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THE DOCTORAL SCHOOL
“IULIU HAŢIEGANU” UNIVERSITY OF MEDICINE AND PHARMACY CLUJ-NAPOCA
CLUJ-NAPOCA 2020
2 Marius Emil Rusu
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
PhD THESIS
Analytical and biological
studies of several bioactive
compounds of the most used
tree nuts and the positive
impact on health
PhD candidate: Marius Emil Rusu
Scientific supervisor: Prof. Laurian Vlase, PhD
4 Marius Emil Rusu
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
Ad majorem Dei gloriam
To my children – George, Alexandra, Dominic, Christian
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
LIST OF PUBLICATIONS
1. Rusu ME, Gheldiu A-M, Mocan A, Vlase L, Popa D-S. Anti-aging potential of tree
nuts with a focus on phytochemical composition, molecular mechanisms and
thermal stability of major bioactive compounds. Food & Function. 2018;
9(5):2554–75. ISI Impact factor: 3.241 (Food Science & Technology Q1)
(review 1 found in Introduction).
2. Rusu ME, Gheldiu A-M, Mocan A, Moldovan C, Popa D-S, Tomuta I, Vlase L.
Process Optimization for Improved Phenolic Compounds Recovery from
Walnut (Juglans regia L.) Septum: Phytochemical Profile and Biological
Activities. Molecules. 2018; 23(11):2814. ISI Impact factor: 3.06 (Biochemistry
& Molecular Biology Q2) (study found in Chapter 2).
3. Rusu ME, Simedrea R, Gheldiu A-M, Mocan A, Vlase L, Popa D-S, Ferreira ICFR.
Benefits of tree nut consumption on aging and age-related diseases:
Mechanisms of actions. Trends in Food Science & Technology. 2019;
88(2):104-20. ISI Impact factor: 8.519 (Food Science & Technology Q1)
(review 2 found in Introduction).
4. Rusu ME, Mocan A, Ferreira ICFR, Popa D-S. Health Benefits of Nut
Consumption in Middle-Aged and Elderly Population. Antioxidants. 2019;
8(8):302. ISI Impact factor: 4.52 (Food Science & Technology Q1) (review 3
found in Introduction).
5. Rusu ME, Fizeșan I, Pop A, Gheldiu A-M, Mocan A, Crișan G, Vlase L, Loghin F,
Popa D-S, Tomuta I. Enhanced Recovery of Antioxidant Compounds from
Hazelnut (Corylus avellana L.) Involucre based on Extraction Optimization:
Phytochemical Profile and Biological Activities. Antioxidants. 2019; 8(10):
460. ISI Impact factor: 4.52 (Food Science & Technology Q1) (study found in
Chapter 5).
6. Rusu ME, Fizesan I, Pop A, Mocan A, Gheldiu A-M, Babota M, Vodnar DC, Jurj A,
Berindan-Neagoe I, Vlase L, Popa D-S. Walnut (Juglans regia L.) septum:
Assessment of bioactive molecules and in vitro biological effects. Molecules.
2020; 25(9):2187. ISI Impact factor: 3.06 (Biochemistry & Molecular Biology
Q2) (study found in Chapter 3).
7. Rusu ME, Georgiu C, Pop A, Mocan A, Kiss B, Vostinaru O, Fizesan I, Stefan MG,
Gheldiu A-M, Mates L, Moldovan R, Muntean DM, Loghin F, Vlase L, Popa D-S.
Antioxidant effects of walnut (Juglans regia L.) kernel and walnut septum
extract in a D-galactose-induced aging model and in naturally aged rats.
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Antioxidants. 2020; 9(5):424. ISI Impact factor: 4.52 (Food Science &
Technology Q1) (study found in Chapter 4).
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
TABLE OF CONTENTS
INTRODUCTION 15
ACTUAL STATE OF KNOWLEDGE
1. General knowledge about tree nuts 19
1.1. Tree nut overview 19
1.2. Macro and micronutrients in tree nuts 19
1.3. Phytochemicals in tree nuts 22
1.4. Health benefits of tree nut consumption 23
1.4.1. Tree nut consumption and cardiometabolic disorders 23
1.4.2. Tree nut consumption and blood lipid 25
1.4.3. Tree nut consumption and cancer 28
1.4.4. Tree nut consumption and cognitive disorders 31
1.4.5. Other possible beneficial associations 33
1.5. Potential mechanisms responsible for beneficial activities 34
1.5.1. Association between tree nuts and gastrointestinal microbiota 39
1.6. Agricultural waste and tree nut by-products 39
PERSONAL CONTRIBUTIONS
1. General objectives 43
2. Study 1. Bioactive compounds of walnut (Juglans regia L.)
septum and the antioxidant activity
45
2.1. Introduction 45
2.2. Materials and methods 46
2.2.1. Chemicals and samples 46
2.2.2. Preparation of extracts 46
2.2.3. Quantitative determination of total bioactive compounds 47
2.2.4. Phytochemical analysis by LC-MS/MS 48
2.2.5. Antioxidant activity assays 50
2.2.6. Tyrosinase inhibitory activity 50
2.2.7. Experimental conditions for phytochemical-rich extracts 51
2.2.8. Statistical analysis 51
2.3. Results and discussion 51
2.3.1. Fitting the experimental data with the models 51
2.3.2. The Influence of variables on studied parameters 56
2.3.3. Quantitative determinations of the bioactive compounds 60
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2.3.4. Identification and quantification of individual polyphenols 62
2.3.5. Identification and quantification of phytosterols 63
2.3.6. Antioxidant activity 63
2.3.7. Tyrosinase inhibitory activity 65
2.4. Conclusions 65
3. Study 2. Assessment of tocopherols and biological effects of
walnut (Juglans regia L.) septum 67
3.1. Introduction 67
3.2. Materials and methods 68
3.2.1. Reagents 68
3.2.2. Plant matrices 68
3.2.3. Tocopherol quantification by LC-MS/MS 68
3.2.4. Enzyme inhibitory activity 69
3.2.5. Antibacterial activity 70
3.2.6. Antifungal activity 71
3.2.7. Antimutagenic assay 71
3.2.8. Biological activities on cell lines 72
3.2.9. Statistical analysis 74
3.3. Results and discussion 74
3.3.1. Bioactive compounds present in septum 74
3.3.2. Biological activities 77
3.4. Conclusions 86
4. Study 3. The effects of walnut (Juglans regia L.) kernel and
septum in induced-aged and naturally aged rats 87
4.1. Introduction 87
4.2. Materials and methods 88
4.2.1. Reagents 88
4.2.2. Animals and experimental protocol 88
4.2.3. Preparation of the walnut septum extract 89
4.2.4. Biological samples 90
4.2.5. Determination of total protein content 91
4.2.6. Hematological and biochemical analyses 91
4.2.7. Antioxidant cellular status 91
4.2.8. Oxidative stress biomarkers 92
4.2.9. Acetylcholinesterase activity 94
4.2.10. Histopathological and immunohistochemical analyses 94
4.2.11. Statistical analysis 95
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
4.3. Results 95
4.3.1. Body weight and organ indices 95
4.3.2. Hematological and biochemical analyses 96
4.3.3. Antioxidant cellular status 99
4.3.4. Oxidative stress biomarkers 100
4.3.5. Acetylcholinesterase activity 102
4.3.6. Histopathological and immunohistochemical analyses 103
4.4. Discussion 106
4.5. Conclusions 111
5. Study 4. Phytochemical profile and biological activities of
hazelnut (Corylus avellana L.) involucre
113
5.1. Introduction 113
5.2. Materials and methods 114
5.2.1. Chemicals 114
5.2.2. Plant samples 114
5.2.3. Determination of bioactive compounds and antioxidant activity 115
5.2.4. Phytochemical analysis by LC-MS 117
5.2.5. Biological activities of the optimal HI extract 118
5.2.6. Biological activities of HI extract on cell lines 119
5.2.7. Statistical analysis 120
5.3. Results and discussion 121
5.3.1. Fitting the experimental data with the models 121
5.3.2. Influence of experimental conditions 124
5.3.3. Determination of bioactive compounds and antioxidant activity 125
5.3.4. Individual bioactive compounds 127
5.3.5. Enzyme inhibitory activities 130
5.3.6. Biological activities on cell lines 131
5.4. Conclusions 134
6. General conclusions 135
7. Originality of the thesis 137
REFERENCES 139
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
ABBREVIATIONS
HPLC High performance liquid chromatography
MS Mass spectrometry
TPC Total phenolic content
TFC Total flavonoid content
CTC Condensed tannin content
TAA Total antioxidant activity
TEAC Trolox equivalent antioxidant capacity
ABTS 2,2’-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid)
DPPH 2,2-diphenyl-1-picrylhydrazyl
FRAP Ferric reducing antioxidant power
ROS Reactive oxygen species
AGE Advanced glycation end product
MDA Malondialdehyde
IL-6 Interleukin 6
TNF-α tumor necrosis factor-α
NF-кB Nuclear factor kappa B
Nrf2 Nuclear factor erythroid 2-related factor 2
T2DM Type 2 diabetes mellitus
CVD Cardiovascular diseases
MS Metabolic syndrome
ALT Alanine transaminase
AST Aspartate transaminase
HDL-C High density lipoprotein-cholesterol
LDL-C Low density lipoprotein-cholesterol
TG Triglycerides
MD Mediterranean diet
MUFA Monounsaturated fatty acid
PUFA Polyunsaturated fatty acid
HI Hazelnut involucre
WK Walnut kernel
WSE Walnut septum extract
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
INTRODUCTION
Due to nutritional choices, population aging, or sedentary lifestyle, the whole
world is facing an increased incidence of cardiometabolic diseases, cancer, or
neurodegenerative disorders associated with a decrease in the quality of life. Healthy
diet, along with physical and cognitive activity, is a modifiable lifestyle factor that has
been associated with overall health. Tree nuts are complete functional foods
containing valuble bioactive compounds that could prevent many diseases and delay
age-related pathologies.
In the Actual state of knowledge section, the first part of this PhD thesis, a
synthesis of the most recent data regarding this topic is presented. Most of the tree
nuts, such as almonds (Prunus dulcis (Mill.) D.A. Webb), hazelnuts (Corylus avellana L.),
pistachios (Pistacia vera L.), or walnuts ( Juglans regia L.), have been a part of the
human diet for millennia. They are low in carbohydrates (less than 30%), are good
sources of proteins (15-21%), and abound in healthy fatty acids composed mostly of
healthy monounsaturated and polyunsaturated fatty acids, ranging from 43 to 76%.
Walnuts have the largest quantity of omega-6 and omega-3 fatty acids, with a healthy
ratio of around 4 : 1. They contain vitamin E, minerals, polyphenols, and phytosterols.
Polyphenols, powerful phytochemicals, act as direct and indirect antioxidants, reduce
the inflammatory response, modulate many cell signaling pathways, have anticancer
potential, prevent cell senescence, and improve gut microbiota. Tree nuts are
considered important components of a healthy diet and are part of the protein food
group.
Because of the healthy biochemical profile, many studies underligned the
benefits of including tree nuts in prevention and treatment protocols. Clinical trials
and cohort studies published recently presented the influence of antioxidant tree nut
diets in preventing or delaying diseases in subjects of all ages. Tree nut
supplementation has the possibility to decrease cardiometabolic morbidity and
mortality, cancers, and cognitive disorders, mainly through their healthy lipid profile
and antioxidant and anti-inflammatory mechanisms of actions. Tree nut intake can
modulate signaling pathways, stimulate antioxidant and detox enzyme systems, reduce
inflammatory conditions, and have a senolytic capacity. Through the antioxidant and
anti-inflammatory action, they are potentially anti-tumoral. By inhibiting mTOR
signaling pathways, but also via epigenetic mechanisms, such as obstructing DNA
methylation or histone and microARN modulation, nuts act as carcinogenesis
inhibitors.
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Scientific findings also revealed that tree nut waste-products could provide the
same benefits. Guided by these facts, we analyzed several by-products which were
rarely mentioned in the scientific literature.
In the first chapter of the Personal Contributions section, we described the
walnut septum, a scarcely tested by-product. We obtained walnut septum extract
(WSE) with high content in bioactive compounds and antioxidant activity based on an
original experimental design. We characterized the phytochemical profile using HPLC-
MS/MS and evaluated the biological potential of the richest polyphenolic WSE.
We extended the WSE knowledge in our second experiment. The tocopherol
content was determined by LC-MS/MS. The in vitro inhibiting assessment against
several enzymes attested a potential in diabetes or obesity management. Also, the WSE
demonstrated antimicrobial potential and revealed antimutagenic inhibitory effects.
The cytotoxicity of the extract was assessed on cancerous and normal cell lines.
Additionally, the extract demonstrated antioxidant activity and anti-inflammatory
activity.
In the third study, based on the knowledge that dietary intervention could delay
age-related dysfunctions, we assessed the antioxidant effects of walnut kernel (WK)
and WSE in D-galactose (D-gal) induced aging rats and in naturally aged rats. The
supplementation positively influenced several body measurements, biochemical
parameters and antioxidant biomarkers, as well as brain and liver histological
architecture. Additionally, WK or WSE lowered acetylcholinesterase activity, a
potential strategy in managing neurodegenerative disorders. Histopathological and
immunohistochemical analyses revealed that WK or WSE diets could protect neurons
in induced-senescence and retain the number of viable neurons. The findings provide
scientific evidence that dietary supplementation with WK or WSE can have the ability
to maintain health functions and may reduce the risk of age-related diseases or delay
the onset of aging processes.
In the last chapter, we presented an experiment on hazelnut involucre (HI),
another by-product with few scientific literature mentions. The phenolic and sterolic
compositions, as well as the antioxidant and biological activities were evaluated.
Experimental designs were developed to select the optimum extraction conditions for
obtaining extracts rich in bioactive compounds. LC-MS/MS analyses revealed
important amounts of individual polyphenols and phytosterols, molecules with
antioxidant potential. The richest polyphenolic extract was evaluated by in vitro
antioxidant tests and enzyme inhibitory assays. Besides, the cytotoxic and antioxidant
effects on two cancerous cell lines and on normal cells were tested.
Our findings revealed that the assessed by-products presented strong biological
activities justifying further research. Moreover, walnut septum and hazelnut involucre
could be considered inexpensive sources of natural antioxidants for food,
pharmaceutical, or cosmetic industry.
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
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ACTUAL STATE OF
KNOWLEDGE
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
1. General knowledge about tree nuts
1.1. Tree nut overview
Tree nuts have been part of the human diet for millennia, as many
archaeological discoveries show 1. Nowadays tree nuts are considered important
components of a healthy diet and they are integrated in the U.S. Food Guide Pyramid
and the Mediterranean Diet Pyramid 2. Nuts are part of the Protein Foods group,
together with seafood, meats, poultry, eggs, seeds, and soy products. Experts
recommend (“at the 2,000-calorie level”) eating 155 g per day from this food group 3,
which can be divided into several servings per day. The Food and Drug Administration
(FDA) even authorized the health claim “that eating 1.5 ounces (43 g) per day of most
nuts as part of a diet low in saturated fat and cholesterol may reduce the risk of heart
disease” 4. By the phrase “most nuts” FDA was referring to almonds (Prunus dulcis
(Mill.) D.A.Webb), Brazil nuts (Bertholletia excelsa Bonpl.), cashews (Anacardium
occidentale L.), hazelnuts (Corylus avellana L.), macadamias (Macadamia integrifolia
Maiden & Betche), pecans (Carya illinoinensis (Wangenh.) K.Koch), pine nuts (Pinus
pinea L.), pistachios (Pistacia vera L.), walnuts (Juglans regia L.), and peanuts (Arachis
hypogaea L.). Although peanuts have a comparable nutrient profile to tree nuts 5, they
are botanically classified as legumes and are not included in this study.
Tree nuts are defined as dry fruits with one seed in which the ovary wall
becomes hard at maturity, the exception being the Brazil nut which is a seed 6. As a
mean, over half of tree nuts’ calories come from lipids, so they are included in the
energy dense food group. There is some anxiety that the high-fat, energy-dense content
of tree nuts can stimulate weight gain, but many reports show that nut consumption is
not associated with body weight gain. In contrast, it gives lower risks of weight gain
and obesity 7 , very important aspects in today’s obesogenic society.
It is worth mentioning that many factors, such as cultivar type, geographical
locations, growing conditions, agricultural practices, degree of ripeness, storage
conditions, distance to market, industrial processing, and cooking methods, can
influence the chemical composition and nutritive value of tree nut kernels.
1.2. Macro and micronutrients in tree nuts
Nuts provide a fairly large amount of calories, from around 550-580 kcal/100 g
in cashews, pistachios, and almonds, to 720 kcal/100 g in macadamias 8. Most of the
energy comes from fat, which ranges from around 45% in cashews and pistachios, to
76% in macadamias. The lipid profile is composed mainly of heart-protective
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monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs).
MUFAs are the most common fatty acid for most nut types, followed by omega-6
(linoleic acid, 18:2 n-6) and omega-3 (alpha-linolenic acid, 18:3 n-3) PUFAs. Walnuts
have the largest quantity of the n-3 fatty acid and the n-6 to n-3 ratio is around 4:1, a
health inducing proportion, compared to other plant oils. The content of saturated
fatty acids (SFA) ranges from 3.8% in almonds to a high of 12.1% and 16.1% in
macadamias and Brazil nuts, respectively (Table I) 8.
Table I. Nutritional value of tree nuts (g/100 g).
Mean value A Bn C H M P Pn Pi W
Energy (kcal) 579 659 553 628 718 691 673 560 654
Energy (kJ) 2423 2757 2314 2629 3004 2889 2816 2342 2738
Protein 21.15 14.32 18.22 14.95 7.91 9.17 13.69 20.16 15.23
Amino acids
Tryptophan 0.21 0.13 0.29 0.19 0.07 0.09 0.11 0.25 0.17
Threonine 0.61 0.36 0.69 0.49 0.37 0.31 0.37 0.68 0.59
Isoleucine 0.75 0.52 0.79 0.54 0.31 0.33 0.54 0.92 0.62
Leucine 1.47 1.19 1.47 1.06 0.60 0.59 0.99 1.60 1.17
Lysine 0.57 0.49 0.93 0.42 0.02 0.28 0.54 1.14 0.42
Methionine 0.16 1.12 0.36 0.22 0.02 0.18 0.26 0.36 0.24
Phenylalanine 1.13 0.64 0.95 0.66 0.66 0.42 0.52 1.09 0.71
Tyrosine 0.45 0.42 0.51 0.36 0.51 0.21 0.51 0.51 0.41
Valine 0.85 0.76 1.09 0.70 0.36 0.41 0.69 1.25 0.75
Arginine 2.46 2.14 2.12 2.21 1.40 1.17 2.41 2.13 2.28
Alanine 0.99 0.61 0.84 0.73 0.39 0.39 0.68 0.97 0.69
Aspartic acid 2.64 1.32 1.79 1.68 1.09 0.93 1.30 1.88 1.83
Glutamic acid 6.21 3.19 4.51 3.71 2.26 1.83 2.92 4.30 2.81
Glycine 1.43 0.73 0.94 0.72 0.45 0.45 0.69 1.01 0.81
Proline 0.97 0.71 0.81 0.56 0.47 0.36 0.67 0.94 0.71
Serine 0.91 0.67 1.08 0.73 0.42 0.47 0.83 1.28 0.93
Total lipid 49.93 67.10 43.85 60.75 75.77 71.97 68.37 45.32 65.21
SFA 3.80 16.13 7.78 4.46 12.06 6.18 4.89 5.91 6.12
MUFA 31.55 23.88 23.79 45.65 58.88 40.80 18.76 23.26 8.93
PUFA 12.33 24.39 7.84 7.92 1.50 21.61 34.07 14.38 47.17
Carbohydrate 21.55 11.74 30.19 16.70 13.82 13.86 13.08 27.17 13.71
Fiber 12.50 7.50 3.30 9.70 8.60 9.60 3.70 10.60 6.70
Starch 0.72 0.25 23.49 0.48 1.05 0.46 1.43 1.67 0.06
A-almonds; Bn-Brazil nuts; C-cashews; H-hazelnuts; M-macadamias; P-pecans; Pn-pine nuts; Pi-pistachios;
W-walnuts. MUFA-monounsaturated fatty acid; PUFA-polyunsaturated fatty acid; SFA-saturated fatty acid.
While some early reports specified a positive relationship between saturated
fatty acids, hyperlipidemia, and an increase in several disease risk factors, many recent
scientific papers have revealed the positive influence of the mix of saturated fatty acids
and n-3 PUFA, in combination with the reduction in the consumption of n-6 PUFA.
Consequently, in the case of nuts, the synergistic effect of all the fatty acids could yield
favorable results on plasma lipid profiles and human health 9.
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
All of the tree nuts are good sources of protein of high biologic value and have
high or very high amounts of proteinogenic amino acids, comparable with the amounts
in eggs or meat. High consumption of proteins and amino acids from red meat and
processed meat appear to activate disease and pro-aging pathways 10, increasing the
incidence of age-related ailments and reducing lifespan, as presented by evidence in
invertebrate, mammalian, and human studies and epidemiological findings 11. The
evidence from recent studies has revealed that reversing the present trend and
replacing animal proteins with plant proteins may be useful for glucose homeostasis
and lowering T2DM risk 12.
The Recommended Dietary Allowance (RDA) for protein in adult population is
0.8 g/kg/day, the same quantity for all age groups 13. This conservative value might be
sufficient for middle-aged adults. Nevertheless, after energy demanding activities,
dietary protein requirements for active adults should be higher than 0.25 g/kg/meal,
based on a diet of 4 meals/day, for proper physical recovery and protein resynthesis.
Also, in order to reduce the risk of osteoporosis and sarcopenia, many studies suggest
an augmentation of protein intake to 1.0–1.2 g/kg/day, 1.2–1.5 g/kg/day when acute
or chronic diseases are present, even up to as much as 2.0 g/kg/day in those adults
with severe malnutrition or illnesses 20.
Tree nuts contain all of the indispensable amino acids needed in the human diet,
some of them in a better concentration for biochemical processes compared to animal-
based foods. The amino acid arginine, which is found in higher concentration in nuts,
can be metabolized to nitric oxide (NO), a potent vasodilator, and can improve insulin
sensitivity in patients with T2DM. The lysine/arginine ratio is lower in nuts than in
proteins from animal sources. This ratio is linked with a significantly lower risk of
hypercholesterolemia and atherosclerosis, which decreases the risk of cardiovascular
diseases 16.
The amino acid methionine is two to four times lower in tree nuts than in
animal-based foods, but this difference proves to be very beneficial. Methionine
restriction showed a decrease in mitochondrial ROS production and carcinogenic
processes, and reduction in the mitochondrial DNA mutations which can be
responsible for part of the age-delaying effect 17.
Tree nuts are low in vitamin C, with the highest level being determined in
hazelnut (6.3 mg/100 g) and pistachio (5.6 mg/100 g). Instead, tree nuts are a good
source of vitamin E, an effective lipid-soluble antioxidant. Because of the high
percentage of lipids, the bioavailability of vitamin E could be significantly greater in
tree nuts 18. Vitamin E consists of a mixture of four tocopherols (α-, β-, γ-, δ-) and four
tocotrienols (α-, β-, γ-, δ-). The total tocopherol content is highest in almond (26.57
mg/100 g kernel) and lowest in cashew (5.79 mg/100 g kernel). Alpha-tocopherol is
found in almonds and hazelnuts, and γ-tocopherol in pecans, walnuts, and pistachios 8.
