, miR-29b-3p, and miR-551a. Nonetheless, it appears no studies have yet evaluated the effect of nut supplementation on miRNAs in secondary prevention of CAD. Although the evidence is promising, more research is needed to clarify the impact of nut consumption on miRNA modulation, particularly in secondary prevention of CVD.

Nut-enriched diets have a positive impact on cardiovascular risk factors, such as body mass, blood pressure, and fasting blood glucose. However, studies in individuals undergoing secondary cardiovascular prevention show controversial results. This systematic review with meta-analysis assessed the effect of nut supplementation on anthropometric, glycemic, and blood pressure indices in patients with atherosclerotic cardiovascular disease, as well as the frequency of adverse events. Six databases were used for the search—PubMed, Cochrane Library, EMBASE, BVS (Biblioteca Virtual da Saude), Web of Science, and ClinicalTrials.gov—until February 2023, with no language restrictions. The Cochrane Handbook for Systematic Reviews of Interventions methodology and the PICOS (Population, Intervention, Comparison, Outcome, Setting/design) strategy were used. Seven independent reviewers were involved in data extraction and resolution of disagreements. Certainty of the evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. From 5187 records identified, 6 publications containing data referring to 5 randomized clinical trials (n = 436) were included in the final analyses. The nuts evaluated were almonds, pecans, Brazil nuts, and mixed nuts, with portions that varied between 5 g and 85 g (median: 30 g/day). The intervention period varied between 6 and 12 weeks. The nuts had no effect on fasting glucose and anthropometric indices, although the certainty of the evidence for most of these outcomes was low or very low. They also had no effect on systolic (mean difference [MD]: -1.16 mmHg [95% CI, -5.68 to 3.35], I² = 0%—moderate certainty of evidence) or diastolic (MD: 0.10 mmHg [95% CI, -2.30 to 2.51], I² = 0%—high certainty of evidence) blood pressure. It was not possible to aggregate data on adverse events. Nut supplementation had no effect on blood pressure, fasting glucose, or anthropometric profile in the context of atherosclerotic cardiovascular disease. PROSPERO registration no. CRD42020163456.

Background: Abdominal obesity has been associated with cardiovascular disease and may be modulated by dietary intake. The deep abdominal subcutaneous adipose tissue (dSAT) is a body fat compartment that can be estimated by using mathematical formulas. Objectives: To evaluate the association between dSAT estimated by the Deep-Abdominal-Adipose-Tissue (DAAT) index and dietary intake in patients with acute coronary syndrome (ACS). Methods: This is a cross-sectional study conducted with patients ≥ 18 years of age admitted to a tertiary hospital. Sociodemographic, [...] Abstract Background: Abdominal obesity has been associated with cardiovascular disease and may be modulated by dietary intake. The deep abdominal subcutaneous adipose tissue (dSAT) is a body fat compartment that can be estimated by using mathematical formulas. Objectives: To evaluate the association between dSAT estimated by the Deep-Abdominal-Adipose-Tissue (DAAT) index and dietary intake in patients with acute coronary syndrome (ACS). Methods: This is a cross-sectional study conducted with patients ≥ 18 years of age admitted to a tertiary hospital. Sociodemographic,