Tocotrienols were found in six types of tree nut (i.e., Brazil nuts, cashews, macadamias,
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pine nuts, pistachios, and walnuts) in minute amounts, with 1.57 mg α-tocotrienol per
100 g in macadamia kernel and 1.79 mg γ-tocotrienol per 100 g in pistachio kernel 33.
Many nuts are good sources of the essential minerals, such as calcium, iron,
magnesium, phosphorus, potassium, zinc, copper, and selenium.
1.3. Phytochemicals in tree nuts
Tree nuts have a high content of, biologically active compounds, secondary
metabolites. The content of these compounds can vary significantly by nut type,
genotype, harvest, and storage conditions. The most important phytochemicals, part of
these metabolites, include polyphenols, phytosterols, sphingolipids, phytates, and
lignans.
Polyphenols, hydrosoluble micronutrients found mostly in vegetables, fruits,
cocoa beans, coffee, tea, and red wine, consist of several important subclasses: phenolic
acids, flavonoids, carotenoids, stilbenes, lignans and tannins, all of which are also
found in tree nuts. Isoflavones, the main class of phytoestrogen, are plant bioactive
nonsteroidal polyphenolic metabolites capable to bind to estrogenic receptors,
exerting agonist and/or antagonist effects. Three aglycones (daidzein, genistein, and
formononetin) are found in minute amounts in walnuts, hazelnuts, cashews, and
almonds, with pistachios presenting higher quantities of daidzein (1.88 mg/100 g) and
genistein (1.75 mg/100 g) 21.
Lignans, another class of phytoestrogens, are also present in nuts. Small
amounts of secoisolariciresinol, pinoresinol, lariciresinol, and matairesinol are found
in pistachios, walnuts, Brazil nuts, almonds, pine nuts, and hazelnuts. On the other
hand, cashews have high levels of lariciresinol (49.6 mg/100 g) and
secoisolariciresinol (6.73 mg/100 g), comparable with flaxseed and sesame seed, the
main food sources for lignans.
Pistachios are rich in β-carotenes and are the only tree nuts that contain
significant amounts of lutein and zeaxanthin 8. Pistachios are also the only tree nut that
contain significant amounts of melatonin 22.
Resveratrol (trans-3,4′,5-trihydroxystilbene) is a polyphenol belonging to the
stilbenes. It was detected in pistachio varieties cultivated in Turkey 23 and Italy 24.
The two important lipophilic bioactive classes that occur in tree nuts are
phytosterols and sphingolipids. Phytosterols, a group of compounds resembling
cholesterol in structure, include plant sterols and stanols. The typical ratio in plants is
~98% sterols to ~2% stanols. β-sitosterol is the main phytosterol among all the tree
nut types 8. The total quantity of sphingolipids in tree nuts is low, ranging from 0.32
g/100 g in hazelnut oil to 0.91 g/100 g in Brazil nut oil 25.
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Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
1.4. Health benefits of tree nut consumption
Healthy diet, along with physical and cognitive activity, is a modifiable lifestyle
factor that has been associated with overall health. Scientific evidence demonstrated
the potential benefits of higher intake of nuts or nut-enriched Mediterranean diets
(MDs) against risk factors associated with pathological conditions, such as
cardiometabolic diseases, cancer, or cognitive disorders.
1.4.1. Tree nut consumption and cardiometabolic disorders
Globally, cardiometabolic diseases including type 2 diabetes mellitus (T2DM),
coronary heart disease (CHD), coronary artery disease (CAD), and stroke are leading
causes of morbidity and mortality 26. Most of these diseases could be prevented by
changing behavioral risk factors such as suboptimal diet 27.
Tree nuts, because of their healthy antioxidant biochemical profile, can improve
the lipid profile, increase insulin sensitivity and metabolism, and favorably influence
other cardiometabolic risk factors.
Clinical trials and lengthy prospective studies showed that higher weekly nut
intake can lower all cause and cause-specific morbidity and mortality
28,29,30,31,32,33,34,35,36 (Table II). Subjects at high cardiovascular (CV) risk, who
supplemented their MD with 30 grams of tree nuts per day, at any time point during
the 4 year study period, had a 53% lower diabetes incidence compared to the control
group 28. Pan et al. 29 observed that women in the highest nut serving group were 26%
less likely to develop diabetes than participants in the very low nut intake group, with
95% confidence that the true value is lying between 16%-35%. Similarly, when
comparing high to very low nut intake the prevalence of diabetes, obesity, and MS
were 13%, 39%, and 26% less likely, respectively 30.
One prospective study showed a nonsignificant reduction in cardiovascular
disease (CVD) mortality when comparing the highest with the lowest nut intake
population groups 32. However, two others concluded that participants who were fed
nut-enhanced MDs had a significantly lower risk for CVD and CHD, as well as lower
CVD, CHD, and all-cause mortality compared to the no-nut group 31,33. Participants who
consumed walnuts ≥1 serving per week had 19%, 21%, and 17% lower risk for CVD,
CHD, and stroke, respectively, while those who consumed walnuts >3 servings per
week had 47% lower risk of CV mortality compared with subjects who did not eat
walnuts 33. A recent prospective study demonstrated lower CVD incidence (hazard
ratio, HR = 0.83, 95% CI: 0.71–0.98) and CHD incidence (HR = 0.80, 95% CI: 0.67–0.96),
31% lower all-cause mortality and 34% lower CVD mortality for at least 5 servings of
nuts per week compared to less than one per month 36. In the same study, total nut
intake was not significantly associated with stroke incidence.
Marius Emil Rusu
24
Table
II.
Nut
consumption
and
cardiometabolic
morbidity
and
mortality.
Author,
Year,
Country
[Ref]
Design
Subjects
(F:M)
Length
of
Study
Intake
of
Nuts
Findings
Salas-Salvadó
et
al.,
2011,
2018
Spain
28
RCT
418
(293:125)
4
y
MD
+
30
g/d
nuts
↓
diabetes
incidence
HR
0.47
(95%
CI:
0.23–0.98)(vs.
control)
Estruch
et
al.,
2018,
Spain
35
RCT,
Parallel
2,454
(1,326:1,128)
4.8
y
MD
+
30
g/d
nuts
↓
incidence
of
CV
events
HR
0.64
(95%
CI:
0.47–0.88)
(vs.
control)
Pan
et
al.,
2013,
US
29
Prospective
58,063
F
22
y
(1)
Never/rarely
(2)
≥5
servings/wk
↓
T2DM
risk
(p-trend˂
0.001)
HR
0.74
(95%
CI:
0.65–0.84)
Ibarrola-Jurado
et
al.,
2013,
Spain
30
Cross-
sectional
7,210
(4,143:3,067)
(1)
˂
1
serving/wk
(2)
˃
3
servings/wk
↓
prevalence
of
diabetes
(p-trend=0.043)
↓
prevalence
of
obesity
(p-trend˂
0.001)
Guasch-Ferré
et
al.,
2013,
Spain
31
Prospective
7216
(4,145:3,071)
4.8
y
(1)
none
(2)
˃
3
servings/wk
↓
CV
mortality
(p-trend=0.031)
↓
total
mortality
risk
(p-trend=0.01)
Hshieh
et
al.,
2015,
USA
32
Prospective
20,742
M
9.6
y
(1)
˂
1
serving/mo
(2)
≥5
servings/wk
↓
CVD
deaths
(p-trend=0.015)
Guasch-Ferré
et
al.,
2017,
USA
33
Prospective
(a)
NHS
(b)
NHS
II
(c)
HPFS
76,364
F
92,946
F
41,526
M
28.7
y
21.5
y
22.5
y
(1)
Never/almost
never
(2)
˂
1
time/wk
(3)
1
time/wk
(4)
2–4
times/wk
(5)
≥5
times/wk
(5)
vs.
(1)
↓
CVD-HR
0.86
(
p-trend<0.001)
↓
CHD-HR
0.80
(p-trend<0.001)
Larsson
et
al.,
2018,
Sweden
34
Prospective
61,364
17
y
(1)
none
(2)
≥3
times/wk
↓
risk
of
atrial
fibrillation
(p-
trend=0.004)
↓
risk
of
heart
failure
(p-trend=0.003)
Liu
et
al.,
2019,
USA
36
Prospective
(NHS,
HPFS)
16,217
(12,006:4,211)
34
y
28
y
(1)
˂
1
serving/mo
(2)
≥5
servings/wk
↓
CVD
incidence
(p-trend=0.01)
↓
CHD
incidence
(p-trend=0.005)
↓
CVD
mortality
(p-trend<0.001)
CHD-coronary
heart
disease;
CVD-cardiovascular
diseases;
F-women;
HR-hazard
ratio;
HPFS-Health
Professionals
Follow-Up
Study;
M-
men;
MD-Mediterranean
diet;
MS-metabolic
syndrome;
NHS-Nurses’
Health
Study;
RCT-randomized
controlled
trial.
25
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
Moreover, a recent intervention study showed that individuals at high CV risk
had a lower incidence of major CV events (myocardial infarction, stroke, death from CV
causes) when nuts were added daily to MD compared with a low-fat, nut-free control
diet 35. Also, three or more servings of nuts per week, as compared to none, can even
lower the risk of atrial fibrillation and heart failure 34.
Peripheral arterial disease (PAD), often caused by atherosclerosis, can lead to
heart attack and stroke. A large cross-sectional study on mature adults indicated that
daily nut consumption was associated with lower odds of PAD (OR = 0.79; 95% CI:
0.77–0.80, p < 0.001) compared to participants with the lowest intake of nuts 37.
A meta-analysis of 11 observational studies confirmed that tree nut
consumption was negatively associated with metabolic syndrome (MS) (p = 0.04) 38.
Another meta-analysis showed a significantly reduced risk for CVD and CHD for higher
nut consumption 39. Luu et al. 40 showed that in different ethnic groups, nut
consumption was associated with decreased overall mortality and CVD mortality and
that a higher versus lower quintile of nut intake had a statistically significant inverse
association for ischemic heart disease (IHD). Mayhew et al. 41, after reviewing several
large prospective cohort studies, concluded that nut consumption was inversely
associated with total CVD, CVD mortality, total CHD, CHD mortality, and sudden cardiac
death. While one meta-analysis established that daily nut intake can reduce the risk of
stroke 42, another study did not find a significant association with stroke, but indicated
an inverse association with IHD, overall CVD, and all-cause mortality for nut
consumption 43. A meta-analysis of randomized controlled trials (RCTs) and
observational studies identified that nut feeding was inversely linked with nonfatal
and fatal IHD and diabetes, but not stroke 44. However, a meta-analysis of prospective
cohorts to evaluate the relation between nuts and stroke risk and mortality, reported
that nut consumption was inversely associated with stroke risk (RR 0.90, 95% CI:
0.83–0.98) and stroke mortality, when comparing the highest with the lowest nut
intake 45.
High blood pressure (BP) is a major risk factor for CVD. The previous feeding
studies showed that nuts had no effect on BP. However, a recent RCT on an elderly
cohort proved that walnuts (42.5 grams per day) reduced systolic BP in the walnut
group (−4.61 mm Hg, 95% CI: −7.43 to −1.79 mm Hg) compared to the no-walnut
group (−0.59 mm Hg, 95% CI: −3.38 to 2.21 mm Hg)(p = 0.051) 46. As no changes in
diastolic BP were noticed, it is safe to say that walnut intake can reduce systolic BP in
mature subjects, mainly in those with mild hypertension.
1.4.2. Tree nut consumption and blood lipids
The effects of tree nut consumption on lipid profiles from intervention studies
published in the last ten years 47,48,49,50,51,52,53,54,55,56,57,58,59 are summarized in Table III.
Marius Emil Rusu
26
Table
III.
Nut
consumption
and
blood
lipid
levels
in
intervention
studies.
Author,
Year,
Country
[Ref]
Design
Subjects
(F:M)
Length
of
Study
Comparison
group
Intake
of
Nuts
Findings
Li
et
al.,
2011,
Taiwan
47
RCT,
Crossover
20
(11:9)
12
wk
Control
(diet
w/o
A)
56
g/d
A
↓
T-C
6.0%,
p
≤
0.0025
↓
LDL-C
11.6%,
p
≤
0.0117
Wu
et
al.,
2014,
Germany
48
RCT,
Crossover
40
(30:10)
8
wk
Control
(nut-free
diet)
43
g/d
W
↓
non-HDL-C
(−10
±
3
mg/dL,
p
=
0.025)
↓
apoB
(−5.0
±
1.3
mg/dL,
p
=
0.009)
Hernández
et
al.,
2015,
Spain
49
RCT,
Crossover
54
(25:29)
9
mo
Control
(diet
w/o
pistachio)
57
g/d
pistachio
↓
LDL-C
vs.
baseline;
p
=
0.02
↓
Non-HDL-C
(vs.
baseline;
p
=
0.04)
Ruisinger
et
al.,
2015,
USA
50
RCT,
Parallel
48
(24:24)
4
wk
Control
(diet
w/o
A)
100
g/d
A
↓
non-HDL-C
(p
=
0.024)
↓
LDL-C,
TG
(p
=
0.068)(vs.
control)
Jamshed
et
al.,
2015,
Pakistan
51
RCT
150
(37:113)
12
wk
Control
(diet
w/o
A)
10
g/d
A
↑
HDL-C
↓
TG
(vs.
baseline;
p
all
˂
0.05)
Njike
et
al.,
2015,
USA
52
RCT,
Parallel
112
(81:31)
6
mo
Control
(diet
w/o
W)
56
g/d
W
↓
T-C
(p
<
0.0001)
↓
LDL-C
(vs.
baseline,
p
<
0.0001)
Huguenin
et
al.,
2015,
Brazil
53
RCT,
Crossover
91
(44:47)
12
wk
Control
(nut-free
diet)
13
g/d
Brazil
nut
↓
Ox
LDL-C
(vs.
baseline,
p
<
0.05)
Sauder
et
al.,
2015,
USA
54
RCT,
Crossover
30
(15:15)
4
wk
Control
(diet
w/o
pistachio)
pistachios
(20%
of
energy)
↓
T-C
(p
=
0.048)
↓
TG
(p
=
0.003)(vs.
control)
Mah
et
al.,
2017,
USA
55
RCT,
Crossover
51
(31:20)
4
wk
Control
(diet
w/o
cashews)
28-64
g/d
cashews
↓
T-C
23.9%
vs.
0.8%
↓
LDL-C
24.8%
vs.
1.2%
(p
˂
0.05)
Bamberger
et
al.,
2017,
Germany
56
RCT,
Crossover
194
(134:60)
24
wk
Control
(diet
w/o
W)
43
g/d
W
↓
T-C
(p
=
0.0003)
↓
LDL-C
(p
=
0.0009)(vs.
control)
McKay
et
al.,
2018,
USA
57
RCT,
Crossover
26
(5:21)
12
wk
Control
(isocaloric,
no
pecan)
42.5
g/d
pecans
↓
T-C
(−8.89
±
4.41,
p
=
0.056)
↓
LDL-C
(−7.41
±
3.85,
p
=
0.067)
Jenkins
et
al.,
2018,
Canada
58
RCT,
Parallel
117
(39:78)
3
mo
Control
(isocaloric
nut-free
diet)
75
g/d
mixed
nuts
↓
T-C
(p
=
0.026)
↓
non
HDL-C
(p
=
0.026)
vs.
control
Bowen
et
al.,
2019,
Australia
59
RCT
76
(31:45)
8
wk
Control
(nut-free
diet)
56
g/d
A
↓
TC/HDL-C
ratio
(in
women,
but
not
in
men)
A—almonds;
apoB—apolipoprotein
B;
F—women;
HDL-C—high
density
lipoprotein-cholesterol;
LDL-C—low
density
lipoprotein-cholesterol;
M—men;
RCT—
randomized
controlled
trial;
T-C—total
cholesterol;
TG—triglycerides;
W—walnuts.
27
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
The results of these clinical trials indicate a causal association between higher
nut intake and lower levels of total cholesterol (T-C), low density lipoprotein-
cholesterol (LDL-C), non-high density lipoprotein-cholesterol (non-HDL-C),
triglycerides (TG), and apolipoprotein B (apoB), markers of CV morbidity and
mortality.
After a 12 week trial and daily intake of 56 g almonds, compared with a no-nut
control diet, plasma apoB, apoB/apoA-1 ratio, T-C, LDL-C, and LDL-C/HDL-C ratio
decreased significantly by 15.6%, 17.4%, 6.0%, 11.6%, and 9.7%, respectively, in
patients with T2DM 47. Similarly, the inclusion of almonds in the diet of patients on
chronic statin therapy revealed a 4.9% reduction in non–HDL-C compared with the no-
nut group, and non-statistical significance decreases in LDL-C and TG 50. Consumed
before breakfast, 10 g almonds proved to increase serum HDL-C by 15% after 12
weeks in CAD patients with low initial HDL-C 51. A trial, comparing almond snacks with
isocaloric carbohydrate snacks, demonstrated that almond snacks can improve the
serum T-C/HDL-C ratio in women but not in men, with no change in body weight (BW)
or inflammatory biomarkers in overweight and obese adults with high T2DM risk 59.
The short 8 weeks trial might be the cause for the differential gender results.
Almond consumption was confirmed to significantly decrease T-C (p ˂ 0.001),
LDL-C (p = 0.001), and TG (p = 0.042), with no modification in HDL-C (p = 0.207) 60.
Also, Nishi et al. 61 showed that the daily consumption of almonds by middle-aged
adults can improve the blood lipid profile, and a 3.5% decrease in the 10-year CHD risk
was noticed for every 30 g increase in almond intake.
Consistent with the effects of other nuts, Brazil nuts and cashews can also
improve lipid profiles. In a group of hypertensive and dyslipidemic subjects, the intake
of partially defatted Brazil nuts significantly increased plasma selenium and the
antioxidant activity of the glutathione peroxidase enzyme, and reduced oxidation in
LDL-C compared to the baseline 53. Mah et al. 55 demonstrated that adding cashews into
the diet of a population with high LDL-C risk could lower the T-C, LDL-C, and LDL-
C/HDL-C ratio. In agreement with these results, a recent trial showed a significant
decrease for the LDL-C/HDL-C ratio in a cashew diet group compared with a no-
cashew control group 62.
Pistachios proved to have a lowering effect on CV risk factors. Daily pistachio
intake significantly decreased the T-C and T-C/HDL-C ratio (p < 0.05), and TG levels (p
= 0.003) compared to the control in T2DM adults 54. Also, after 4 months of 57 g
pistachio daily, small LDL particles and non-HDL particles significantly decreased
compared to the nut-free diet 49. This change of lipoprotein particle size may explain
the decrease of CVD risk. Kay et al. 63 showed that the consumption of a pistachio-
enriched diet, when compared to the control, significantly increased serum
concentration of antioxidants, including β-carotene, γ-tocopherol, and lutein, and
significantly decreased serum oxidized-LDL, an important factor in CVD.
28 Marius Emil Rusu
Walnuts may influence CVD risks via its lipid-lowering impact. Compared with a
control diet without walnuts, a walnut-included diet for 6 months significantly
decreased T-C and LDL-C and improved diet quality 52. In a shorter cross-over trial, a
walnut-enriched diet significantly reduced non-HDL-C (p = 0.025) and apoB (p =
0.009) compared with a control diet, while T-C displayed a tendency toward reduction
(p = 0.073) 48. Bamberger et al. 56 indicated that a walnut-enriched diet versus a control
diet caused a significant decrease in fasting cholesterol (p = 0.002), LDL-C (p = 0.029),
non-HDL-C (p ≤ 0.001), TG (p = 0.015), and apoB (p ≤ 0.001) in healthy mature adults.
Also, 15 mL walnut oil daily (corresponding to ~28 g walnuts) added for 90 days to the
diet of hyperlipidemic T2DM patients significantly decreased the T-C, LDL-C, T-C/HDL-
C ratio (p ˂ 0.001 for all), and TG level (p = 0.021), compared with the control group,
while the HDL level showed an increased trend (p = 0.06) 64. Similarly, Austel et al. 65
noticed beneficial changes in blood lipids after replacing saturated fats with walnut oil.
A meta-analysis of trials confirmed that walnut-enriched diets compared with
control groups significantly reduced T-C (p ˂ 0.001), LDL-C (p ˂ 0.001), TG (p = 0.03),
and apoB (p = 0.008), with no significant modifications in BW or blood pressure 66.
A new trial confirmed that, compared to a carbohydrate control diet, adding 75
g per day of mixed nuts to healthy diets could significantly lower small-size LDL-C (p =
0.018), with a trend towards reduction for T-C (p = 0.066) and non-HDL-C (p = 0.067)
in T2DM patients 58.
These outcomes are validated by a meta-analysis of 61 trials which concluded
that nut intake significantly lowered the levels of T-C, LDL-C, apoB, and TG, with the
key factor of changing lipid profile appearing to be nut dose rather than nut type 67.
As many strategies for reducing T-C and LDL-C levels could lower HDL-C levels,
all the dietary plans for lowering LDL-C levels should aim to maintain or even increase
HDL-C. In their 2017 guidelines, the American Association of Clinical Endocrinologists
and American College of Endocrinology recommend a minimum blood HDL-C level of
40 mg/dL in CVD risk individuals 68. However, data showed that small HDL particles
present only a weak defense, the strong protection against CVD risks coming from
large HDL units. Equally, small LDL particles, due to their proneness to oxidation
compared with larger ones, are responsible for atherosclerosis progress and CVD,
while large LDL components are only weakly linked with CVD 69.
1.4.3. Tree nut consumption and cancer
Nutrition was demonstrated to have a causal and protective role in the progress
of several types of cancer, the second leading cause of death worldwide 70. Numerous
studies demonstrated the influence of nut consumption on cancer
71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86 (Table IV).
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health 29
Table
IV.
Association
between
nut
consumption
and
cancer.
Author,
Year,
Country
[Ref]
Design
Subjects
Study
length
Intake
of
Nuts
Findings
Hardman
et
al.,
2019,
USA
84
RCT
10
F
2
to
3
wk
56
g/d
walnuts
↓
growth
and
survival
of
cancer
cells
Raimondi
et
al.,
2010,
Canada
71
Case-control
394
M
0
g/d
vs.
˃
3
g/d
↓
prostate
cancer
risk
(p-trend=0.01)
Ibiebele
et
al.,
2012,
Australia
72
Case-control
2780
F
0.13
vs.
3.35
n-6
(g)
↓
ovarian
cancer
risk
(p-trend=0.02)
Guasch-Ferré
et
al.,
2013,
Spain
31
Prospective
7216
4.8
y
None
vs.
˃
3
servings/wk
↓
cancer
mortality
(p-trend=0.064
)
Bao
et
al.,
2013,
USA
73
Prospective
75,680
F
30
y
Never
vs.
≥2
times/wk
↓
pancreatic
cancer
risk
(p-trend
=
0.01)
van
den
Brandt
et
al.,
2015,
the
Netherlands
74
Prospective
120,852
10
y
(1)
0
g/d
(2)
10+
g/d
↓
cancer
mortality
(p-trend
=
0.002)
HR
0.79
(95%
CI:
0.67–0.93)
(2)
vs.
(1)
Yang
et
al.,
2016,
USA
75
Prospective
75,680
F
30
y
Never
vs.
≥2
times/wk
↓
colorectal
cancer
risk
(p-trend
=
0.06)
Wang
et
al.,
2016,
USA
76
Prospective
47,299
M
26
y
Never
vs.
≥5
times/wk
↓
overall
mortality
(p=0.0005)
Lee
et
al.,
2017,
Italy/USA
77
EAGLE
study
AARP
study
3639
495,785
16
y
(1)
never
(2)
≥2
times
per
day
↓
lung
cancer
risk;
OR
EAGLE
0.74(p=
0.017);
HR
AARP
0.86
(p<0.001)
Hashemian
et
al.,
2017,
USA
78
Prospective
566,407
15.5
y
(C0)
0
g/1000
kcal
(C1)
2.20
(1.35,
4.12)
↓
gastric
noncardia
adenocarcinoma
risk
(C1)vs(C0);
HR
0.73
(95%
CI:
0.57–0.94)
Nieuwenhuis
et
al.,
2018,
the
Netherlands
79
Prospective
120,852
20.3
y
(1)
non-consumers
(2)
˃
10
g/d
↓
pancreatic
cancer
risk
in
men
(2)
vs.
(1)
HR
0.53
(95%
CI:
0.28–1.00),
p=0.047
Nieuwenhuis
et
al.,
2018,
the
Netherlands
80
Prospective
120,852
20.3
y
(1)
non-consumers
(2)
˃
10
g/d
↓
esophageal
cell
carcinoma
risk
HR
0.54
(95%
CI:
0.30–0.96),
p=0.050
Fadelu
et
al.,
2018,
USA
81
Prospective
826
6.5
y
(1)
none
(2)
≥2
servings/wk
↑
overall
survival
↓
cancer
recurrence
and
mortality
van
den
Brandt
et
al.,
2018,
the
Netherlands
82
Prospective
62,573
F
20.3
y
(1)
non-consumers
(2)
˃
10
g/d
↓
(ER
-)
breast
cancer
risk
(p=0.025)
↓
ER–PR
breast
cancer
risk
(p=0.037)
Lee
et
al.,
2018,
Korea
83
Case-control
2,769
(1)
None
(15g)
(2)
≥3
servings/wk
↓
distal
colon
cancer
risk
(p˂
0.001)
↓
rectal
cancer
risk
(p˂
0.001
)
Sui
et
al.,
2019,
USA
85
Prospective
88,783
F
51,492
M
27.9
y
(1)
0.01
servings/wk
(2)
1.25
servings/wk
↓
hepatocellular
carcinoma
HR
0.64
(p-trend=0.07)
Nieuwenhuis
et
al.,
2019,
the
Netherlands
86
Prospective
120,852
20.3
y
(1)
non-consumers
(2)
˃
10
g/d
↓
small
cell
carcinoma
(p-trend=0.024)
↓
lung
cancer
risk
(non-significantly)
F
–
women;
M
–
men.
(ER
-)—estrogen
receptor
negative;
HR—hazard
ratio;
n-6—omega
6;
OR—odds
ratio;
PR—progesterone
receptor;
RCT—randomized
controlled
trial.
30 Marius Emil Rusu
Although, in the observational studies no causality could be proven, still there
were several obvious strengths: prospective design for the majority of the studies,
large population size, high retention rates with long-term follow-up, and adjustments
for a multitude of other potential risk factors.
Several studies indicated that patients in the highest nut-intake group compared
to the lowest intake group at any time point during the study period were: 40%, 25%,
and 14% less likely to die from total cancer, gastric noncardia adenocarcinoma, and
lung cancer, respectively 31,77,78. Also, they were 46%, 45%, and 47% less likely to die
from esophageal squamous cell carcinoma, estrogen receptor negative breast cancer,
and estrogen - progesterone receptor breast cancer, respectively 80,82. Subjects having
at least two servings of nuts per week had 0.68 times the risk of pancreatic cancer
compared with subjects having nuts never or almost never 73. The oil extracted from
walnuts exhibited in vitro ability to reduce the viability of esophageal cancer cells,
induced necrosis and cell cycle arrest, and displayed anticarcinogenic effect, thus it
may present favorable effects in esophageal cancer in humans 87.
A prospective study showed that tree nut intake was significantly inverse
associated with hepatocellular carcinoma 85. Higher intake of tree nuts was linked with
a significantly reduced risk for small cell carcinoma (lung cancer subtype), after
adjusting for smoking frequency and duration, and a non-significant decrease in lung
cancer risk for men, results which have not been replicated in women 86.
The following case control studies also reported inverse associations between
nut consumption and different types of cancer. In the highest intake group the
outcomes were 57% and 28% less likely for prostate cancer and ovarian cancer,
respectively 71,72. Lee et al. 83 noticed that odd ratios were 70% less likely for colorectal
cancer in women and men, 60% (in women) and 77% (in men) less likely for rectal
cancer, and 87% (in women) and 61% (in men) less likely for distal colon cancer, for
the highest nut-intake group. Also, the results of another study suggested that,
particularly among women, moderate to high nut intakes (2 to 5.5 servings/week) may
be associated with a lower risk of colorectal adenomas, the precursor to most
colorectal cancers 88. Yang et al. 75 showed that the colorectal cancer risk for women
who consumed nuts ≥2 times per week was 13% lower compared to non-consumers,
with a borderline statistical significance. Fadelu et al. 81 proved that higher tree nut
intake was linked with a significantly reduced incidence of cancer relapse and death in
subjects with stage III colon cancer. These results confirm those of Casari and Falasca
89, who linked nut intake with a positive effect against cancer, and Aune et al. 39, who
noticed a 15% decreased cancer risk in subjects eating 28 g of nuts daily compared to
subjects who did not have nuts.
A new clinical trial showed that walnuts could alter tumor gene expression in
women with confirmed breast cancer in ways expected to decrease cancer growth,
delay proliferation, reduce metastasis, and increase cancer cell death 84. Toledo et al. 90
31
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
indicated also that walnut-enriched diets could modulate breast cancer growth. These
outcomes are in accordance with those reported by Soriano-Hernandez et al. 91 where
in the group that consumed higher amounts of nuts the breast cancer risk was between
55 and 67% less likely.
1.4.4. Tree nut consumption and cognitive disorders
Inflammation-associated chronic pathologies, such as dementia, Parkinson’s
disease (PD), or Alzheimer’s disease (AD), lead to one of the most unfavorable health
problems – age-related cognitive deterioration, a condition which may be prevented or
delayed by modifiable lifestyle factors, including antioxidant diets 92.
Quite a few studies examined the association between diets supplemented with
nuts and cognitive performance 93,94,95,96,97,98 (Table V).
Consumption of walnuts was related to better cognitive performance, mainly
working memory, although the causality could not be inferred 95. These results were
consistent with another cross-sectional study that indicated a positive association
between nut consumption and cognitive function in mature Chinese adults. Patients
with mild cognition impairment symptoms had less nuts in their diet compared to
healthy subjects (p = 0.031) 99. Similarly, positive relations between cognitive functions
and nut intake were shown in the US population. Significant improvements in almost
all cognitive test scores were noted among adults who added walnuts in their diet 100.
The scores from two neuropsychological tests, the Mini-Mental State
Examination (an indicator of cognitive impairment) and the Clock Drawing Test (a
neuropsychological test which evaluates cognitive decline and dementia), were higher
for subjects allocated to the nut-enhanced MD compared to the low-fat, nut-free diet
group 96. Comparable results were obtained by Valls-Pedret et al. 98; in an older
population, MD supplemented with tree nuts (walnuts, almonds, hazelnuts) was
associated with improved cognitive functions. Also, a high consumption of nuts was
linked to better cognitive function at baseline and might reduce cognitive decline in
mature adults 94. Equally, O’Brien et al. 97 suggested that long-term nut intake was
related to overall level of cognition but had no effect on cognitive decline.
The addition of walnuts (15% of energy) to an ad libitum diet confirmed that
regular nut consumption can delay the onset of age-related neurodegenerative
disorders. Compared with the control, individuals in the walnut group reported
significantly lower intake of animal protein, total carbohydrates, saturated fatty acids,
and sodium, but significantly higher ingestion of vegetable protein, antioxidant n-3 and
n-6 PUFAs 101.
Brain-derived neurotrophic factor (BDNF), a protein belonging to the
neurotrophic family, controls axonal elongation, neurotransmitter release, growth,
differentiation, and survival of presynaptic structure.
Marius Emil Rusu
32
Table
V.
Association
between
nut
consumption
and
cognitive
disorders.
Author,
Year,
Country
[Ref]
Design
Subjects
(F:M)
Length
of
study
Comparison
Group
Intake
of
Nuts
Findings
Sánchez-Villegas
et
al.,
2011,
Spain
93
RCT
152
(76:76)
3
y
Control
(low-fat
diet
*)
MD
+
30
g/d
nuts
↓
risk
for
low
plasma
BDNF
values
OR
0.22
(p=0.04)
vs.
control
Martínez-Lapiscina
et
al.,
2013,
Spain
96
RCT
522
(289:233)
6.5
y
Control
(low-fat
diet
*)
MD
+
30
g/d
nuts
↑
cognition
↑
MMSE
0.57
(p=0.015)
↑
CDT
0.33
(p=0.048)
vs.
control
Valls-Pedret
et
al.,
2015,
Spain
98
RCT
334
(170:164)
4.1
y
Control
(low-fat
diet
*)
MD
+
30
g/d
nuts
↓
age-related
cognitive
decline
↑
memory
composite
0.09
(p=0.04)
↑
frontal
cognition
composite
0.03
(p=0.03)
vs.
control
Nooyens
et
al.,
2011,
the
Netherlands
94
Prospective
2613
(1325:1288)
Ongoing
since
1995
5
quintiles
of
nut
consumption
↑
cognitive
function
at
baseline
↓
cognitive
decline:
memory
(highest
vs.
lowest
nut
intake,
p
=
0.03);
global
cognitive
function
(highest
vs.
lowest
nut
intake,
p
=
0.02)
Valls-Pedret
et
al.,
2012,
Spain
95
Cross-
sectional
447
(233:214)
30
g
W/d
↑
cognitive
function
(working
memory,
p=0.039)
O’Brien
et
al.,
2014,
USA
97
Prospective
15,467
F
6
y
(1)
never,
<1/mo
(2)
1–4/wk
(3)
5/wk
↑
cognitive
performance
↑
cognition
(3)
vs.
(1)
*
low-fat
diet—all
types
of
fat,
from
both
animal
and
vegetable
sources,
reduced,
but
no
fat-free
foods.
BDNF—brain-derived
neurotrophic
factor;
CDT—Clock
Drawing
Test;
F—women;
M—men;
MD—Mediterranean
diet;
MMSE—Mini-Mental
State
Examination;
OR—odds
ratio;
RCT—randomized
controlled
trial.
33
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
While low plasma levels of BDNF could lead to the atrophy of specific brain
areas in mammals such as the hippocampus and frontal cortex. Higher concentrations
of BDNF provided by enhanced-nut MD were likely to prevent depression, memory
loss, and cognitive decline 93. It seems that n-3 PUFA, with its powerful antioxidant
potential, is responsible for the increased levels of the BDNF signaling factor 102.
Major depressive disorder (MDD) is a chronic disease where healthy dietary
practices in combination with current treatments may prevent or delay its evolution.
Increased consumption of nuts, seeds, vegetables, fruits, and legumes, with proven
antioxidant and anti-inflammatory capacities, is the principal nutritional
recommendation, with a key reminder that the beneficial effects are possible to come
from wholesome nutritious diets rather than from individual nutrients 103. Ali-Sisto et
al. 104 showed that MDD is characterized by a decreased arginine level, an amino acid
found in nuts and a precursor of NO, which is needed to modulate neuronal and
vasodilation functions, to prevent oxidation of LDL-C, aggregation of platelets, or
vascular inflammation, and inhibit oxidation in the central nervous system (CNS). MDD
is associated with increased CV events, and the biological mechanism connecting MDD
and CVD is apparently a chronic inflammation induced by a low level or bioavailability
of arginine 104.
Optimal dietary choices can improve endothelial function, decrease
inflammatory biomarkers, protect neuronal and cell-signaling function, increase
cognitive performance, and prevent or delay the onset of cognitive dysfunction during
aging. In anxiety-based psychopathology, replacing pro-inflammatory saturated fats
with anti-inflammatory walnut oil might result in faster, more profound elimination of
fear-based learning 105.
1.4.5. Other possible beneficial association
Sarcopenia and frailty, mostly gerontological conditions, are characterized by
increased levels of pro-inflammatory cytokines, including TNF-α, IL-6, and CRP. One
recent study mentioned that quantities of 2 to 5 g per day of marine n-3 PUFA,
corresponding to approximately 20 to 50 g walnuts, is shown to reduce muscle wasting
and augment the intracellular anabolic signaling, thus having beneficial effects for the
prevention and treatment of sarcopenia in mature adults 106. Also in this age group,
malnutrition and sarcopenia frequently overlap. In order to overcome the loss of lean
mass and meet the increased energy requirements, the recommended protein intake is
higher (1.2–1.4 g/kg/day) than that of healthy adults 107. Because the protein level is
between 15 to 21% in tree nuts, they should be included in healthy diets as plant food
sources of protein.
Nutrition is a factor that could influence osteoarthritis (OA), the most dominant
form of arthritis with limited treatment, mainly through symptom management 108. As
food impacts systemic lipid levels, high consumption of saturated fat is linked with
34 Marius Emil Rusu
higher levels of pro-inflammatory fatty acids, while diets rich in less-inflammatory
MUFAs and PUFAs, lipids also found in tree nuts, may reduce cartilage degradation and
OA progression 109.
In a group of postmenopausal women, MD enhanced with up to 20 g/day nuts
was significantly associated with bone mineral density (p = 0.045), indicating that nuts
may be beneficial in osteoporosis prevention 110.
Together with physical exercises, long-term daily intake of tree nuts may
contribute to maintaining the health of the skeletal system, muscle mass and strength,
as well as population well-being.
1.5. Potential mechanisms responsible for beneficial activities
Biologically active antioxidant compounds found in nuts can modulate essential
physiological processes inside human bodies and influence key mechanisms of actions
involved in health. These phytochemicals are credited to many important tasks in the
human body, such as antioxidant, anti-inflammatory, anti-mutagenic, neuroprotection
enhancement, and the capacity to modulate key cellular enzyme functions, all of which
contribute to health maintenance. Nut antioxidant polyphenols, the majority of which
are found in the pellicle of nuts, can have anti-carcinogenic potential. They retard the
initiation, differentiation, and proliferation of cancer cells, modulate signaling
pathways related to cell survival, attenuate the growth of tumors, diminish
angiogenesis and metastasis, and stimulate the expression of detoxification enzymes
and antioxidants 111.
Some polyphenols are found in significant amounts in certain types of nuts,
giving them specific biological actions. Thus, ellagic acid (EA), physiologically
hydrolyzed from ellagitannins (ETs) abundant in walnuts, found also in pecans and
pine nuts, could reduce adipocyte expansion and might be beneficial in the
management of obesity and the metabolic complications related to obesity. Another
example is anacardic acid, a strong antioxidant polyphenol contained in cashew nut
shells, which was shown to have anticancer potential, inhibited prostate tumor
angiogenesis, cell proliferation, and prompted apoptosis 112.
Other polyphenols, found only in very small amounts in nuts, can contribute to
beneficial health effects through their hormetic and/or synergistic actions with other
polyphenols. In pistachios, the small amounts of genistein, (-) epigallocatechin-3-
gallate (EGCG) or resveratrol can act synergistically through common or
complementary action pathways with proven antioxidant and anti-aging activity. Thus,
the flavonoid (isoflavone) genistein has demonstrated antioxidant, chemopreventive,
and chemotherapeutic effects 113. Growing evidence suggests that EGCG, also present in
pecans and hazelnuts, can contribute to the anti-cancer potential. It has an inhibitory
proliferation effect on human pancreatic cancer cells 114. In oral cancer, EGCG exerted
35
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
an apoptotic therapeutic role, controlling cancer cell proliferation, and in breast cancer
showed an anti-angiogenic effect 115.
Several epidemiological studies showed the benefits dietary isoflavones can
have on human health in menopause and age-related pathologies, including
osteoporosis, hormonal cancers, or cardiovascular diseases 113.
Pterostilbene (PTS), a natural dimethylated analog of resveratrol, had the
capability to significantly inhibit secretion of TNF-α and alter the cytokine production
in IGROV-1 ovarian cancer cell line 116.
Melatonin, found in walnuts, could be protective against CV damage and cancer
initiation and propagation 117.
Selenium, a trace element supplied mostly by Brazil nuts, is associated with
reduced risks for prostate cancer and hepatocellular carcinoma 118.
Lipophilic bioactive compounds found in nuts can also influence the aging
process. Lignans may present antioxidant and anti-inflammatory potential in humans
119. Phytosterols can diminish serum LDL cholesterol level, through competitive
replacement of dietary and biliary cholesterol, and seem to have anticancer activity. In
combination with n-3 PUFAs, phytosterols show both complementary and synergistic
lipid-lowering effects in hyperlipidemic mature adults 120.
Lipophilic isomers of vitamin E (tocopherols and tocotrienols), via their
antioxidant properties, might inhibit the propagation of free radical damage in
biological membranes and enhance immune functions 71. They have the ability to
scavenge ROS in cellular membranes, subsequently inhibiting the oxidative damage
correlated with many illnesses 121. Vitamin E presents powerful antioxidant, anti-
inflammatory, antibacterial, cardioprotective, anticancer, hypoglycemic,
hepatoprotective, and nephroprotective potential 30. Moreover, vitamin E can prolong
the reproductive period 123. Oxidation stress and inflammation, processes involved in
the decline of cognitive function and neural capacity of the aging brain, can be reduced
by tocols through their antioxidant and anti-inflammatory properties 124. It was
suggested that dietary intake of tocotrienols could be sufficient to support
neuroprotection 125.
The lipophilic antioxidant phytochemicals, even in minute amounts, showed
increased bioavailability and bioaccessibility, with their intestinal absorption being
favored by the presence of lipids in tree nuts. Age-related macular degeneration
(AMD), the primary cause of blindness and vision impairment in old age, can be
amended or prevented by lutein. Higher ingestion of bioavailable carotenoids, such as
lutein/zeaxanthin found in pistachios, is associated with a reduced risk of AMD. Lutein
and zeaxanthin form macular pigments and may protect against AMD by reducing
oxidative stress, absorbing blue light, and stabilizing cell membranes, while
carotenoids reduce systemic oxidative stress and indirectly influence the macula. Data
indicate the significant impact macular pigment density, a biomarker of brain lutein,
36 Marius Emil Rusu
might also have on the brain health and cognition by improving neurobiological
efficiency, neural structure and efficacy, visual perception, and decision-making.
Scientific evidence show that lutein could stop neuroinflammation, a pathological
condition of many neurodegenerative disorders, diminish lipid peroxidation, and
decrease the release of pro-inflammatory cytokines 126.
Two mechanisms of actions, increased cholesterol efflux and improved
endothelial function, favorably affected by whole walnuts and walnut oil, may answer
in part the CV benefits of walnut consumption. The favorable effect walnuts have on
endothelial function could be credited to ALA, oxylipins (PUFA metabolites with a
protective role in CVD and aging), polyphenols, L-arginine, and magnesium. Walnut
kernels provide ~9% ALA, while walnut oil provides ~10% ALA 127.
Similarly, ALA might be the factor for the decreased number of atherogenic
small and dense LDL-C particles and increased number of large HDL-C particles
noticed after walnut intake, as well as the reduction of detrimental lipid classes, such
as ceramides and sphingomyelins, associated with CVD risk 128.
Essential vitamins and minerals in the daily diet, combined with long chain fatty
acids, are vital to boost immunity and maintain health. Recent evidence shows that
patients with AD have lower plasma levels of vitamins and minerals compared with
cognitively intact adults 129. Epidemiological research suggests that nuts, seeds,
vegetables, and fruits in the diet have a much more protective effect on health
compared to vitamin supplements 130.
In pathological conditions, such as AD, there is a diminished expression of
glucose transporters, which apparently contributes to a reduced utilization of glucose
in cognition-critical brain areas. However, transport and metabolism of ketone bodies
(KBs), metabolites produced by the liver as alternative energy sources, are not affected
in AD 131. For that reason, periods of ketogenic diets (KDs) might be effective
preventive or treatment measures for neurological disorders. We argue that nuts, due
to their phytochemical profile (fat content between 49 and 75%, low amounts of
carbohydrates, and high content of ketogenic amino acids including leucine) and
strong antioxidant potential, can be part of KDs. Important actions of KDs are related
to decrease oxidative stress and inflammatory activity and improve mitochondrial
function 132.
The health benefits of tree nuts in humans depend on the bioaccessibility of the
active compounds, mediated by many factors, such as the amount of dietary fiber, the
properties of cell walls, lipid and protein content of each nut, the food matrix, or the
processing methods (Fig. 1). The best processing method for almonds, hazelnuts,
pistachios, cashews, seems to be roasting which, by the thermal and chemical
reactions that occur during the process, enhances the antioxidant activity of
polyphenols with a positive influence on human well-being 133, while walnuts and
pecans 134 shoul be consumed fresh avoiding thermal processing methods.
37
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
Fig. 1. Total phenol content (TPC) and antioxidant capacity (AOC) for the evaluated tree nuts correlated with
the best processing methods.
Polyphenols modulate the nuclear factor erythroid 2-related factor
2/electrophile-responsive elements (Nrf2/EpRE) signaling pathway with major role in
cell protection (Fig. 2).
Fig. 2. Cytoprotection and anti-inflammatory effects of tree nuts mediated via Nrf2/EpRE and NF-κB
signaling pathways.
Through this pathway, polyphenols increase the activity of some antioxidant
and detoxifying enzymatic systems and down-regulate the Nuclear Factor kappa B
(NF-кB) system, as a result reducing the inflammatory response. Activation of
Nrf2/EpRE pathway is a very important cytoprotective mechanism against oxidative
stress and/or electrophilic stress. It is closely related to the anti-inflammatory process,
38 Marius Emil Rusu
provides mitochondrial redox homeostasis, improves mitochondrial function,
promotes protein homeostasis and prevents cellular senescence 135.
Because tree nut pellicles contain high concentrations of polyphenols, all tree
nuts should be consumed whole without discarding their thin coating. Various studies
demonstrated the positive role antioxidant polyphenols could have in prolonging life,
either by arresting and neutralizing free radicals thus preventing lipid peroxidation, or
through enhancing the detoxification in endogenous systems 123. The antioxidant
potential depends on the number of hydroxyl group and their place in the molecule 136.
In conclusion, the bioactive compounds found in tree nuts can act through
diverse signaling pathways and mechanisms of actions with beneficial results on
human health (Fig. 3).
Fig. 3. The key mechanisms of actions and main signaling pathways of tree nuts bioactive compounds
implicated in healthspan and lifespan ( Stimulated; Ͱ Inhibited;  Increased;  Decreased) [Akt - protein
kinase B; AMPK - AMP-activated protein kinase; ATG7 - Autophagy-related protein 7; DNMT - DNA-
methyltransferase; EpRE - Electrophile-responsive elements; ER - endoplasmic reticulum; FOXO - forkhead
box O; HDACs - histone deacetylases; IGF-1 - insulin-like growth factor 1; miRNAs - microRNAs; mTOR -
Mammalian Target of Rapamycin; NF-кB - Nuclear Factor kappa B; Nrf2 - Nuclear factor erythroid 2-related
factor 2; PGC-1α - Peroxisome proliferator-activated receptor gamma coactivator 1alpha; PI3K -
phosphatidylinositol 3-kinase; ROS - reactive oxygen species; SASP - senescence-associated secretory
phenotype; SIRT - sirtuins (silent information regulators)]
39
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
1.5.1. Association between tree nuts and gastrointestinal
microbiota
The relationship between gut microbiota (GM), diet, and health has been already
established 137. Nutrition is a vital instrument in keeping a friendly microbiome, and
this is more important in aging, when increased usage of medication can reduce
healthy GM diversity and stability. GM can impact CNS function, via gut-brain axis,
regulate the immune system, and be involved in several brain disorders (autism, PD,
schizophrenia) 138. Patients having PD revealed pro-inflammatory bacteria in their
gastrointestinal tract. Pathological by-products of these microorganisms could leak
from the intestinal lumen in the enteric nervous system and aggregate into insoluble
fibrils in the CNS 139.
Nut polyphenols were reported to increase the abundance of Bifidobacterium
and Lactobacillus bacteria, probiotic strains related to significant lowering of CRP
concentrations and increase in plasma HDL-C, cancer prevention, immune-modulation,
as well as reductions of pathogenic Clostridium species. Walnut ingestion increased the
abundance of Lactobacillus and decreased microbial derived, proinflammatory LDL-C
and secondary bile acids 140. Similar results were achieved in a recent 8-week long RCT,
including 194 healthy individuals, where after 43 g/day walnut-enriched diet, the
probiotic and butyric acid-producing species (Ruminococcaceae and Bifidobacteria)
significantly increased, while Clostridium species significantly decreased 141. Also,
pistachio and almond consumption via the prebiotic compounds they contain may
stimulate the growth of beneficial butyrate-producing bacteria and inhibit the
development of pathogenic ones. Holscher et al. 142 demonstrated that daily
consumption of around 42 g almonds for at least 3 weeks can increase the abundance
of Roseburia species, a favorable genus known to be negatively affected by age.
Human diet influences the relative abundance of bacterial communities present
in the gastrointestinal tract. A significant diversity and number of bacteria ensure a
greater ability to resist metabolic changes and infections and constitute the
prerequisite for a healthy status of the gut. Consequently, a nut enhanced diet
characterized by high antioxidant and anti-inflammatory activities can delay age-
related microbiota changes and positively alter the microbial composition of the
human GM with benefits for health.
1.6. Agricultural waste and tree nut by-products
In recent years, industrial waste created during plant material processing in the
food industry presented a real concern. The inadequate disposal of the agricultural by-
products could create pollution problems as much of the waste is discarded. However,
this inexpensive and available in large quantity wastes may well be sources of
biologically active molecules, such as fatty acids, vitamins, or polyphenols, and
40 Marius Emil Rusu
included into food supplements. Polyphenols, common secondary plant metabolites
characterized by several hydroxyl groups linked to a phenol ring, can act
synergistically with other molecules to lower the oxidation and inflammation
processes which may trigger many pathological conditions or chronic diseases. These
biologically active molecules donate electrons or hydrogen atoms to reactive free
radicals preventing lipid oxidation or cellular damage and acting as natural
antioxidants with many health benefits 136. Coupled with the tendency of the
consumers to avoid foods prepared with chemical origin preservatives, many studies
have been recently conducted, intended to find natural alternatives, such as plant by-
products, rich in bioactive compounds with high potential for health and
pharmaceutical industry 143.
Some by-products were recognized as sources of bioactive compounds having
diverse biological activities, such as antioxidant, anti-inflammatory, antimicrobial, or
antimutagenic 144. In the pharmacological screening step, by-products are currently
examined as inhibitors of enzymes involved in physiological processes or various
pathologies. The action of nut by-product extracts against cholinesterase
(neurodegenerative disorders), glucosidase (diabetes), or lipase (obesity) revealed
encouraging results 145.
Special interest was also given to tree nut by-products, waste plant matrices,
with great potential as sources of biologically active compounds. Both walnut (Juglans
regia L.) and hazelnut (Corylus avellana L.) are native plants, which grow
spontaneously in Romania and present multiple benefits (nutritional,
phytotherapeutic, economical), both through their nuts and by-products. The
phytochemical profile and biological activity of walnut leaves and green husks were
characterized and demonstrated to constitute good sources of bioactive molecules
including tocopherols and phenolic compounds that could induce health benefits 146.
Previous studies reported on the phytochemicals and antioxidant activity of hazelnut
skin, hard shell, or leaves 147.
However, few data are available about walnut septum and hazelnut involucre,
two interesting tree nut by-products. Walnut septum was traditionally used as a cold
remedy or cough suppressant and presented a hypoglycemic activity, besides
improving the blood profile, in murinic experiments 148. Five phenolic acids were
identified in hazelnut green leafy cover and the antioxidant and antiradical activities
were analyzed 149.
Therefore, the aims of this thesis was the in-depth assessment of the
phytochemical profiles of walnut (Juglans regia L.) septum and hazelnut (Corylus
avellana L.) involucre and their biological activities.
41
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
PERSONAL
CONTRIBUTIONS
42 Marius Emil Rusu
43
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
1. General objectives
Globally, non-communicable or chronic diseases, such as cardiometabolic
diseases and cancer, are leading causes of morbidity and mortality. Most of these
diseases could be prevented by changing behavioral risk factors including nutrition.
Tree nuts, complete functional foods, contain macro- and micronutrients of high
biological value. These bioactive compounds have a synergistic effect in preventing and
delaying many chronic diseases. Tree nuts have a healthy lipid profile, are good
sources of proteins, rich in proteinogenic amino acids, and are low in carbohydrates.
They contain significant amounts of vitamin E, minerals, polyphenols, and
phytosterols, molecules that are powerful antioxidants, can reduce the inflammation
and prevent cell senescence.
In the beginning of the study, the first objectives of the thesis were the
description of tree nut phytochemical composition (review 1) and highlight their
health benefits and contribution on helthspan and lifespan (review 2). The most
common tree nuts, presented and described in our studies were almonds (Prunus
dulcis (Mill.) D.A. Webb), Brazil nuts (Bertholletia excelsa Bonpl.), cashews
(Anacardium occidentale L.), hazelnuts (Corylus avellana L.), pecans (Carya illinoinensis
(Wangenh.) K. Koch), pine nuts (Pinus pinea L.), macadamias (Macadamia integrifolia
Maiden & Betche), pistachios (Pistacia vera L.), and walnuts (Juglans regia L.).
Another objective was the documentation of the most recent clinical trials and
cohort studies, which presented the influence of tree nut in preventing or delaying
diseases in middle-aged and elderly subjects (review 3). Clinical evidence and scientific
findings demonstrated the importance of diets characterized by high intake of nuts and
emphasize their potential in preventing diseases. We also emphasized the mechanisms
of actions of tree nuts in delaying aging and preventing diseases through their
biologically active compounds (reviews 1 and 2).
As the positive impact of tree nuts in prevention and even treatment of many
disorders have been documented, a new research path, with personal practical
contribution, was orientated to tree nut by-products and to find if they, via their
phytochemical contents, can have the same beneficial effects. Many of these by-
products including walnut and hazelnut leaves, walnut bark and green husk, were
analyzed. We have concentrated our research on two important by-products, walnut
septum and hazelnut involucre, rarely mentioned in scientific literature.
The objectives were the characterization of their phytochemical profiles and
biological activities.
The first studies determined the phenolics, phytosterols, and tocopherols from
the walnut septum based on an experimental design. The variables, extraction method,
44 Marius Emil Rusu
solvent, temperature, and water percentage, were combined with statistical tools and
LC-MS/MS analyses in order to determine the optimal extraction conditions, identify
and quantify the main bioactive molecules from septum. Several methods were
employed to determine the antioxidant capacity (ABTS, DPPH, and FRAP). Moreover, a
number of biological activities were investigated. We assessed the in vitro inhibiting
potential against acetylcholinesterase, α-glucosidase, lipase, and tyrosinase, as well as
the antimicrobial and antimutagenic inhibitory effects. The cytotoxicity of the extract
was assessed on cancerous (A549, T47D-KBluc, MCF-7) and normal (HGF) cell lines.
Another objective was the assessment of the antioxidant effects of walnut kernel
and walnut septum extract in an 8-week D-galactose induced aging model and in
naturally aged rats. We investigated an improvement in cellular antioxidant activity,
decrease of the oxidative stress biomarkers, and liver and neuron protection against
senescence.
The aim of the last study was to evaluate the phenolic and sterolic composition,
as well as the antioxidant and other biological activities, of hazelnut involucre extracts.
Experimental designs were developed in order to select the optimum extraction
conditions (solvent, temperature, time) using turbo-extraction by Ultra-Turrax for
obtaining extracts rich in bioactive compounds. Qualitative and quantitative analyses
were performed by LC-MS and LC-MS/MS and they revealed important amounts of
individual polyphenols and phytosterols, molecules with antioxidant potential. The
richest polyphenolic involucre extract with the highest antioxidant activity by TEAC
assay was further evaluated by other in vitro antioxidant tests (DPPH, FRAP) and
enzyme inhibitory assays. Additionally, the cytotoxic and antioxidant effects of this
extract on two cancerous cell lines and on normal cells were tested.
All the objectives of the thesis were successfully accomplished, the findings
revealing that these by-products justify further research and could be considered good
sources of natural antioxidants for food, pharmaceutical, or cosmetic industry.
45
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
2. Study 1. Bioactive compounds of walnut (Juglans
regia L.) septum and the antioxidant activity
2.1. Introduction
In the last decades, the number of people with body mass problems increased in
the world obesogenic culture. Overweight and obesity are increasingly seen as major
concerns for human health 150. Processed food, the so called “junk food”, with high
content of carbohydrates, fats, and salt, is linked to overweight and obesity via several
mechanisms 151. Excessive body weight, associated with several pro-inflammatory
cytokines (e.g., leptin, interleukin 6, interleukin 8, tumor necrosis factor-alpha), and a
chronic, low-grade inflammation, is seen as a major risk factor for a plethora of
diseases.
Epidemiological studies and clinical trials demonstrated that diets with high
intake of plant origin foods (vegetables, fruits, nuts) can safeguard against excessive
weight-related diseases and offer powerful protection for the cardiovascular,
gastrointestinal, and immune systems 39. Phytochemicals, including carotenoids,
glucosinolates, and polyphenols, work synergistically to reduce inflammation and
oxidation, providing defense against initiation and evolution of ailments 10. Phenolic
acids and flavonoids, the major contributors of the polyphenols group, act as natural
antioxidants decreasing the risk of degenerative diseases 136. Besides their role as
antioxidants in the detoxifying system with a scavenging role against reactive oxygen
or nitrogen species, polyphenols can take part in the enzymatic pathways involved in
the energetic balance or act as signaling molecules in the cell 152.
Walnut (Juglans regia L.), a valued crop of high economic importance,
represents a good source of nutritional and nutraceutical compounds 107 with well-
known antioxidant, antibacterial, and anti-inflammatory bioactivity 153.
The goal of the study was the determination of phenolic and phytosterol
compounds from the walnut septum (WS) based on an experimental design. Extraction
method, solvent, temperature, and water percentage, the variables of the study, were
combined with statistical tools and analysis using LC-MS/MS in order to determine the
optimal extraction conditions, identification, and quantification of main phenolic and
phytosterol molecules from septum. Several methods were employed to determine the
antioxidant capacity (ABTS, DPPH, and FRAP) and the enzymatic inhibitory activity.
46 Marius Emil Rusu
2.2. Materials and methods
2.2.1. Chemicals and samples
All reagents were of analytical grade and all solvents were of LC grade. Water
was of Milli-Q-quality.
The standards used for LC-MS/MS analysis were: quercetin (≥95%), hyperoside
(≥97%), isoquercitrin (≥98%), quercitrin (≥78%), (+)-catechin (≥96%), (-)-epicatechin
(≥90%), vanillic acid (≥97%), syringic acid (≥95%), protocatechuic acid (≥97%),
campesterol (~65%), ergosterol (≥95%), and stigmasterol (~95%) from Sigma-
Aldrich, gallic acid (≥98%) from Merck (Darmstadt, Germany), and β-sitosterol (≥80%)
from Carl Roth (Karlsruhe, Germany).
Plant samples
Walnuts (Juglans regia L.) of high quality were provided by an organic orchard
in Buciumi, Maramureş County, Romania. In the autumn of 2016, walnuts were
harvested and kept in a dark, airy shelter, at temperatures ~0 °C. At the beginning of
March 2017, the unshelled walnuts were delivered to the Faculty of Pharmacy, “Iuliu
Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, and identified
by Dr. Andrei Mocan from the Department of Pharmaceutical Botany. A voucher
specimen was deposited in the Herbarium of this Department. The unshelled walnuts
were cracked and the septum removed from the hard shells just prior to the
extractions. WS was ground in a coffee grinder (Argis, RC-21, Electroarges SA,
Romania) for 5 min. Then, the ground septum powder was screened through a 200 µm
Retsch sieve.
2.2.2. Preparation of extracts
The extraction process was carried out based on a D-optimal experimental
design developed by Modde software, version 11.0 (Sartorius Stedim Data Analytics
AB, Umeå, Sweden) using four variable factors: preparation method, temperature,
solvent, and percentage of water in solvent (Table VI).
WS was weighed (2 g) and mixed with the extraction solvent (20 mL). The Ultra-
Turrax extraction (UTE) was performed in two steps: using an Ultra-Turrax
homogenizer (T 18; IKA Labortechnik, Staufen, Germany) for 2 min (1 min at 9500
rpm and 1 min at 13,500 rpm) 154 and again 2 min using a Vortex RX-3 (Velp
Scientifica, Usmate, Italy). The homogenate was centrifuged (Hettich, Micro 22R,
Andreas Hettich GmbH & Co., Tuttlingen, Germany) 15 min at 3000 rpm, maintaining
the extraction temperature. The supernatant was carefully separated, and the solvent
removed under vacuum at 40 °C using a rotary evaporator (Hei-VAP, Heidolph
Instruments GmbH & Co., Schwabach, Germany). The dry residue was taken up in
water, placed in amber glass vials, and lyophilized (Advantage 2.0, SP Scientific,
Warminster, USA).
47
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
Table VI. Variables of experimental design evaluated for walnut septum extracts.
Variables
Level
-1 0 1
Independent variables (factors)
Extraction method (X1) Ultra-turrax Maceration
Temperature (°C) (X2) 20 30 40
Solvent (X3) Acetone Ethanol
Water in solvent (%, v/v) (X4) 5 25 50
Dependent variables (responses)
Total phenolic content (TPC, mg GAE/g dw1) (Y1)
Total flavonoid content (TFC, mg QE/g dw2) (Y2)
Condensed tannin content (CTC, mg CE/g dw3) (Y3)
Total antioxidant activity (TAA, mg TE/g dw4) (Y4)
1-mg GAE/g dw = gallic acid equivalents per dry weight of walnut septum; 2-mg QE/g dw = quercetin
equivalents per dry weight of walnut septum; 3-mg CE/g dw = catechin equivalents per dry weight of walnut
septum; 4-mg TE/g dw = trolox equivalents per dry weight of walnut septum.
For the maceration method, WS (2 g) was added to Erlenmayer flasks with the
extraction solvent and kept for 10 days at 20, 30, and 40 °C (Conterm Oven, JP Selecta
S.A., Barcelona, Spain) and stirred twice daily. After 10 days, the samples were
centrifuged 10 min at 5300 rpm, maintaining the extraction temperature. Then, the
supernatant was separated, the solvent evaporated and the remaining water removed
as seen before. After lyophilization, the samples (for both extraction methods) were
stored at room temperature.
For further determinations, lyophilized extract was dissolved in EtOH 70% (10
mg/mL). All assays were executed in triplicate.
2.2.3. Quantitative determinations of total bioactive compounds
Total phenolic content
The total phenolic content (TPC) of the WS extracts was determined by Folin-
Ciocâlteu spectrophotometric method according to a method described previously 155.
In brief, in a 96 well plate, 20 µL of each sample (WS extracts diluted 5 times) were
mixed with 100 µL of FC reagent (diluted 1:10). After 3 min, 80 µL of sodium carbonate
solution (7.5% w/v) was added to the wells. The plate was incubated for 30 min in the
dark at room temperature. A Synergy HT Multi-Detection Microplate Reader with 96
well plates (BioTek Instruments, Inc., Winooski, VT) was used to measure the
absorbance at 760 nm against a solvent blank. Gallic acid was used as a reference
standard, and the content of phenolics was expressed as gallic acid equivalents (GAE)
per dry weight of septum (mg GAE/g dw).
Total flavonoid content
The total flavonoid content (TFC) of the WS extracts was determined according
to a method described previously 156. In a 96 well plate, 100 µL of sample extracts were
48 Marius Emil Rusu
added to 100 µL of 2% AlCl3 ethanolic solution. The plate was incubated for 15 min in
the dark at room temperature. The absorbance at 420 nm was measured against a
solvent blank. The TFC was expressed as quercetin equivalents (QE) per dry weight
(dw) of vegetal material (mg QE/g dw).
Condensed tannin content
The condensed tannin content (CTC) in WS extracts was determined according
to a modified version of the vanillin assay described before 149. Briefly, in a 96 well
plate, 50 µL of sample WS extracts were added to 250 µL 0.5% vanillin in 4%
concentrated HCl in methanol. The plate was incubated for 20 min in the dark at 30 °C.
The absorbance at 500 nm was measured against a solvent blank. The condensed
tannins were expressed as catechin equivalents (CE) per dry weight (dw) of vegetal
material (mg CE/g dw).
2.2.4. Phytochemical analysis by LC-MS/MS
The phytochemical profile of lyophilized WS extracts obtained by UTE method
was assessed by liquid chromatography coupled with mass spectrometry in tandem
(LC-MS/MS). The experiment was carried out using an Agilent 1100 HPLC Series
system (Agilent, USA) equipped with degasser, binary gradient pump, column
thermostat, auto sampler, and UV detector. The HPLC system was coupled with an
Agilent Ion Trap 1100 SL mass spectrometer (LC/MSD Ion Trap VL).
Identification and quantification of polyphenolic compounds
A previously LC-MS/MS method 157 was slightly modified (replacing of sodium
phosphate with acetic acid in the mobile phase) and applied for the identification of 18
polyphenols in the sample WS extracts: caftaric acid, gentisic acid, caffeic acid,
chlorogenic acid, p-coumaric acid, ferulic acid, sinapic acid, hyperoside, isoquercitrin,
rutozid, myricetol, fisetin, quercitrin, quercetin, patuletin, luteolin, kaempferol, and
apigenin. In brief, chromatographic separation was performed on a reverse-phase
analytical column (Zorbax SB-C18, 100 mm x 3.0 mm i.d., 3.5 µm) with a mixture of
methanol: 0.1% acetic acid (v/v) as mobile phase and a binary gradient. The elution
started with a linear gradient, beginning with 5% methanol and ending at 42%
methanol at 35 minutes; isocratic elution followed for the next 3 minutes with 42%
methanol; rebalancing in the next 7 minutes with 5% methanol. The flow rate was 1
mL/min, the column temperature 48 ºC and the injection volume was 5 μL.
The detection of the compounds was performed on both UV and MS mode. The
UV detector was set at 330 nm until 17 min (for the detection of polyphenolic acids,
then at 370 nm until 38 min to detect flavonoids and their aglycones. The MS system
operated using an electrospray ion source in negative mode (capillary +3000 V,
nebulizer 60 psi (nitrogen), dry gas nitrogen at 12 L/min, dry gas temperature 360 °C).
49
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
The chromatographic data were processed using ChemStation and DataAnalysis
software from Agilent, USA.
Another LC-MS method was used to identify other six polyphenols in WS
extracts: epicatechin, catechin, syringic acid, gallic acid, protocatechuic acid, and
vanillic acid. The chromatographic separation was performed on the same analytical
column as mentioned before (Zorbax SB-C18, 100 mm x 3.0 mm i.d., 3.5 µm) with a
mixture of methanol: 0.1% acetic acid (v/v) as mobile phase and a binary gradient
(start: 3% methanol; at 3 min: 8% methanol; at 8.5 min: 20% methanol; keep 20%
methanol until 10 min then rebalance column with 3% methanol). The flow rate was 1
mL/min and the injection volume was 5 μL. The detection of the compounds was
performed on MS mode (Table VII). The MS system operated using an electrospray ion
source in negative mode (capillary +3000 V, nebulizer 60 psi (nitrogen), dry gas
nitrogen at 12 L/min, dry gas temperature 360 °C). All identified polyphenols were
quantified both in the WS extracts and hydrolyzed WS extracts (equal quantities of
extract and 4M HCl kept 30 min on 100 °C water bath) on the basis of their peak areas
and comparison with a calibration curve of their corresponding standards
(epicatechin, catechin, syringic acid, gallic acid, protocatechuic acid, vanillic acid,
hyperoside, isoquercitrin, quercitrin). The results were expressed as milligrams of
phenolic per gram of dry weight of septum extract.
Table VII. Detection and quantification of certain polyphenols by the new LC-MS method
developed in view of their analysis in walnut septum extracts.
Polyphenol
Monitored
ion (m/z)
Retention
time (min)
Calibration range
(n=8) (µg/mL)
Coefficient of
linearity (R2)
Accuracy
(bias, %)
Epicatechin 289 9.0 0.3-21.5 0.9922 90.7-112.1
Catechin 289 6.0 0.3-21.5 0.9974 94.3-108.9
Gallic acid 169 1.5 0.3-22.2 0.9987 96.4-108.6
Syringic acid 197 8.4 0.3-21.0 0.9997 90.5-105.5
Protocatechuic acid 153 2.8 0.3-23.9 0.9977 87.0-112.2
Vanillic acid 167 6.7 0.3-21.1 0.9993 95.6-105.6
Identification and quantification of phytosterols
The pytosterols in the septum extracts were determined according to a method
described previously 158. In brief, chromatographic separation was performed on a
Zorbax SB-C18 (100 mm x 3.0 mm i.d., 5 µm) column (Agilent Technologies) with a
mixture of methanol: acetonitrile (10:90, v/v) and isocratic elution, at 45 °C with a flow
rate of 1 mL/min. The detection of analytes was performed in the multiple reaction
monitoring (MRM) mode for the quantification of phytosterols, positive ion detection,
using an ion trap mass spectrometer equipped with an atmospheric pressure chemical
ionization (APCI) source (capillary -4000 V, nebulizer 60 psi (nitrogen), vaporizer 400
°C, dry gas nitrogen at 7 L/min, dry gas temperature 325 °C).
50 Marius Emil Rusu
Four external standards were used for quantification: β-sitosterol, stigmasterol,
campesterol, and ergosterol. The identified phytosterols (β-sitosterol and
campesterol) were quantified on the basis of their peak areas and comparison with a
calibration curve of their corresponding standards. The results were expressed as
milligrams phytosterols per gram of dry weight of septum extract.
2.2.5. Antioxidant activity assays
ABTS radical cation scavenging activity
The antiradical activity of WS extracts was determined according to the trolox
equivalent antioxidant capacity (TEAC) assay described previously 159. The scavenging
activity against ABTS radical cation (2,2′-azino-bis(3-ethylbenzothiazoline)-6-
sulphonic acid) was assessed and used to plot the trolox calibration curve. The total
antioxidant activity (TAA) according to TEAC assay was expressed as trolox
equivalents (TE) per gram of dry lyophilized extract (mg TE/g dw extract). This assay
was used during the screening phase of the study for the evaluation of total antioxidant
activity of the 23 samples obtained by either maceration or UTE method.
DPPH radical scavenging activity
The antiradical activity of WS extracts was assessed using a method previously
described 160. The capacity to scavenge the free radical DPPH was determined in a 96
well plate mixing 30 μL of sample solution with a 0.004% methanolic solution of DPPH
for 30 min in the dark. The absorbance at 517 nm was measured against a solvent
blank. Trolox was used as a reference standard and the results were expressed as
trolox equivalents per gram of dry lyophilized extract (mg TE/g dw extract). This assay
was performed on the richest polyphenolic WS extract.
FRAP assay
The reduction capacity of the WS extract was evaluated by FRAP (ferric
reducing antioxidant power) assay that analyzes the blue-colored Fe2+-TPTZ formed by
the reduction of Fe3+-TPTZ. A method previously described 161 was used with slight
modifications. In brief, 25 μL of sample were incubated with 175 μL FRAP reagent (300
mM acetate buffer, pH 3.6 : 10 mM TPTZ in 40 mM HCl : 20 mM FeCl3
.6H2O in 40 mM
HCl, 10:1:1, v/v/v) in a 96 well plate for 30 min in the dark. Trolox was used as an
external standard (calibration curve obtained for 0.01-0.10 mg/mL) and the
absorbance was measured at 593 nm. The results were expressed as trolox equivalents
per gram of dry lyophilized extract (mg TE/g dw extract). This assay was done on the
richest polyphenolic WS extract.
2.2.6. Tyrosinase inhibitory activity
The tyrosinase inhibitory activity of WS extract was evaluated by a 96-well
microplate method previously described 162 with slight changes. Briefly, four wells
51
Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive
impact on health
were designated (WS lyophilized extract dissolved in water containing 5% DMSO) as
follows: (A) 66 mM phosphate buffer, pH 6.6 (PB) (120 μL) and mushroom tyrosinase
in the same buffer, 46 U/mL (MT) (40 μL); (B) only PB (160 μL); (C) PB (80 μL), MT
(40 μL) and the sample (40 μL); (D) PB (120 μL) and the sample (40 μL). After 10 min
incubation at room temperature, 2.5 mM L-DOPA prepared in PB (40 μL) was added in
all wells. The microplate was kept again at room temperature for 20 min and the
absorbance was measured at 475 nm. The tyrosinase inhibitory activity was assessed
using kojic acid as an external standard (0.01-0.10 mg/mL). The inhibition percentage
of enzymatic activity was calculated by the following equation: [(A-B)-(C-D)]*100/(A-
B). The results were expressed as milligram kojic acid equivalents per gram of dry
lyophilized extract (mg KAE/g dw extract). This evaluation was carried out for the
richest polyphenolic WS extract.
2.2.7. Experimental conditions for phytochemical-rich extracts
During the screening step, the quantifiable responses TPC, TFC, CTC, TAA
according to TEAC assay, were analyzed by the Modde software, version 11.0, to
identify the optimal extraction conditions. For the optimization step, individual
phenolic and phytosterol levels were evaluated and the independent factors
investigated were working temperature, organic solvent, and percentage of water in
solvent mixture. The responses were identification and quantification of each
quantified phytochemical compound: epicatechin, catechin, syringic acid, gallic acid,
protocatechuic acid, vanillic acid, hyperoside, isoquercitrin, quercitrin, campesterol,
and β-sitosterol.
2.2.8. Statistical analysis
All samples were analyzed in triplicate (n = 3) and the results were expressed as
the mean ± Standard Deviation (SD).
2.3. Results and discussion
2.3.1. Fitting the experimental data with the models
The independent and dependent variables of experimental design evaluated for
WS extraction yield during the screening step are shown in Table VI. The independent
variables (factors) were the extraction method, working temperature, organic solvent,
and percent of water in solvent mixture. The dependent variables (responses) were
TPC, TFC, CTC, and TAA. The matrix of the experimental design generated by the
Modde software, version 11.0, along with the responses obtained after performing all
the experimental runs are given in Table VIII.
As it can be observed from the results, the extraction yields of TPC, TFC, CTC, as
well as the TAA, were influenced by the extraction method and factors evaluated in the
experimental design.
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Teza marius emil_rusu

  • 1. THE DOCTORAL SCHOOL “IULIU HAŢIEGANU” UNIVERSITY OF MEDICINE AND PHARMACY CLUJ-NAPOCA CLUJ-NAPOCA 2020
  • 3. 3 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health PhD THESIS Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health PhD candidate: Marius Emil Rusu Scientific supervisor: Prof. Laurian Vlase, PhD
  • 5. 5 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health Ad majorem Dei gloriam To my children – George, Alexandra, Dominic, Christian
  • 7. 7 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health LIST OF PUBLICATIONS 1. Rusu ME, Gheldiu A-M, Mocan A, Vlase L, Popa D-S. Anti-aging potential of tree nuts with a focus on phytochemical composition, molecular mechanisms and thermal stability of major bioactive compounds. Food & Function. 2018; 9(5):2554–75. ISI Impact factor: 3.241 (Food Science & Technology Q1) (review 1 found in Introduction). 2. Rusu ME, Gheldiu A-M, Mocan A, Moldovan C, Popa D-S, Tomuta I, Vlase L. Process Optimization for Improved Phenolic Compounds Recovery from Walnut (Juglans regia L.) Septum: Phytochemical Profile and Biological Activities. Molecules. 2018; 23(11):2814. ISI Impact factor: 3.06 (Biochemistry & Molecular Biology Q2) (study found in Chapter 2). 3. Rusu ME, Simedrea R, Gheldiu A-M, Mocan A, Vlase L, Popa D-S, Ferreira ICFR. Benefits of tree nut consumption on aging and age-related diseases: Mechanisms of actions. Trends in Food Science & Technology. 2019; 88(2):104-20. ISI Impact factor: 8.519 (Food Science & Technology Q1) (review 2 found in Introduction). 4. Rusu ME, Mocan A, Ferreira ICFR, Popa D-S. Health Benefits of Nut Consumption in Middle-Aged and Elderly Population. Antioxidants. 2019; 8(8):302. ISI Impact factor: 4.52 (Food Science & Technology Q1) (review 3 found in Introduction). 5. Rusu ME, Fizeșan I, Pop A, Gheldiu A-M, Mocan A, Crișan G, Vlase L, Loghin F, Popa D-S, Tomuta I. Enhanced Recovery of Antioxidant Compounds from Hazelnut (Corylus avellana L.) Involucre based on Extraction Optimization: Phytochemical Profile and Biological Activities. Antioxidants. 2019; 8(10): 460. ISI Impact factor: 4.52 (Food Science & Technology Q1) (study found in Chapter 5). 6. Rusu ME, Fizesan I, Pop A, Mocan A, Gheldiu A-M, Babota M, Vodnar DC, Jurj A, Berindan-Neagoe I, Vlase L, Popa D-S. Walnut (Juglans regia L.) septum: Assessment of bioactive molecules and in vitro biological effects. Molecules. 2020; 25(9):2187. ISI Impact factor: 3.06 (Biochemistry & Molecular Biology Q2) (study found in Chapter 3). 7. Rusu ME, Georgiu C, Pop A, Mocan A, Kiss B, Vostinaru O, Fizesan I, Stefan MG, Gheldiu A-M, Mates L, Moldovan R, Muntean DM, Loghin F, Vlase L, Popa D-S. Antioxidant effects of walnut (Juglans regia L.) kernel and walnut septum extract in a D-galactose-induced aging model and in naturally aged rats.
  • 8. 8 Marius Emil Rusu Antioxidants. 2020; 9(5):424. ISI Impact factor: 4.52 (Food Science & Technology Q1) (study found in Chapter 4).
  • 9. 9 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health TABLE OF CONTENTS INTRODUCTION 15 ACTUAL STATE OF KNOWLEDGE 1. General knowledge about tree nuts 19 1.1. Tree nut overview 19 1.2. Macro and micronutrients in tree nuts 19 1.3. Phytochemicals in tree nuts 22 1.4. Health benefits of tree nut consumption 23 1.4.1. Tree nut consumption and cardiometabolic disorders 23 1.4.2. Tree nut consumption and blood lipid 25 1.4.3. Tree nut consumption and cancer 28 1.4.4. Tree nut consumption and cognitive disorders 31 1.4.5. Other possible beneficial associations 33 1.5. Potential mechanisms responsible for beneficial activities 34 1.5.1. Association between tree nuts and gastrointestinal microbiota 39 1.6. Agricultural waste and tree nut by-products 39 PERSONAL CONTRIBUTIONS 1. General objectives 43 2. Study 1. Bioactive compounds of walnut (Juglans regia L.) septum and the antioxidant activity 45 2.1. Introduction 45 2.2. Materials and methods 46 2.2.1. Chemicals and samples 46 2.2.2. Preparation of extracts 46 2.2.3. Quantitative determination of total bioactive compounds 47 2.2.4. Phytochemical analysis by LC-MS/MS 48 2.2.5. Antioxidant activity assays 50 2.2.6. Tyrosinase inhibitory activity 50 2.2.7. Experimental conditions for phytochemical-rich extracts 51 2.2.8. Statistical analysis 51 2.3. Results and discussion 51 2.3.1. Fitting the experimental data with the models 51 2.3.2. The Influence of variables on studied parameters 56 2.3.3. Quantitative determinations of the bioactive compounds 60
  • 10. 10 Marius Emil Rusu 2.3.4. Identification and quantification of individual polyphenols 62 2.3.5. Identification and quantification of phytosterols 63 2.3.6. Antioxidant activity 63 2.3.7. Tyrosinase inhibitory activity 65 2.4. Conclusions 65 3. Study 2. Assessment of tocopherols and biological effects of walnut (Juglans regia L.) septum 67 3.1. Introduction 67 3.2. Materials and methods 68 3.2.1. Reagents 68 3.2.2. Plant matrices 68 3.2.3. Tocopherol quantification by LC-MS/MS 68 3.2.4. Enzyme inhibitory activity 69 3.2.5. Antibacterial activity 70 3.2.6. Antifungal activity 71 3.2.7. Antimutagenic assay 71 3.2.8. Biological activities on cell lines 72 3.2.9. Statistical analysis 74 3.3. Results and discussion 74 3.3.1. Bioactive compounds present in septum 74 3.3.2. Biological activities 77 3.4. Conclusions 86 4. Study 3. The effects of walnut (Juglans regia L.) kernel and septum in induced-aged and naturally aged rats 87 4.1. Introduction 87 4.2. Materials and methods 88 4.2.1. Reagents 88 4.2.2. Animals and experimental protocol 88 4.2.3. Preparation of the walnut septum extract 89 4.2.4. Biological samples 90 4.2.5. Determination of total protein content 91 4.2.6. Hematological and biochemical analyses 91 4.2.7. Antioxidant cellular status 91 4.2.8. Oxidative stress biomarkers 92 4.2.9. Acetylcholinesterase activity 94 4.2.10. Histopathological and immunohistochemical analyses 94 4.2.11. Statistical analysis 95
  • 11. 11 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 4.3. Results 95 4.3.1. Body weight and organ indices 95 4.3.2. Hematological and biochemical analyses 96 4.3.3. Antioxidant cellular status 99 4.3.4. Oxidative stress biomarkers 100 4.3.5. Acetylcholinesterase activity 102 4.3.6. Histopathological and immunohistochemical analyses 103 4.4. Discussion 106 4.5. Conclusions 111 5. Study 4. Phytochemical profile and biological activities of hazelnut (Corylus avellana L.) involucre 113 5.1. Introduction 113 5.2. Materials and methods 114 5.2.1. Chemicals 114 5.2.2. Plant samples 114 5.2.3. Determination of bioactive compounds and antioxidant activity 115 5.2.4. Phytochemical analysis by LC-MS 117 5.2.5. Biological activities of the optimal HI extract 118 5.2.6. Biological activities of HI extract on cell lines 119 5.2.7. Statistical analysis 120 5.3. Results and discussion 121 5.3.1. Fitting the experimental data with the models 121 5.3.2. Influence of experimental conditions 124 5.3.3. Determination of bioactive compounds and antioxidant activity 125 5.3.4. Individual bioactive compounds 127 5.3.5. Enzyme inhibitory activities 130 5.3.6. Biological activities on cell lines 131 5.4. Conclusions 134 6. General conclusions 135 7. Originality of the thesis 137 REFERENCES 139
  • 13. 13 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health ABBREVIATIONS HPLC High performance liquid chromatography MS Mass spectrometry TPC Total phenolic content TFC Total flavonoid content CTC Condensed tannin content TAA Total antioxidant activity TEAC Trolox equivalent antioxidant capacity ABTS 2,2’-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) DPPH 2,2-diphenyl-1-picrylhydrazyl FRAP Ferric reducing antioxidant power ROS Reactive oxygen species AGE Advanced glycation end product MDA Malondialdehyde IL-6 Interleukin 6 TNF-α tumor necrosis factor-α NF-кB Nuclear factor kappa B Nrf2 Nuclear factor erythroid 2-related factor 2 T2DM Type 2 diabetes mellitus CVD Cardiovascular diseases MS Metabolic syndrome ALT Alanine transaminase AST Aspartate transaminase HDL-C High density lipoprotein-cholesterol LDL-C Low density lipoprotein-cholesterol TG Triglycerides MD Mediterranean diet MUFA Monounsaturated fatty acid PUFA Polyunsaturated fatty acid HI Hazelnut involucre WK Walnut kernel WSE Walnut septum extract
  • 15. 15 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health INTRODUCTION Due to nutritional choices, population aging, or sedentary lifestyle, the whole world is facing an increased incidence of cardiometabolic diseases, cancer, or neurodegenerative disorders associated with a decrease in the quality of life. Healthy diet, along with physical and cognitive activity, is a modifiable lifestyle factor that has been associated with overall health. Tree nuts are complete functional foods containing valuble bioactive compounds that could prevent many diseases and delay age-related pathologies. In the Actual state of knowledge section, the first part of this PhD thesis, a synthesis of the most recent data regarding this topic is presented. Most of the tree nuts, such as almonds (Prunus dulcis (Mill.) D.A. Webb), hazelnuts (Corylus avellana L.), pistachios (Pistacia vera L.), or walnuts ( Juglans regia L.), have been a part of the human diet for millennia. They are low in carbohydrates (less than 30%), are good sources of proteins (15-21%), and abound in healthy fatty acids composed mostly of healthy monounsaturated and polyunsaturated fatty acids, ranging from 43 to 76%. Walnuts have the largest quantity of omega-6 and omega-3 fatty acids, with a healthy ratio of around 4 : 1. They contain vitamin E, minerals, polyphenols, and phytosterols. Polyphenols, powerful phytochemicals, act as direct and indirect antioxidants, reduce the inflammatory response, modulate many cell signaling pathways, have anticancer potential, prevent cell senescence, and improve gut microbiota. Tree nuts are considered important components of a healthy diet and are part of the protein food group. Because of the healthy biochemical profile, many studies underligned the benefits of including tree nuts in prevention and treatment protocols. Clinical trials and cohort studies published recently presented the influence of antioxidant tree nut diets in preventing or delaying diseases in subjects of all ages. Tree nut supplementation has the possibility to decrease cardiometabolic morbidity and mortality, cancers, and cognitive disorders, mainly through their healthy lipid profile and antioxidant and anti-inflammatory mechanisms of actions. Tree nut intake can modulate signaling pathways, stimulate antioxidant and detox enzyme systems, reduce inflammatory conditions, and have a senolytic capacity. Through the antioxidant and anti-inflammatory action, they are potentially anti-tumoral. By inhibiting mTOR signaling pathways, but also via epigenetic mechanisms, such as obstructing DNA methylation or histone and microARN modulation, nuts act as carcinogenesis inhibitors.
  • 16. 16 Marius Emil Rusu Scientific findings also revealed that tree nut waste-products could provide the same benefits. Guided by these facts, we analyzed several by-products which were rarely mentioned in the scientific literature. In the first chapter of the Personal Contributions section, we described the walnut septum, a scarcely tested by-product. We obtained walnut septum extract (WSE) with high content in bioactive compounds and antioxidant activity based on an original experimental design. We characterized the phytochemical profile using HPLC- MS/MS and evaluated the biological potential of the richest polyphenolic WSE. We extended the WSE knowledge in our second experiment. The tocopherol content was determined by LC-MS/MS. The in vitro inhibiting assessment against several enzymes attested a potential in diabetes or obesity management. Also, the WSE demonstrated antimicrobial potential and revealed antimutagenic inhibitory effects. The cytotoxicity of the extract was assessed on cancerous and normal cell lines. Additionally, the extract demonstrated antioxidant activity and anti-inflammatory activity. In the third study, based on the knowledge that dietary intervention could delay age-related dysfunctions, we assessed the antioxidant effects of walnut kernel (WK) and WSE in D-galactose (D-gal) induced aging rats and in naturally aged rats. The supplementation positively influenced several body measurements, biochemical parameters and antioxidant biomarkers, as well as brain and liver histological architecture. Additionally, WK or WSE lowered acetylcholinesterase activity, a potential strategy in managing neurodegenerative disorders. Histopathological and immunohistochemical analyses revealed that WK or WSE diets could protect neurons in induced-senescence and retain the number of viable neurons. The findings provide scientific evidence that dietary supplementation with WK or WSE can have the ability to maintain health functions and may reduce the risk of age-related diseases or delay the onset of aging processes. In the last chapter, we presented an experiment on hazelnut involucre (HI), another by-product with few scientific literature mentions. The phenolic and sterolic compositions, as well as the antioxidant and biological activities were evaluated. Experimental designs were developed to select the optimum extraction conditions for obtaining extracts rich in bioactive compounds. LC-MS/MS analyses revealed important amounts of individual polyphenols and phytosterols, molecules with antioxidant potential. The richest polyphenolic extract was evaluated by in vitro antioxidant tests and enzyme inhibitory assays. Besides, the cytotoxic and antioxidant effects on two cancerous cell lines and on normal cells were tested. Our findings revealed that the assessed by-products presented strong biological activities justifying further research. Moreover, walnut septum and hazelnut involucre could be considered inexpensive sources of natural antioxidants for food, pharmaceutical, or cosmetic industry.
  • 17. 17 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health ACTUAL STATE OF KNOWLEDGE
  • 19. 19 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 1. General knowledge about tree nuts 1.1. Tree nut overview Tree nuts have been part of the human diet for millennia, as many archaeological discoveries show 1. Nowadays tree nuts are considered important components of a healthy diet and they are integrated in the U.S. Food Guide Pyramid and the Mediterranean Diet Pyramid 2. Nuts are part of the Protein Foods group, together with seafood, meats, poultry, eggs, seeds, and soy products. Experts recommend (“at the 2,000-calorie level”) eating 155 g per day from this food group 3, which can be divided into several servings per day. The Food and Drug Administration (FDA) even authorized the health claim “that eating 1.5 ounces (43 g) per day of most nuts as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease” 4. By the phrase “most nuts” FDA was referring to almonds (Prunus dulcis (Mill.) D.A.Webb), Brazil nuts (Bertholletia excelsa Bonpl.), cashews (Anacardium occidentale L.), hazelnuts (Corylus avellana L.), macadamias (Macadamia integrifolia Maiden & Betche), pecans (Carya illinoinensis (Wangenh.) K.Koch), pine nuts (Pinus pinea L.), pistachios (Pistacia vera L.), walnuts (Juglans regia L.), and peanuts (Arachis hypogaea L.). Although peanuts have a comparable nutrient profile to tree nuts 5, they are botanically classified as legumes and are not included in this study. Tree nuts are defined as dry fruits with one seed in which the ovary wall becomes hard at maturity, the exception being the Brazil nut which is a seed 6. As a mean, over half of tree nuts’ calories come from lipids, so they are included in the energy dense food group. There is some anxiety that the high-fat, energy-dense content of tree nuts can stimulate weight gain, but many reports show that nut consumption is not associated with body weight gain. In contrast, it gives lower risks of weight gain and obesity 7 , very important aspects in today’s obesogenic society. It is worth mentioning that many factors, such as cultivar type, geographical locations, growing conditions, agricultural practices, degree of ripeness, storage conditions, distance to market, industrial processing, and cooking methods, can influence the chemical composition and nutritive value of tree nut kernels. 1.2. Macro and micronutrients in tree nuts Nuts provide a fairly large amount of calories, from around 550-580 kcal/100 g in cashews, pistachios, and almonds, to 720 kcal/100 g in macadamias 8. Most of the energy comes from fat, which ranges from around 45% in cashews and pistachios, to 76% in macadamias. The lipid profile is composed mainly of heart-protective
  • 20. 20 Marius Emil Rusu monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs). MUFAs are the most common fatty acid for most nut types, followed by omega-6 (linoleic acid, 18:2 n-6) and omega-3 (alpha-linolenic acid, 18:3 n-3) PUFAs. Walnuts have the largest quantity of the n-3 fatty acid and the n-6 to n-3 ratio is around 4:1, a health inducing proportion, compared to other plant oils. The content of saturated fatty acids (SFA) ranges from 3.8% in almonds to a high of 12.1% and 16.1% in macadamias and Brazil nuts, respectively (Table I) 8. Table I. Nutritional value of tree nuts (g/100 g). Mean value A Bn C H M P Pn Pi W Energy (kcal) 579 659 553 628 718 691 673 560 654 Energy (kJ) 2423 2757 2314 2629 3004 2889 2816 2342 2738 Protein 21.15 14.32 18.22 14.95 7.91 9.17 13.69 20.16 15.23 Amino acids Tryptophan 0.21 0.13 0.29 0.19 0.07 0.09 0.11 0.25 0.17 Threonine 0.61 0.36 0.69 0.49 0.37 0.31 0.37 0.68 0.59 Isoleucine 0.75 0.52 0.79 0.54 0.31 0.33 0.54 0.92 0.62 Leucine 1.47 1.19 1.47 1.06 0.60 0.59 0.99 1.60 1.17 Lysine 0.57 0.49 0.93 0.42 0.02 0.28 0.54 1.14 0.42 Methionine 0.16 1.12 0.36 0.22 0.02 0.18 0.26 0.36 0.24 Phenylalanine 1.13 0.64 0.95 0.66 0.66 0.42 0.52 1.09 0.71 Tyrosine 0.45 0.42 0.51 0.36 0.51 0.21 0.51 0.51 0.41 Valine 0.85 0.76 1.09 0.70 0.36 0.41 0.69 1.25 0.75 Arginine 2.46 2.14 2.12 2.21 1.40 1.17 2.41 2.13 2.28 Alanine 0.99 0.61 0.84 0.73 0.39 0.39 0.68 0.97 0.69 Aspartic acid 2.64 1.32 1.79 1.68 1.09 0.93 1.30 1.88 1.83 Glutamic acid 6.21 3.19 4.51 3.71 2.26 1.83 2.92 4.30 2.81 Glycine 1.43 0.73 0.94 0.72 0.45 0.45 0.69 1.01 0.81 Proline 0.97 0.71 0.81 0.56 0.47 0.36 0.67 0.94 0.71 Serine 0.91 0.67 1.08 0.73 0.42 0.47 0.83 1.28 0.93 Total lipid 49.93 67.10 43.85 60.75 75.77 71.97 68.37 45.32 65.21 SFA 3.80 16.13 7.78 4.46 12.06 6.18 4.89 5.91 6.12 MUFA 31.55 23.88 23.79 45.65 58.88 40.80 18.76 23.26 8.93 PUFA 12.33 24.39 7.84 7.92 1.50 21.61 34.07 14.38 47.17 Carbohydrate 21.55 11.74 30.19 16.70 13.82 13.86 13.08 27.17 13.71 Fiber 12.50 7.50 3.30 9.70 8.60 9.60 3.70 10.60 6.70 Starch 0.72 0.25 23.49 0.48 1.05 0.46 1.43 1.67 0.06 A-almonds; Bn-Brazil nuts; C-cashews; H-hazelnuts; M-macadamias; P-pecans; Pn-pine nuts; Pi-pistachios; W-walnuts. MUFA-monounsaturated fatty acid; PUFA-polyunsaturated fatty acid; SFA-saturated fatty acid. While some early reports specified a positive relationship between saturated fatty acids, hyperlipidemia, and an increase in several disease risk factors, many recent scientific papers have revealed the positive influence of the mix of saturated fatty acids and n-3 PUFA, in combination with the reduction in the consumption of n-6 PUFA. Consequently, in the case of nuts, the synergistic effect of all the fatty acids could yield favorable results on plasma lipid profiles and human health 9.
  • 21. 21 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health All of the tree nuts are good sources of protein of high biologic value and have high or very high amounts of proteinogenic amino acids, comparable with the amounts in eggs or meat. High consumption of proteins and amino acids from red meat and processed meat appear to activate disease and pro-aging pathways 10, increasing the incidence of age-related ailments and reducing lifespan, as presented by evidence in invertebrate, mammalian, and human studies and epidemiological findings 11. The evidence from recent studies has revealed that reversing the present trend and replacing animal proteins with plant proteins may be useful for glucose homeostasis and lowering T2DM risk 12. The Recommended Dietary Allowance (RDA) for protein in adult population is 0.8 g/kg/day, the same quantity for all age groups 13. This conservative value might be sufficient for middle-aged adults. Nevertheless, after energy demanding activities, dietary protein requirements for active adults should be higher than 0.25 g/kg/meal, based on a diet of 4 meals/day, for proper physical recovery and protein resynthesis. Also, in order to reduce the risk of osteoporosis and sarcopenia, many studies suggest an augmentation of protein intake to 1.0–1.2 g/kg/day, 1.2–1.5 g/kg/day when acute or chronic diseases are present, even up to as much as 2.0 g/kg/day in those adults with severe malnutrition or illnesses 20. Tree nuts contain all of the indispensable amino acids needed in the human diet, some of them in a better concentration for biochemical processes compared to animal- based foods. The amino acid arginine, which is found in higher concentration in nuts, can be metabolized to nitric oxide (NO), a potent vasodilator, and can improve insulin sensitivity in patients with T2DM. The lysine/arginine ratio is lower in nuts than in proteins from animal sources. This ratio is linked with a significantly lower risk of hypercholesterolemia and atherosclerosis, which decreases the risk of cardiovascular diseases 16. The amino acid methionine is two to four times lower in tree nuts than in animal-based foods, but this difference proves to be very beneficial. Methionine restriction showed a decrease in mitochondrial ROS production and carcinogenic processes, and reduction in the mitochondrial DNA mutations which can be responsible for part of the age-delaying effect 17. Tree nuts are low in vitamin C, with the highest level being determined in hazelnut (6.3 mg/100 g) and pistachio (5.6 mg/100 g). Instead, tree nuts are a good source of vitamin E, an effective lipid-soluble antioxidant. Because of the high percentage of lipids, the bioavailability of vitamin E could be significantly greater in tree nuts 18. Vitamin E consists of a mixture of four tocopherols (α-, β-, γ-, δ-) and four tocotrienols (α-, β-, γ-, δ-). The total tocopherol content is highest in almond (26.57 mg/100 g kernel) and lowest in cashew (5.79 mg/100 g kernel). Alpha-tocopherol is found in almonds and hazelnuts, and γ-tocopherol in pecans, walnuts, and pistachios 8. Tocotrienols were found in six types of tree nut (i.e., Brazil nuts, cashews, macadamias,
  • 22. 22 Marius Emil Rusu pine nuts, pistachios, and walnuts) in minute amounts, with 1.57 mg α-tocotrienol per 100 g in macadamia kernel and 1.79 mg γ-tocotrienol per 100 g in pistachio kernel 33. Many nuts are good sources of the essential minerals, such as calcium, iron, magnesium, phosphorus, potassium, zinc, copper, and selenium. 1.3. Phytochemicals in tree nuts Tree nuts have a high content of, biologically active compounds, secondary metabolites. The content of these compounds can vary significantly by nut type, genotype, harvest, and storage conditions. The most important phytochemicals, part of these metabolites, include polyphenols, phytosterols, sphingolipids, phytates, and lignans. Polyphenols, hydrosoluble micronutrients found mostly in vegetables, fruits, cocoa beans, coffee, tea, and red wine, consist of several important subclasses: phenolic acids, flavonoids, carotenoids, stilbenes, lignans and tannins, all of which are also found in tree nuts. Isoflavones, the main class of phytoestrogen, are plant bioactive nonsteroidal polyphenolic metabolites capable to bind to estrogenic receptors, exerting agonist and/or antagonist effects. Three aglycones (daidzein, genistein, and formononetin) are found in minute amounts in walnuts, hazelnuts, cashews, and almonds, with pistachios presenting higher quantities of daidzein (1.88 mg/100 g) and genistein (1.75 mg/100 g) 21. Lignans, another class of phytoestrogens, are also present in nuts. Small amounts of secoisolariciresinol, pinoresinol, lariciresinol, and matairesinol are found in pistachios, walnuts, Brazil nuts, almonds, pine nuts, and hazelnuts. On the other hand, cashews have high levels of lariciresinol (49.6 mg/100 g) and secoisolariciresinol (6.73 mg/100 g), comparable with flaxseed and sesame seed, the main food sources for lignans. Pistachios are rich in β-carotenes and are the only tree nuts that contain significant amounts of lutein and zeaxanthin 8. Pistachios are also the only tree nut that contain significant amounts of melatonin 22. Resveratrol (trans-3,4′,5-trihydroxystilbene) is a polyphenol belonging to the stilbenes. It was detected in pistachio varieties cultivated in Turkey 23 and Italy 24. The two important lipophilic bioactive classes that occur in tree nuts are phytosterols and sphingolipids. Phytosterols, a group of compounds resembling cholesterol in structure, include plant sterols and stanols. The typical ratio in plants is ~98% sterols to ~2% stanols. β-sitosterol is the main phytosterol among all the tree nut types 8. The total quantity of sphingolipids in tree nuts is low, ranging from 0.32 g/100 g in hazelnut oil to 0.91 g/100 g in Brazil nut oil 25.
  • 23. 23 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 1.4. Health benefits of tree nut consumption Healthy diet, along with physical and cognitive activity, is a modifiable lifestyle factor that has been associated with overall health. Scientific evidence demonstrated the potential benefits of higher intake of nuts or nut-enriched Mediterranean diets (MDs) against risk factors associated with pathological conditions, such as cardiometabolic diseases, cancer, or cognitive disorders. 1.4.1. Tree nut consumption and cardiometabolic disorders Globally, cardiometabolic diseases including type 2 diabetes mellitus (T2DM), coronary heart disease (CHD), coronary artery disease (CAD), and stroke are leading causes of morbidity and mortality 26. Most of these diseases could be prevented by changing behavioral risk factors such as suboptimal diet 27. Tree nuts, because of their healthy antioxidant biochemical profile, can improve the lipid profile, increase insulin sensitivity and metabolism, and favorably influence other cardiometabolic risk factors. Clinical trials and lengthy prospective studies showed that higher weekly nut intake can lower all cause and cause-specific morbidity and mortality 28,29,30,31,32,33,34,35,36 (Table II). Subjects at high cardiovascular (CV) risk, who supplemented their MD with 30 grams of tree nuts per day, at any time point during the 4 year study period, had a 53% lower diabetes incidence compared to the control group 28. Pan et al. 29 observed that women in the highest nut serving group were 26% less likely to develop diabetes than participants in the very low nut intake group, with 95% confidence that the true value is lying between 16%-35%. Similarly, when comparing high to very low nut intake the prevalence of diabetes, obesity, and MS were 13%, 39%, and 26% less likely, respectively 30. One prospective study showed a nonsignificant reduction in cardiovascular disease (CVD) mortality when comparing the highest with the lowest nut intake population groups 32. However, two others concluded that participants who were fed nut-enhanced MDs had a significantly lower risk for CVD and CHD, as well as lower CVD, CHD, and all-cause mortality compared to the no-nut group 31,33. Participants who consumed walnuts ≥1 serving per week had 19%, 21%, and 17% lower risk for CVD, CHD, and stroke, respectively, while those who consumed walnuts >3 servings per week had 47% lower risk of CV mortality compared with subjects who did not eat walnuts 33. A recent prospective study demonstrated lower CVD incidence (hazard ratio, HR = 0.83, 95% CI: 0.71–0.98) and CHD incidence (HR = 0.80, 95% CI: 0.67–0.96), 31% lower all-cause mortality and 34% lower CVD mortality for at least 5 servings of nuts per week compared to less than one per month 36. In the same study, total nut intake was not significantly associated with stroke incidence.
  • 24. Marius Emil Rusu 24 Table II. Nut consumption and cardiometabolic morbidity and mortality. Author, Year, Country [Ref] Design Subjects (F:M) Length of Study Intake of Nuts Findings Salas-Salvadó et al., 2011, 2018 Spain 28 RCT 418 (293:125) 4 y MD + 30 g/d nuts ↓ diabetes incidence HR 0.47 (95% CI: 0.23–0.98)(vs. control) Estruch et al., 2018, Spain 35 RCT, Parallel 2,454 (1,326:1,128) 4.8 y MD + 30 g/d nuts ↓ incidence of CV events HR 0.64 (95% CI: 0.47–0.88) (vs. control) Pan et al., 2013, US 29 Prospective 58,063 F 22 y (1) Never/rarely (2) ≥5 servings/wk ↓ T2DM risk (p-trend˂ 0.001) HR 0.74 (95% CI: 0.65–0.84) Ibarrola-Jurado et al., 2013, Spain 30 Cross- sectional 7,210 (4,143:3,067) (1) ˂ 1 serving/wk (2) ˃ 3 servings/wk ↓ prevalence of diabetes (p-trend=0.043) ↓ prevalence of obesity (p-trend˂ 0.001) Guasch-Ferré et al., 2013, Spain 31 Prospective 7216 (4,145:3,071) 4.8 y (1) none (2) ˃ 3 servings/wk ↓ CV mortality (p-trend=0.031) ↓ total mortality risk (p-trend=0.01) Hshieh et al., 2015, USA 32 Prospective 20,742 M 9.6 y (1) ˂ 1 serving/mo (2) ≥5 servings/wk ↓ CVD deaths (p-trend=0.015) Guasch-Ferré et al., 2017, USA 33 Prospective (a) NHS (b) NHS II (c) HPFS 76,364 F 92,946 F 41,526 M 28.7 y 21.5 y 22.5 y (1) Never/almost never (2) ˂ 1 time/wk (3) 1 time/wk (4) 2–4 times/wk (5) ≥5 times/wk (5) vs. (1) ↓ CVD-HR 0.86 ( p-trend<0.001) ↓ CHD-HR 0.80 (p-trend<0.001) Larsson et al., 2018, Sweden 34 Prospective 61,364 17 y (1) none (2) ≥3 times/wk ↓ risk of atrial fibrillation (p- trend=0.004) ↓ risk of heart failure (p-trend=0.003) Liu et al., 2019, USA 36 Prospective (NHS, HPFS) 16,217 (12,006:4,211) 34 y 28 y (1) ˂ 1 serving/mo (2) ≥5 servings/wk ↓ CVD incidence (p-trend=0.01) ↓ CHD incidence (p-trend=0.005) ↓ CVD mortality (p-trend<0.001) CHD-coronary heart disease; CVD-cardiovascular diseases; F-women; HR-hazard ratio; HPFS-Health Professionals Follow-Up Study; M- men; MD-Mediterranean diet; MS-metabolic syndrome; NHS-Nurses’ Health Study; RCT-randomized controlled trial.
  • 25. 25 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health Moreover, a recent intervention study showed that individuals at high CV risk had a lower incidence of major CV events (myocardial infarction, stroke, death from CV causes) when nuts were added daily to MD compared with a low-fat, nut-free control diet 35. Also, three or more servings of nuts per week, as compared to none, can even lower the risk of atrial fibrillation and heart failure 34. Peripheral arterial disease (PAD), often caused by atherosclerosis, can lead to heart attack and stroke. A large cross-sectional study on mature adults indicated that daily nut consumption was associated with lower odds of PAD (OR = 0.79; 95% CI: 0.77–0.80, p < 0.001) compared to participants with the lowest intake of nuts 37. A meta-analysis of 11 observational studies confirmed that tree nut consumption was negatively associated with metabolic syndrome (MS) (p = 0.04) 38. Another meta-analysis showed a significantly reduced risk for CVD and CHD for higher nut consumption 39. Luu et al. 40 showed that in different ethnic groups, nut consumption was associated with decreased overall mortality and CVD mortality and that a higher versus lower quintile of nut intake had a statistically significant inverse association for ischemic heart disease (IHD). Mayhew et al. 41, after reviewing several large prospective cohort studies, concluded that nut consumption was inversely associated with total CVD, CVD mortality, total CHD, CHD mortality, and sudden cardiac death. While one meta-analysis established that daily nut intake can reduce the risk of stroke 42, another study did not find a significant association with stroke, but indicated an inverse association with IHD, overall CVD, and all-cause mortality for nut consumption 43. A meta-analysis of randomized controlled trials (RCTs) and observational studies identified that nut feeding was inversely linked with nonfatal and fatal IHD and diabetes, but not stroke 44. However, a meta-analysis of prospective cohorts to evaluate the relation between nuts and stroke risk and mortality, reported that nut consumption was inversely associated with stroke risk (RR 0.90, 95% CI: 0.83–0.98) and stroke mortality, when comparing the highest with the lowest nut intake 45. High blood pressure (BP) is a major risk factor for CVD. The previous feeding studies showed that nuts had no effect on BP. However, a recent RCT on an elderly cohort proved that walnuts (42.5 grams per day) reduced systolic BP in the walnut group (−4.61 mm Hg, 95% CI: −7.43 to −1.79 mm Hg) compared to the no-walnut group (−0.59 mm Hg, 95% CI: −3.38 to 2.21 mm Hg)(p = 0.051) 46. As no changes in diastolic BP were noticed, it is safe to say that walnut intake can reduce systolic BP in mature subjects, mainly in those with mild hypertension. 1.4.2. Tree nut consumption and blood lipids The effects of tree nut consumption on lipid profiles from intervention studies published in the last ten years 47,48,49,50,51,52,53,54,55,56,57,58,59 are summarized in Table III.
  • 26. Marius Emil Rusu 26 Table III. Nut consumption and blood lipid levels in intervention studies. Author, Year, Country [Ref] Design Subjects (F:M) Length of Study Comparison group Intake of Nuts Findings Li et al., 2011, Taiwan 47 RCT, Crossover 20 (11:9) 12 wk Control (diet w/o A) 56 g/d A ↓ T-C 6.0%, p ≤ 0.0025 ↓ LDL-C 11.6%, p ≤ 0.0117 Wu et al., 2014, Germany 48 RCT, Crossover 40 (30:10) 8 wk Control (nut-free diet) 43 g/d W ↓ non-HDL-C (−10 ± 3 mg/dL, p = 0.025) ↓ apoB (−5.0 ± 1.3 mg/dL, p = 0.009) Hernández et al., 2015, Spain 49 RCT, Crossover 54 (25:29) 9 mo Control (diet w/o pistachio) 57 g/d pistachio ↓ LDL-C vs. baseline; p = 0.02 ↓ Non-HDL-C (vs. baseline; p = 0.04) Ruisinger et al., 2015, USA 50 RCT, Parallel 48 (24:24) 4 wk Control (diet w/o A) 100 g/d A ↓ non-HDL-C (p = 0.024) ↓ LDL-C, TG (p = 0.068)(vs. control) Jamshed et al., 2015, Pakistan 51 RCT 150 (37:113) 12 wk Control (diet w/o A) 10 g/d A ↑ HDL-C ↓ TG (vs. baseline; p all ˂ 0.05) Njike et al., 2015, USA 52 RCT, Parallel 112 (81:31) 6 mo Control (diet w/o W) 56 g/d W ↓ T-C (p < 0.0001) ↓ LDL-C (vs. baseline, p < 0.0001) Huguenin et al., 2015, Brazil 53 RCT, Crossover 91 (44:47) 12 wk Control (nut-free diet) 13 g/d Brazil nut ↓ Ox LDL-C (vs. baseline, p < 0.05) Sauder et al., 2015, USA 54 RCT, Crossover 30 (15:15) 4 wk Control (diet w/o pistachio) pistachios (20% of energy) ↓ T-C (p = 0.048) ↓ TG (p = 0.003)(vs. control) Mah et al., 2017, USA 55 RCT, Crossover 51 (31:20) 4 wk Control (diet w/o cashews) 28-64 g/d cashews ↓ T-C 23.9% vs. 0.8% ↓ LDL-C 24.8% vs. 1.2% (p ˂ 0.05) Bamberger et al., 2017, Germany 56 RCT, Crossover 194 (134:60) 24 wk Control (diet w/o W) 43 g/d W ↓ T-C (p = 0.0003) ↓ LDL-C (p = 0.0009)(vs. control) McKay et al., 2018, USA 57 RCT, Crossover 26 (5:21) 12 wk Control (isocaloric, no pecan) 42.5 g/d pecans ↓ T-C (−8.89 ± 4.41, p = 0.056) ↓ LDL-C (−7.41 ± 3.85, p = 0.067) Jenkins et al., 2018, Canada 58 RCT, Parallel 117 (39:78) 3 mo Control (isocaloric nut-free diet) 75 g/d mixed nuts ↓ T-C (p = 0.026) ↓ non HDL-C (p = 0.026) vs. control Bowen et al., 2019, Australia 59 RCT 76 (31:45) 8 wk Control (nut-free diet) 56 g/d A ↓ TC/HDL-C ratio (in women, but not in men) A—almonds; apoB—apolipoprotein B; F—women; HDL-C—high density lipoprotein-cholesterol; LDL-C—low density lipoprotein-cholesterol; M—men; RCT— randomized controlled trial; T-C—total cholesterol; TG—triglycerides; W—walnuts.
  • 27. 27 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health The results of these clinical trials indicate a causal association between higher nut intake and lower levels of total cholesterol (T-C), low density lipoprotein- cholesterol (LDL-C), non-high density lipoprotein-cholesterol (non-HDL-C), triglycerides (TG), and apolipoprotein B (apoB), markers of CV morbidity and mortality. After a 12 week trial and daily intake of 56 g almonds, compared with a no-nut control diet, plasma apoB, apoB/apoA-1 ratio, T-C, LDL-C, and LDL-C/HDL-C ratio decreased significantly by 15.6%, 17.4%, 6.0%, 11.6%, and 9.7%, respectively, in patients with T2DM 47. Similarly, the inclusion of almonds in the diet of patients on chronic statin therapy revealed a 4.9% reduction in non–HDL-C compared with the no- nut group, and non-statistical significance decreases in LDL-C and TG 50. Consumed before breakfast, 10 g almonds proved to increase serum HDL-C by 15% after 12 weeks in CAD patients with low initial HDL-C 51. A trial, comparing almond snacks with isocaloric carbohydrate snacks, demonstrated that almond snacks can improve the serum T-C/HDL-C ratio in women but not in men, with no change in body weight (BW) or inflammatory biomarkers in overweight and obese adults with high T2DM risk 59. The short 8 weeks trial might be the cause for the differential gender results. Almond consumption was confirmed to significantly decrease T-C (p ˂ 0.001), LDL-C (p = 0.001), and TG (p = 0.042), with no modification in HDL-C (p = 0.207) 60. Also, Nishi et al. 61 showed that the daily consumption of almonds by middle-aged adults can improve the blood lipid profile, and a 3.5% decrease in the 10-year CHD risk was noticed for every 30 g increase in almond intake. Consistent with the effects of other nuts, Brazil nuts and cashews can also improve lipid profiles. In a group of hypertensive and dyslipidemic subjects, the intake of partially defatted Brazil nuts significantly increased plasma selenium and the antioxidant activity of the glutathione peroxidase enzyme, and reduced oxidation in LDL-C compared to the baseline 53. Mah et al. 55 demonstrated that adding cashews into the diet of a population with high LDL-C risk could lower the T-C, LDL-C, and LDL- C/HDL-C ratio. In agreement with these results, a recent trial showed a significant decrease for the LDL-C/HDL-C ratio in a cashew diet group compared with a no- cashew control group 62. Pistachios proved to have a lowering effect on CV risk factors. Daily pistachio intake significantly decreased the T-C and T-C/HDL-C ratio (p < 0.05), and TG levels (p = 0.003) compared to the control in T2DM adults 54. Also, after 4 months of 57 g pistachio daily, small LDL particles and non-HDL particles significantly decreased compared to the nut-free diet 49. This change of lipoprotein particle size may explain the decrease of CVD risk. Kay et al. 63 showed that the consumption of a pistachio- enriched diet, when compared to the control, significantly increased serum concentration of antioxidants, including β-carotene, γ-tocopherol, and lutein, and significantly decreased serum oxidized-LDL, an important factor in CVD.
  • 28. 28 Marius Emil Rusu Walnuts may influence CVD risks via its lipid-lowering impact. Compared with a control diet without walnuts, a walnut-included diet for 6 months significantly decreased T-C and LDL-C and improved diet quality 52. In a shorter cross-over trial, a walnut-enriched diet significantly reduced non-HDL-C (p = 0.025) and apoB (p = 0.009) compared with a control diet, while T-C displayed a tendency toward reduction (p = 0.073) 48. Bamberger et al. 56 indicated that a walnut-enriched diet versus a control diet caused a significant decrease in fasting cholesterol (p = 0.002), LDL-C (p = 0.029), non-HDL-C (p ≤ 0.001), TG (p = 0.015), and apoB (p ≤ 0.001) in healthy mature adults. Also, 15 mL walnut oil daily (corresponding to ~28 g walnuts) added for 90 days to the diet of hyperlipidemic T2DM patients significantly decreased the T-C, LDL-C, T-C/HDL- C ratio (p ˂ 0.001 for all), and TG level (p = 0.021), compared with the control group, while the HDL level showed an increased trend (p = 0.06) 64. Similarly, Austel et al. 65 noticed beneficial changes in blood lipids after replacing saturated fats with walnut oil. A meta-analysis of trials confirmed that walnut-enriched diets compared with control groups significantly reduced T-C (p ˂ 0.001), LDL-C (p ˂ 0.001), TG (p = 0.03), and apoB (p = 0.008), with no significant modifications in BW or blood pressure 66. A new trial confirmed that, compared to a carbohydrate control diet, adding 75 g per day of mixed nuts to healthy diets could significantly lower small-size LDL-C (p = 0.018), with a trend towards reduction for T-C (p = 0.066) and non-HDL-C (p = 0.067) in T2DM patients 58. These outcomes are validated by a meta-analysis of 61 trials which concluded that nut intake significantly lowered the levels of T-C, LDL-C, apoB, and TG, with the key factor of changing lipid profile appearing to be nut dose rather than nut type 67. As many strategies for reducing T-C and LDL-C levels could lower HDL-C levels, all the dietary plans for lowering LDL-C levels should aim to maintain or even increase HDL-C. In their 2017 guidelines, the American Association of Clinical Endocrinologists and American College of Endocrinology recommend a minimum blood HDL-C level of 40 mg/dL in CVD risk individuals 68. However, data showed that small HDL particles present only a weak defense, the strong protection against CVD risks coming from large HDL units. Equally, small LDL particles, due to their proneness to oxidation compared with larger ones, are responsible for atherosclerosis progress and CVD, while large LDL components are only weakly linked with CVD 69. 1.4.3. Tree nut consumption and cancer Nutrition was demonstrated to have a causal and protective role in the progress of several types of cancer, the second leading cause of death worldwide 70. Numerous studies demonstrated the influence of nut consumption on cancer 71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86 (Table IV).
  • 29. Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 29 Table IV. Association between nut consumption and cancer. Author, Year, Country [Ref] Design Subjects Study length Intake of Nuts Findings Hardman et al., 2019, USA 84 RCT 10 F 2 to 3 wk 56 g/d walnuts ↓ growth and survival of cancer cells Raimondi et al., 2010, Canada 71 Case-control 394 M 0 g/d vs. ˃ 3 g/d ↓ prostate cancer risk (p-trend=0.01) Ibiebele et al., 2012, Australia 72 Case-control 2780 F 0.13 vs. 3.35 n-6 (g) ↓ ovarian cancer risk (p-trend=0.02) Guasch-Ferré et al., 2013, Spain 31 Prospective 7216 4.8 y None vs. ˃ 3 servings/wk ↓ cancer mortality (p-trend=0.064 ) Bao et al., 2013, USA 73 Prospective 75,680 F 30 y Never vs. ≥2 times/wk ↓ pancreatic cancer risk (p-trend = 0.01) van den Brandt et al., 2015, the Netherlands 74 Prospective 120,852 10 y (1) 0 g/d (2) 10+ g/d ↓ cancer mortality (p-trend = 0.002) HR 0.79 (95% CI: 0.67–0.93) (2) vs. (1) Yang et al., 2016, USA 75 Prospective 75,680 F 30 y Never vs. ≥2 times/wk ↓ colorectal cancer risk (p-trend = 0.06) Wang et al., 2016, USA 76 Prospective 47,299 M 26 y Never vs. ≥5 times/wk ↓ overall mortality (p=0.0005) Lee et al., 2017, Italy/USA 77 EAGLE study AARP study 3639 495,785 16 y (1) never (2) ≥2 times per day ↓ lung cancer risk; OR EAGLE 0.74(p= 0.017); HR AARP 0.86 (p<0.001) Hashemian et al., 2017, USA 78 Prospective 566,407 15.5 y (C0) 0 g/1000 kcal (C1) 2.20 (1.35, 4.12) ↓ gastric noncardia adenocarcinoma risk (C1)vs(C0); HR 0.73 (95% CI: 0.57–0.94) Nieuwenhuis et al., 2018, the Netherlands 79 Prospective 120,852 20.3 y (1) non-consumers (2) ˃ 10 g/d ↓ pancreatic cancer risk in men (2) vs. (1) HR 0.53 (95% CI: 0.28–1.00), p=0.047 Nieuwenhuis et al., 2018, the Netherlands 80 Prospective 120,852 20.3 y (1) non-consumers (2) ˃ 10 g/d ↓ esophageal cell carcinoma risk HR 0.54 (95% CI: 0.30–0.96), p=0.050 Fadelu et al., 2018, USA 81 Prospective 826 6.5 y (1) none (2) ≥2 servings/wk ↑ overall survival ↓ cancer recurrence and mortality van den Brandt et al., 2018, the Netherlands 82 Prospective 62,573 F 20.3 y (1) non-consumers (2) ˃ 10 g/d ↓ (ER -) breast cancer risk (p=0.025) ↓ ER–PR breast cancer risk (p=0.037) Lee et al., 2018, Korea 83 Case-control 2,769 (1) None (15g) (2) ≥3 servings/wk ↓ distal colon cancer risk (p˂ 0.001) ↓ rectal cancer risk (p˂ 0.001 ) Sui et al., 2019, USA 85 Prospective 88,783 F 51,492 M 27.9 y (1) 0.01 servings/wk (2) 1.25 servings/wk ↓ hepatocellular carcinoma HR 0.64 (p-trend=0.07) Nieuwenhuis et al., 2019, the Netherlands 86 Prospective 120,852 20.3 y (1) non-consumers (2) ˃ 10 g/d ↓ small cell carcinoma (p-trend=0.024) ↓ lung cancer risk (non-significantly) F – women; M – men. (ER -)—estrogen receptor negative; HR—hazard ratio; n-6—omega 6; OR—odds ratio; PR—progesterone receptor; RCT—randomized controlled trial.
  • 30. 30 Marius Emil Rusu Although, in the observational studies no causality could be proven, still there were several obvious strengths: prospective design for the majority of the studies, large population size, high retention rates with long-term follow-up, and adjustments for a multitude of other potential risk factors. Several studies indicated that patients in the highest nut-intake group compared to the lowest intake group at any time point during the study period were: 40%, 25%, and 14% less likely to die from total cancer, gastric noncardia adenocarcinoma, and lung cancer, respectively 31,77,78. Also, they were 46%, 45%, and 47% less likely to die from esophageal squamous cell carcinoma, estrogen receptor negative breast cancer, and estrogen - progesterone receptor breast cancer, respectively 80,82. Subjects having at least two servings of nuts per week had 0.68 times the risk of pancreatic cancer compared with subjects having nuts never or almost never 73. The oil extracted from walnuts exhibited in vitro ability to reduce the viability of esophageal cancer cells, induced necrosis and cell cycle arrest, and displayed anticarcinogenic effect, thus it may present favorable effects in esophageal cancer in humans 87. A prospective study showed that tree nut intake was significantly inverse associated with hepatocellular carcinoma 85. Higher intake of tree nuts was linked with a significantly reduced risk for small cell carcinoma (lung cancer subtype), after adjusting for smoking frequency and duration, and a non-significant decrease in lung cancer risk for men, results which have not been replicated in women 86. The following case control studies also reported inverse associations between nut consumption and different types of cancer. In the highest intake group the outcomes were 57% and 28% less likely for prostate cancer and ovarian cancer, respectively 71,72. Lee et al. 83 noticed that odd ratios were 70% less likely for colorectal cancer in women and men, 60% (in women) and 77% (in men) less likely for rectal cancer, and 87% (in women) and 61% (in men) less likely for distal colon cancer, for the highest nut-intake group. Also, the results of another study suggested that, particularly among women, moderate to high nut intakes (2 to 5.5 servings/week) may be associated with a lower risk of colorectal adenomas, the precursor to most colorectal cancers 88. Yang et al. 75 showed that the colorectal cancer risk for women who consumed nuts ≥2 times per week was 13% lower compared to non-consumers, with a borderline statistical significance. Fadelu et al. 81 proved that higher tree nut intake was linked with a significantly reduced incidence of cancer relapse and death in subjects with stage III colon cancer. These results confirm those of Casari and Falasca 89, who linked nut intake with a positive effect against cancer, and Aune et al. 39, who noticed a 15% decreased cancer risk in subjects eating 28 g of nuts daily compared to subjects who did not have nuts. A new clinical trial showed that walnuts could alter tumor gene expression in women with confirmed breast cancer in ways expected to decrease cancer growth, delay proliferation, reduce metastasis, and increase cancer cell death 84. Toledo et al. 90
  • 31. 31 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health indicated also that walnut-enriched diets could modulate breast cancer growth. These outcomes are in accordance with those reported by Soriano-Hernandez et al. 91 where in the group that consumed higher amounts of nuts the breast cancer risk was between 55 and 67% less likely. 1.4.4. Tree nut consumption and cognitive disorders Inflammation-associated chronic pathologies, such as dementia, Parkinson’s disease (PD), or Alzheimer’s disease (AD), lead to one of the most unfavorable health problems – age-related cognitive deterioration, a condition which may be prevented or delayed by modifiable lifestyle factors, including antioxidant diets 92. Quite a few studies examined the association between diets supplemented with nuts and cognitive performance 93,94,95,96,97,98 (Table V). Consumption of walnuts was related to better cognitive performance, mainly working memory, although the causality could not be inferred 95. These results were consistent with another cross-sectional study that indicated a positive association between nut consumption and cognitive function in mature Chinese adults. Patients with mild cognition impairment symptoms had less nuts in their diet compared to healthy subjects (p = 0.031) 99. Similarly, positive relations between cognitive functions and nut intake were shown in the US population. Significant improvements in almost all cognitive test scores were noted among adults who added walnuts in their diet 100. The scores from two neuropsychological tests, the Mini-Mental State Examination (an indicator of cognitive impairment) and the Clock Drawing Test (a neuropsychological test which evaluates cognitive decline and dementia), were higher for subjects allocated to the nut-enhanced MD compared to the low-fat, nut-free diet group 96. Comparable results were obtained by Valls-Pedret et al. 98; in an older population, MD supplemented with tree nuts (walnuts, almonds, hazelnuts) was associated with improved cognitive functions. Also, a high consumption of nuts was linked to better cognitive function at baseline and might reduce cognitive decline in mature adults 94. Equally, O’Brien et al. 97 suggested that long-term nut intake was related to overall level of cognition but had no effect on cognitive decline. The addition of walnuts (15% of energy) to an ad libitum diet confirmed that regular nut consumption can delay the onset of age-related neurodegenerative disorders. Compared with the control, individuals in the walnut group reported significantly lower intake of animal protein, total carbohydrates, saturated fatty acids, and sodium, but significantly higher ingestion of vegetable protein, antioxidant n-3 and n-6 PUFAs 101. Brain-derived neurotrophic factor (BDNF), a protein belonging to the neurotrophic family, controls axonal elongation, neurotransmitter release, growth, differentiation, and survival of presynaptic structure.
  • 32. Marius Emil Rusu 32 Table V. Association between nut consumption and cognitive disorders. Author, Year, Country [Ref] Design Subjects (F:M) Length of study Comparison Group Intake of Nuts Findings Sánchez-Villegas et al., 2011, Spain 93 RCT 152 (76:76) 3 y Control (low-fat diet *) MD + 30 g/d nuts ↓ risk for low plasma BDNF values OR 0.22 (p=0.04) vs. control Martínez-Lapiscina et al., 2013, Spain 96 RCT 522 (289:233) 6.5 y Control (low-fat diet *) MD + 30 g/d nuts ↑ cognition ↑ MMSE 0.57 (p=0.015) ↑ CDT 0.33 (p=0.048) vs. control Valls-Pedret et al., 2015, Spain 98 RCT 334 (170:164) 4.1 y Control (low-fat diet *) MD + 30 g/d nuts ↓ age-related cognitive decline ↑ memory composite 0.09 (p=0.04) ↑ frontal cognition composite 0.03 (p=0.03) vs. control Nooyens et al., 2011, the Netherlands 94 Prospective 2613 (1325:1288) Ongoing since 1995 5 quintiles of nut consumption ↑ cognitive function at baseline ↓ cognitive decline: memory (highest vs. lowest nut intake, p = 0.03); global cognitive function (highest vs. lowest nut intake, p = 0.02) Valls-Pedret et al., 2012, Spain 95 Cross- sectional 447 (233:214) 30 g W/d ↑ cognitive function (working memory, p=0.039) O’Brien et al., 2014, USA 97 Prospective 15,467 F 6 y (1) never, <1/mo (2) 1–4/wk (3) 5/wk ↑ cognitive performance ↑ cognition (3) vs. (1) * low-fat diet—all types of fat, from both animal and vegetable sources, reduced, but no fat-free foods. BDNF—brain-derived neurotrophic factor; CDT—Clock Drawing Test; F—women; M—men; MD—Mediterranean diet; MMSE—Mini-Mental State Examination; OR—odds ratio; RCT—randomized controlled trial.
  • 33. 33 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health While low plasma levels of BDNF could lead to the atrophy of specific brain areas in mammals such as the hippocampus and frontal cortex. Higher concentrations of BDNF provided by enhanced-nut MD were likely to prevent depression, memory loss, and cognitive decline 93. It seems that n-3 PUFA, with its powerful antioxidant potential, is responsible for the increased levels of the BDNF signaling factor 102. Major depressive disorder (MDD) is a chronic disease where healthy dietary practices in combination with current treatments may prevent or delay its evolution. Increased consumption of nuts, seeds, vegetables, fruits, and legumes, with proven antioxidant and anti-inflammatory capacities, is the principal nutritional recommendation, with a key reminder that the beneficial effects are possible to come from wholesome nutritious diets rather than from individual nutrients 103. Ali-Sisto et al. 104 showed that MDD is characterized by a decreased arginine level, an amino acid found in nuts and a precursor of NO, which is needed to modulate neuronal and vasodilation functions, to prevent oxidation of LDL-C, aggregation of platelets, or vascular inflammation, and inhibit oxidation in the central nervous system (CNS). MDD is associated with increased CV events, and the biological mechanism connecting MDD and CVD is apparently a chronic inflammation induced by a low level or bioavailability of arginine 104. Optimal dietary choices can improve endothelial function, decrease inflammatory biomarkers, protect neuronal and cell-signaling function, increase cognitive performance, and prevent or delay the onset of cognitive dysfunction during aging. In anxiety-based psychopathology, replacing pro-inflammatory saturated fats with anti-inflammatory walnut oil might result in faster, more profound elimination of fear-based learning 105. 1.4.5. Other possible beneficial association Sarcopenia and frailty, mostly gerontological conditions, are characterized by increased levels of pro-inflammatory cytokines, including TNF-α, IL-6, and CRP. One recent study mentioned that quantities of 2 to 5 g per day of marine n-3 PUFA, corresponding to approximately 20 to 50 g walnuts, is shown to reduce muscle wasting and augment the intracellular anabolic signaling, thus having beneficial effects for the prevention and treatment of sarcopenia in mature adults 106. Also in this age group, malnutrition and sarcopenia frequently overlap. In order to overcome the loss of lean mass and meet the increased energy requirements, the recommended protein intake is higher (1.2–1.4 g/kg/day) than that of healthy adults 107. Because the protein level is between 15 to 21% in tree nuts, they should be included in healthy diets as plant food sources of protein. Nutrition is a factor that could influence osteoarthritis (OA), the most dominant form of arthritis with limited treatment, mainly through symptom management 108. As food impacts systemic lipid levels, high consumption of saturated fat is linked with
  • 34. 34 Marius Emil Rusu higher levels of pro-inflammatory fatty acids, while diets rich in less-inflammatory MUFAs and PUFAs, lipids also found in tree nuts, may reduce cartilage degradation and OA progression 109. In a group of postmenopausal women, MD enhanced with up to 20 g/day nuts was significantly associated with bone mineral density (p = 0.045), indicating that nuts may be beneficial in osteoporosis prevention 110. Together with physical exercises, long-term daily intake of tree nuts may contribute to maintaining the health of the skeletal system, muscle mass and strength, as well as population well-being. 1.5. Potential mechanisms responsible for beneficial activities Biologically active antioxidant compounds found in nuts can modulate essential physiological processes inside human bodies and influence key mechanisms of actions involved in health. These phytochemicals are credited to many important tasks in the human body, such as antioxidant, anti-inflammatory, anti-mutagenic, neuroprotection enhancement, and the capacity to modulate key cellular enzyme functions, all of which contribute to health maintenance. Nut antioxidant polyphenols, the majority of which are found in the pellicle of nuts, can have anti-carcinogenic potential. They retard the initiation, differentiation, and proliferation of cancer cells, modulate signaling pathways related to cell survival, attenuate the growth of tumors, diminish angiogenesis and metastasis, and stimulate the expression of detoxification enzymes and antioxidants 111. Some polyphenols are found in significant amounts in certain types of nuts, giving them specific biological actions. Thus, ellagic acid (EA), physiologically hydrolyzed from ellagitannins (ETs) abundant in walnuts, found also in pecans and pine nuts, could reduce adipocyte expansion and might be beneficial in the management of obesity and the metabolic complications related to obesity. Another example is anacardic acid, a strong antioxidant polyphenol contained in cashew nut shells, which was shown to have anticancer potential, inhibited prostate tumor angiogenesis, cell proliferation, and prompted apoptosis 112. Other polyphenols, found only in very small amounts in nuts, can contribute to beneficial health effects through their hormetic and/or synergistic actions with other polyphenols. In pistachios, the small amounts of genistein, (-) epigallocatechin-3- gallate (EGCG) or resveratrol can act synergistically through common or complementary action pathways with proven antioxidant and anti-aging activity. Thus, the flavonoid (isoflavone) genistein has demonstrated antioxidant, chemopreventive, and chemotherapeutic effects 113. Growing evidence suggests that EGCG, also present in pecans and hazelnuts, can contribute to the anti-cancer potential. It has an inhibitory proliferation effect on human pancreatic cancer cells 114. In oral cancer, EGCG exerted
  • 35. 35 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health an apoptotic therapeutic role, controlling cancer cell proliferation, and in breast cancer showed an anti-angiogenic effect 115. Several epidemiological studies showed the benefits dietary isoflavones can have on human health in menopause and age-related pathologies, including osteoporosis, hormonal cancers, or cardiovascular diseases 113. Pterostilbene (PTS), a natural dimethylated analog of resveratrol, had the capability to significantly inhibit secretion of TNF-α and alter the cytokine production in IGROV-1 ovarian cancer cell line 116. Melatonin, found in walnuts, could be protective against CV damage and cancer initiation and propagation 117. Selenium, a trace element supplied mostly by Brazil nuts, is associated with reduced risks for prostate cancer and hepatocellular carcinoma 118. Lipophilic bioactive compounds found in nuts can also influence the aging process. Lignans may present antioxidant and anti-inflammatory potential in humans 119. Phytosterols can diminish serum LDL cholesterol level, through competitive replacement of dietary and biliary cholesterol, and seem to have anticancer activity. In combination with n-3 PUFAs, phytosterols show both complementary and synergistic lipid-lowering effects in hyperlipidemic mature adults 120. Lipophilic isomers of vitamin E (tocopherols and tocotrienols), via their antioxidant properties, might inhibit the propagation of free radical damage in biological membranes and enhance immune functions 71. They have the ability to scavenge ROS in cellular membranes, subsequently inhibiting the oxidative damage correlated with many illnesses 121. Vitamin E presents powerful antioxidant, anti- inflammatory, antibacterial, cardioprotective, anticancer, hypoglycemic, hepatoprotective, and nephroprotective potential 30. Moreover, vitamin E can prolong the reproductive period 123. Oxidation stress and inflammation, processes involved in the decline of cognitive function and neural capacity of the aging brain, can be reduced by tocols through their antioxidant and anti-inflammatory properties 124. It was suggested that dietary intake of tocotrienols could be sufficient to support neuroprotection 125. The lipophilic antioxidant phytochemicals, even in minute amounts, showed increased bioavailability and bioaccessibility, with their intestinal absorption being favored by the presence of lipids in tree nuts. Age-related macular degeneration (AMD), the primary cause of blindness and vision impairment in old age, can be amended or prevented by lutein. Higher ingestion of bioavailable carotenoids, such as lutein/zeaxanthin found in pistachios, is associated with a reduced risk of AMD. Lutein and zeaxanthin form macular pigments and may protect against AMD by reducing oxidative stress, absorbing blue light, and stabilizing cell membranes, while carotenoids reduce systemic oxidative stress and indirectly influence the macula. Data indicate the significant impact macular pigment density, a biomarker of brain lutein,
  • 36. 36 Marius Emil Rusu might also have on the brain health and cognition by improving neurobiological efficiency, neural structure and efficacy, visual perception, and decision-making. Scientific evidence show that lutein could stop neuroinflammation, a pathological condition of many neurodegenerative disorders, diminish lipid peroxidation, and decrease the release of pro-inflammatory cytokines 126. Two mechanisms of actions, increased cholesterol efflux and improved endothelial function, favorably affected by whole walnuts and walnut oil, may answer in part the CV benefits of walnut consumption. The favorable effect walnuts have on endothelial function could be credited to ALA, oxylipins (PUFA metabolites with a protective role in CVD and aging), polyphenols, L-arginine, and magnesium. Walnut kernels provide ~9% ALA, while walnut oil provides ~10% ALA 127. Similarly, ALA might be the factor for the decreased number of atherogenic small and dense LDL-C particles and increased number of large HDL-C particles noticed after walnut intake, as well as the reduction of detrimental lipid classes, such as ceramides and sphingomyelins, associated with CVD risk 128. Essential vitamins and minerals in the daily diet, combined with long chain fatty acids, are vital to boost immunity and maintain health. Recent evidence shows that patients with AD have lower plasma levels of vitamins and minerals compared with cognitively intact adults 129. Epidemiological research suggests that nuts, seeds, vegetables, and fruits in the diet have a much more protective effect on health compared to vitamin supplements 130. In pathological conditions, such as AD, there is a diminished expression of glucose transporters, which apparently contributes to a reduced utilization of glucose in cognition-critical brain areas. However, transport and metabolism of ketone bodies (KBs), metabolites produced by the liver as alternative energy sources, are not affected in AD 131. For that reason, periods of ketogenic diets (KDs) might be effective preventive or treatment measures for neurological disorders. We argue that nuts, due to their phytochemical profile (fat content between 49 and 75%, low amounts of carbohydrates, and high content of ketogenic amino acids including leucine) and strong antioxidant potential, can be part of KDs. Important actions of KDs are related to decrease oxidative stress and inflammatory activity and improve mitochondrial function 132. The health benefits of tree nuts in humans depend on the bioaccessibility of the active compounds, mediated by many factors, such as the amount of dietary fiber, the properties of cell walls, lipid and protein content of each nut, the food matrix, or the processing methods (Fig. 1). The best processing method for almonds, hazelnuts, pistachios, cashews, seems to be roasting which, by the thermal and chemical reactions that occur during the process, enhances the antioxidant activity of polyphenols with a positive influence on human well-being 133, while walnuts and pecans 134 shoul be consumed fresh avoiding thermal processing methods.
  • 37. 37 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health Fig. 1. Total phenol content (TPC) and antioxidant capacity (AOC) for the evaluated tree nuts correlated with the best processing methods. Polyphenols modulate the nuclear factor erythroid 2-related factor 2/electrophile-responsive elements (Nrf2/EpRE) signaling pathway with major role in cell protection (Fig. 2). Fig. 2. Cytoprotection and anti-inflammatory effects of tree nuts mediated via Nrf2/EpRE and NF-κB signaling pathways. Through this pathway, polyphenols increase the activity of some antioxidant and detoxifying enzymatic systems and down-regulate the Nuclear Factor kappa B (NF-кB) system, as a result reducing the inflammatory response. Activation of Nrf2/EpRE pathway is a very important cytoprotective mechanism against oxidative stress and/or electrophilic stress. It is closely related to the anti-inflammatory process,
  • 38. 38 Marius Emil Rusu provides mitochondrial redox homeostasis, improves mitochondrial function, promotes protein homeostasis and prevents cellular senescence 135. Because tree nut pellicles contain high concentrations of polyphenols, all tree nuts should be consumed whole without discarding their thin coating. Various studies demonstrated the positive role antioxidant polyphenols could have in prolonging life, either by arresting and neutralizing free radicals thus preventing lipid peroxidation, or through enhancing the detoxification in endogenous systems 123. The antioxidant potential depends on the number of hydroxyl group and their place in the molecule 136. In conclusion, the bioactive compounds found in tree nuts can act through diverse signaling pathways and mechanisms of actions with beneficial results on human health (Fig. 3). Fig. 3. The key mechanisms of actions and main signaling pathways of tree nuts bioactive compounds implicated in healthspan and lifespan ( Stimulated; Ͱ Inhibited;  Increased;  Decreased) [Akt - protein kinase B; AMPK - AMP-activated protein kinase; ATG7 - Autophagy-related protein 7; DNMT - DNA- methyltransferase; EpRE - Electrophile-responsive elements; ER - endoplasmic reticulum; FOXO - forkhead box O; HDACs - histone deacetylases; IGF-1 - insulin-like growth factor 1; miRNAs - microRNAs; mTOR - Mammalian Target of Rapamycin; NF-кB - Nuclear Factor kappa B; Nrf2 - Nuclear factor erythroid 2-related factor 2; PGC-1α - Peroxisome proliferator-activated receptor gamma coactivator 1alpha; PI3K - phosphatidylinositol 3-kinase; ROS - reactive oxygen species; SASP - senescence-associated secretory phenotype; SIRT - sirtuins (silent information regulators)]
  • 39. 39 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 1.5.1. Association between tree nuts and gastrointestinal microbiota The relationship between gut microbiota (GM), diet, and health has been already established 137. Nutrition is a vital instrument in keeping a friendly microbiome, and this is more important in aging, when increased usage of medication can reduce healthy GM diversity and stability. GM can impact CNS function, via gut-brain axis, regulate the immune system, and be involved in several brain disorders (autism, PD, schizophrenia) 138. Patients having PD revealed pro-inflammatory bacteria in their gastrointestinal tract. Pathological by-products of these microorganisms could leak from the intestinal lumen in the enteric nervous system and aggregate into insoluble fibrils in the CNS 139. Nut polyphenols were reported to increase the abundance of Bifidobacterium and Lactobacillus bacteria, probiotic strains related to significant lowering of CRP concentrations and increase in plasma HDL-C, cancer prevention, immune-modulation, as well as reductions of pathogenic Clostridium species. Walnut ingestion increased the abundance of Lactobacillus and decreased microbial derived, proinflammatory LDL-C and secondary bile acids 140. Similar results were achieved in a recent 8-week long RCT, including 194 healthy individuals, where after 43 g/day walnut-enriched diet, the probiotic and butyric acid-producing species (Ruminococcaceae and Bifidobacteria) significantly increased, while Clostridium species significantly decreased 141. Also, pistachio and almond consumption via the prebiotic compounds they contain may stimulate the growth of beneficial butyrate-producing bacteria and inhibit the development of pathogenic ones. Holscher et al. 142 demonstrated that daily consumption of around 42 g almonds for at least 3 weeks can increase the abundance of Roseburia species, a favorable genus known to be negatively affected by age. Human diet influences the relative abundance of bacterial communities present in the gastrointestinal tract. A significant diversity and number of bacteria ensure a greater ability to resist metabolic changes and infections and constitute the prerequisite for a healthy status of the gut. Consequently, a nut enhanced diet characterized by high antioxidant and anti-inflammatory activities can delay age- related microbiota changes and positively alter the microbial composition of the human GM with benefits for health. 1.6. Agricultural waste and tree nut by-products In recent years, industrial waste created during plant material processing in the food industry presented a real concern. The inadequate disposal of the agricultural by- products could create pollution problems as much of the waste is discarded. However, this inexpensive and available in large quantity wastes may well be sources of biologically active molecules, such as fatty acids, vitamins, or polyphenols, and
  • 40. 40 Marius Emil Rusu included into food supplements. Polyphenols, common secondary plant metabolites characterized by several hydroxyl groups linked to a phenol ring, can act synergistically with other molecules to lower the oxidation and inflammation processes which may trigger many pathological conditions or chronic diseases. These biologically active molecules donate electrons or hydrogen atoms to reactive free radicals preventing lipid oxidation or cellular damage and acting as natural antioxidants with many health benefits 136. Coupled with the tendency of the consumers to avoid foods prepared with chemical origin preservatives, many studies have been recently conducted, intended to find natural alternatives, such as plant by- products, rich in bioactive compounds with high potential for health and pharmaceutical industry 143. Some by-products were recognized as sources of bioactive compounds having diverse biological activities, such as antioxidant, anti-inflammatory, antimicrobial, or antimutagenic 144. In the pharmacological screening step, by-products are currently examined as inhibitors of enzymes involved in physiological processes or various pathologies. The action of nut by-product extracts against cholinesterase (neurodegenerative disorders), glucosidase (diabetes), or lipase (obesity) revealed encouraging results 145. Special interest was also given to tree nut by-products, waste plant matrices, with great potential as sources of biologically active compounds. Both walnut (Juglans regia L.) and hazelnut (Corylus avellana L.) are native plants, which grow spontaneously in Romania and present multiple benefits (nutritional, phytotherapeutic, economical), both through their nuts and by-products. The phytochemical profile and biological activity of walnut leaves and green husks were characterized and demonstrated to constitute good sources of bioactive molecules including tocopherols and phenolic compounds that could induce health benefits 146. Previous studies reported on the phytochemicals and antioxidant activity of hazelnut skin, hard shell, or leaves 147. However, few data are available about walnut septum and hazelnut involucre, two interesting tree nut by-products. Walnut septum was traditionally used as a cold remedy or cough suppressant and presented a hypoglycemic activity, besides improving the blood profile, in murinic experiments 148. Five phenolic acids were identified in hazelnut green leafy cover and the antioxidant and antiradical activities were analyzed 149. Therefore, the aims of this thesis was the in-depth assessment of the phytochemical profiles of walnut (Juglans regia L.) septum and hazelnut (Corylus avellana L.) involucre and their biological activities.
  • 41. 41 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health PERSONAL CONTRIBUTIONS
  • 43. 43 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 1. General objectives Globally, non-communicable or chronic diseases, such as cardiometabolic diseases and cancer, are leading causes of morbidity and mortality. Most of these diseases could be prevented by changing behavioral risk factors including nutrition. Tree nuts, complete functional foods, contain macro- and micronutrients of high biological value. These bioactive compounds have a synergistic effect in preventing and delaying many chronic diseases. Tree nuts have a healthy lipid profile, are good sources of proteins, rich in proteinogenic amino acids, and are low in carbohydrates. They contain significant amounts of vitamin E, minerals, polyphenols, and phytosterols, molecules that are powerful antioxidants, can reduce the inflammation and prevent cell senescence. In the beginning of the study, the first objectives of the thesis were the description of tree nut phytochemical composition (review 1) and highlight their health benefits and contribution on helthspan and lifespan (review 2). The most common tree nuts, presented and described in our studies were almonds (Prunus dulcis (Mill.) D.A. Webb), Brazil nuts (Bertholletia excelsa Bonpl.), cashews (Anacardium occidentale L.), hazelnuts (Corylus avellana L.), pecans (Carya illinoinensis (Wangenh.) K. Koch), pine nuts (Pinus pinea L.), macadamias (Macadamia integrifolia Maiden & Betche), pistachios (Pistacia vera L.), and walnuts (Juglans regia L.). Another objective was the documentation of the most recent clinical trials and cohort studies, which presented the influence of tree nut in preventing or delaying diseases in middle-aged and elderly subjects (review 3). Clinical evidence and scientific findings demonstrated the importance of diets characterized by high intake of nuts and emphasize their potential in preventing diseases. We also emphasized the mechanisms of actions of tree nuts in delaying aging and preventing diseases through their biologically active compounds (reviews 1 and 2). As the positive impact of tree nuts in prevention and even treatment of many disorders have been documented, a new research path, with personal practical contribution, was orientated to tree nut by-products and to find if they, via their phytochemical contents, can have the same beneficial effects. Many of these by- products including walnut and hazelnut leaves, walnut bark and green husk, were analyzed. We have concentrated our research on two important by-products, walnut septum and hazelnut involucre, rarely mentioned in scientific literature. The objectives were the characterization of their phytochemical profiles and biological activities. The first studies determined the phenolics, phytosterols, and tocopherols from the walnut septum based on an experimental design. The variables, extraction method,
  • 44. 44 Marius Emil Rusu solvent, temperature, and water percentage, were combined with statistical tools and LC-MS/MS analyses in order to determine the optimal extraction conditions, identify and quantify the main bioactive molecules from septum. Several methods were employed to determine the antioxidant capacity (ABTS, DPPH, and FRAP). Moreover, a number of biological activities were investigated. We assessed the in vitro inhibiting potential against acetylcholinesterase, α-glucosidase, lipase, and tyrosinase, as well as the antimicrobial and antimutagenic inhibitory effects. The cytotoxicity of the extract was assessed on cancerous (A549, T47D-KBluc, MCF-7) and normal (HGF) cell lines. Another objective was the assessment of the antioxidant effects of walnut kernel and walnut septum extract in an 8-week D-galactose induced aging model and in naturally aged rats. We investigated an improvement in cellular antioxidant activity, decrease of the oxidative stress biomarkers, and liver and neuron protection against senescence. The aim of the last study was to evaluate the phenolic and sterolic composition, as well as the antioxidant and other biological activities, of hazelnut involucre extracts. Experimental designs were developed in order to select the optimum extraction conditions (solvent, temperature, time) using turbo-extraction by Ultra-Turrax for obtaining extracts rich in bioactive compounds. Qualitative and quantitative analyses were performed by LC-MS and LC-MS/MS and they revealed important amounts of individual polyphenols and phytosterols, molecules with antioxidant potential. The richest polyphenolic involucre extract with the highest antioxidant activity by TEAC assay was further evaluated by other in vitro antioxidant tests (DPPH, FRAP) and enzyme inhibitory assays. Additionally, the cytotoxic and antioxidant effects of this extract on two cancerous cell lines and on normal cells were tested. All the objectives of the thesis were successfully accomplished, the findings revealing that these by-products justify further research and could be considered good sources of natural antioxidants for food, pharmaceutical, or cosmetic industry.
  • 45. 45 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health 2. Study 1. Bioactive compounds of walnut (Juglans regia L.) septum and the antioxidant activity 2.1. Introduction In the last decades, the number of people with body mass problems increased in the world obesogenic culture. Overweight and obesity are increasingly seen as major concerns for human health 150. Processed food, the so called “junk food”, with high content of carbohydrates, fats, and salt, is linked to overweight and obesity via several mechanisms 151. Excessive body weight, associated with several pro-inflammatory cytokines (e.g., leptin, interleukin 6, interleukin 8, tumor necrosis factor-alpha), and a chronic, low-grade inflammation, is seen as a major risk factor for a plethora of diseases. Epidemiological studies and clinical trials demonstrated that diets with high intake of plant origin foods (vegetables, fruits, nuts) can safeguard against excessive weight-related diseases and offer powerful protection for the cardiovascular, gastrointestinal, and immune systems 39. Phytochemicals, including carotenoids, glucosinolates, and polyphenols, work synergistically to reduce inflammation and oxidation, providing defense against initiation and evolution of ailments 10. Phenolic acids and flavonoids, the major contributors of the polyphenols group, act as natural antioxidants decreasing the risk of degenerative diseases 136. Besides their role as antioxidants in the detoxifying system with a scavenging role against reactive oxygen or nitrogen species, polyphenols can take part in the enzymatic pathways involved in the energetic balance or act as signaling molecules in the cell 152. Walnut (Juglans regia L.), a valued crop of high economic importance, represents a good source of nutritional and nutraceutical compounds 107 with well- known antioxidant, antibacterial, and anti-inflammatory bioactivity 153. The goal of the study was the determination of phenolic and phytosterol compounds from the walnut septum (WS) based on an experimental design. Extraction method, solvent, temperature, and water percentage, the variables of the study, were combined with statistical tools and analysis using LC-MS/MS in order to determine the optimal extraction conditions, identification, and quantification of main phenolic and phytosterol molecules from septum. Several methods were employed to determine the antioxidant capacity (ABTS, DPPH, and FRAP) and the enzymatic inhibitory activity.
  • 46. 46 Marius Emil Rusu 2.2. Materials and methods 2.2.1. Chemicals and samples All reagents were of analytical grade and all solvents were of LC grade. Water was of Milli-Q-quality. The standards used for LC-MS/MS analysis were: quercetin (≥95%), hyperoside (≥97%), isoquercitrin (≥98%), quercitrin (≥78%), (+)-catechin (≥96%), (-)-epicatechin (≥90%), vanillic acid (≥97%), syringic acid (≥95%), protocatechuic acid (≥97%), campesterol (~65%), ergosterol (≥95%), and stigmasterol (~95%) from Sigma- Aldrich, gallic acid (≥98%) from Merck (Darmstadt, Germany), and β-sitosterol (≥80%) from Carl Roth (Karlsruhe, Germany). Plant samples Walnuts (Juglans regia L.) of high quality were provided by an organic orchard in Buciumi, Maramureş County, Romania. In the autumn of 2016, walnuts were harvested and kept in a dark, airy shelter, at temperatures ~0 °C. At the beginning of March 2017, the unshelled walnuts were delivered to the Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, and identified by Dr. Andrei Mocan from the Department of Pharmaceutical Botany. A voucher specimen was deposited in the Herbarium of this Department. The unshelled walnuts were cracked and the septum removed from the hard shells just prior to the extractions. WS was ground in a coffee grinder (Argis, RC-21, Electroarges SA, Romania) for 5 min. Then, the ground septum powder was screened through a 200 µm Retsch sieve. 2.2.2. Preparation of extracts The extraction process was carried out based on a D-optimal experimental design developed by Modde software, version 11.0 (Sartorius Stedim Data Analytics AB, Umeå, Sweden) using four variable factors: preparation method, temperature, solvent, and percentage of water in solvent (Table VI). WS was weighed (2 g) and mixed with the extraction solvent (20 mL). The Ultra- Turrax extraction (UTE) was performed in two steps: using an Ultra-Turrax homogenizer (T 18; IKA Labortechnik, Staufen, Germany) for 2 min (1 min at 9500 rpm and 1 min at 13,500 rpm) 154 and again 2 min using a Vortex RX-3 (Velp Scientifica, Usmate, Italy). The homogenate was centrifuged (Hettich, Micro 22R, Andreas Hettich GmbH & Co., Tuttlingen, Germany) 15 min at 3000 rpm, maintaining the extraction temperature. The supernatant was carefully separated, and the solvent removed under vacuum at 40 °C using a rotary evaporator (Hei-VAP, Heidolph Instruments GmbH & Co., Schwabach, Germany). The dry residue was taken up in water, placed in amber glass vials, and lyophilized (Advantage 2.0, SP Scientific, Warminster, USA).
  • 47. 47 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health Table VI. Variables of experimental design evaluated for walnut septum extracts. Variables Level -1 0 1 Independent variables (factors) Extraction method (X1) Ultra-turrax Maceration Temperature (°C) (X2) 20 30 40 Solvent (X3) Acetone Ethanol Water in solvent (%, v/v) (X4) 5 25 50 Dependent variables (responses) Total phenolic content (TPC, mg GAE/g dw1) (Y1) Total flavonoid content (TFC, mg QE/g dw2) (Y2) Condensed tannin content (CTC, mg CE/g dw3) (Y3) Total antioxidant activity (TAA, mg TE/g dw4) (Y4) 1-mg GAE/g dw = gallic acid equivalents per dry weight of walnut septum; 2-mg QE/g dw = quercetin equivalents per dry weight of walnut septum; 3-mg CE/g dw = catechin equivalents per dry weight of walnut septum; 4-mg TE/g dw = trolox equivalents per dry weight of walnut septum. For the maceration method, WS (2 g) was added to Erlenmayer flasks with the extraction solvent and kept for 10 days at 20, 30, and 40 °C (Conterm Oven, JP Selecta S.A., Barcelona, Spain) and stirred twice daily. After 10 days, the samples were centrifuged 10 min at 5300 rpm, maintaining the extraction temperature. Then, the supernatant was separated, the solvent evaporated and the remaining water removed as seen before. After lyophilization, the samples (for both extraction methods) were stored at room temperature. For further determinations, lyophilized extract was dissolved in EtOH 70% (10 mg/mL). All assays were executed in triplicate. 2.2.3. Quantitative determinations of total bioactive compounds Total phenolic content The total phenolic content (TPC) of the WS extracts was determined by Folin- Ciocâlteu spectrophotometric method according to a method described previously 155. In brief, in a 96 well plate, 20 µL of each sample (WS extracts diluted 5 times) were mixed with 100 µL of FC reagent (diluted 1:10). After 3 min, 80 µL of sodium carbonate solution (7.5% w/v) was added to the wells. The plate was incubated for 30 min in the dark at room temperature. A Synergy HT Multi-Detection Microplate Reader with 96 well plates (BioTek Instruments, Inc., Winooski, VT) was used to measure the absorbance at 760 nm against a solvent blank. Gallic acid was used as a reference standard, and the content of phenolics was expressed as gallic acid equivalents (GAE) per dry weight of septum (mg GAE/g dw). Total flavonoid content The total flavonoid content (TFC) of the WS extracts was determined according to a method described previously 156. In a 96 well plate, 100 µL of sample extracts were
  • 48. 48 Marius Emil Rusu added to 100 µL of 2% AlCl3 ethanolic solution. The plate was incubated for 15 min in the dark at room temperature. The absorbance at 420 nm was measured against a solvent blank. The TFC was expressed as quercetin equivalents (QE) per dry weight (dw) of vegetal material (mg QE/g dw). Condensed tannin content The condensed tannin content (CTC) in WS extracts was determined according to a modified version of the vanillin assay described before 149. Briefly, in a 96 well plate, 50 µL of sample WS extracts were added to 250 µL 0.5% vanillin in 4% concentrated HCl in methanol. The plate was incubated for 20 min in the dark at 30 °C. The absorbance at 500 nm was measured against a solvent blank. The condensed tannins were expressed as catechin equivalents (CE) per dry weight (dw) of vegetal material (mg CE/g dw). 2.2.4. Phytochemical analysis by LC-MS/MS The phytochemical profile of lyophilized WS extracts obtained by UTE method was assessed by liquid chromatography coupled with mass spectrometry in tandem (LC-MS/MS). The experiment was carried out using an Agilent 1100 HPLC Series system (Agilent, USA) equipped with degasser, binary gradient pump, column thermostat, auto sampler, and UV detector. The HPLC system was coupled with an Agilent Ion Trap 1100 SL mass spectrometer (LC/MSD Ion Trap VL). Identification and quantification of polyphenolic compounds A previously LC-MS/MS method 157 was slightly modified (replacing of sodium phosphate with acetic acid in the mobile phase) and applied for the identification of 18 polyphenols in the sample WS extracts: caftaric acid, gentisic acid, caffeic acid, chlorogenic acid, p-coumaric acid, ferulic acid, sinapic acid, hyperoside, isoquercitrin, rutozid, myricetol, fisetin, quercitrin, quercetin, patuletin, luteolin, kaempferol, and apigenin. In brief, chromatographic separation was performed on a reverse-phase analytical column (Zorbax SB-C18, 100 mm x 3.0 mm i.d., 3.5 µm) with a mixture of methanol: 0.1% acetic acid (v/v) as mobile phase and a binary gradient. The elution started with a linear gradient, beginning with 5% methanol and ending at 42% methanol at 35 minutes; isocratic elution followed for the next 3 minutes with 42% methanol; rebalancing in the next 7 minutes with 5% methanol. The flow rate was 1 mL/min, the column temperature 48 ºC and the injection volume was 5 μL. The detection of the compounds was performed on both UV and MS mode. The UV detector was set at 330 nm until 17 min (for the detection of polyphenolic acids, then at 370 nm until 38 min to detect flavonoids and their aglycones. The MS system operated using an electrospray ion source in negative mode (capillary +3000 V, nebulizer 60 psi (nitrogen), dry gas nitrogen at 12 L/min, dry gas temperature 360 °C).
  • 49. 49 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health The chromatographic data were processed using ChemStation and DataAnalysis software from Agilent, USA. Another LC-MS method was used to identify other six polyphenols in WS extracts: epicatechin, catechin, syringic acid, gallic acid, protocatechuic acid, and vanillic acid. The chromatographic separation was performed on the same analytical column as mentioned before (Zorbax SB-C18, 100 mm x 3.0 mm i.d., 3.5 µm) with a mixture of methanol: 0.1% acetic acid (v/v) as mobile phase and a binary gradient (start: 3% methanol; at 3 min: 8% methanol; at 8.5 min: 20% methanol; keep 20% methanol until 10 min then rebalance column with 3% methanol). The flow rate was 1 mL/min and the injection volume was 5 μL. The detection of the compounds was performed on MS mode (Table VII). The MS system operated using an electrospray ion source in negative mode (capillary +3000 V, nebulizer 60 psi (nitrogen), dry gas nitrogen at 12 L/min, dry gas temperature 360 °C). All identified polyphenols were quantified both in the WS extracts and hydrolyzed WS extracts (equal quantities of extract and 4M HCl kept 30 min on 100 °C water bath) on the basis of their peak areas and comparison with a calibration curve of their corresponding standards (epicatechin, catechin, syringic acid, gallic acid, protocatechuic acid, vanillic acid, hyperoside, isoquercitrin, quercitrin). The results were expressed as milligrams of phenolic per gram of dry weight of septum extract. Table VII. Detection and quantification of certain polyphenols by the new LC-MS method developed in view of their analysis in walnut septum extracts. Polyphenol Monitored ion (m/z) Retention time (min) Calibration range (n=8) (µg/mL) Coefficient of linearity (R2) Accuracy (bias, %) Epicatechin 289 9.0 0.3-21.5 0.9922 90.7-112.1 Catechin 289 6.0 0.3-21.5 0.9974 94.3-108.9 Gallic acid 169 1.5 0.3-22.2 0.9987 96.4-108.6 Syringic acid 197 8.4 0.3-21.0 0.9997 90.5-105.5 Protocatechuic acid 153 2.8 0.3-23.9 0.9977 87.0-112.2 Vanillic acid 167 6.7 0.3-21.1 0.9993 95.6-105.6 Identification and quantification of phytosterols The pytosterols in the septum extracts were determined according to a method described previously 158. In brief, chromatographic separation was performed on a Zorbax SB-C18 (100 mm x 3.0 mm i.d., 5 µm) column (Agilent Technologies) with a mixture of methanol: acetonitrile (10:90, v/v) and isocratic elution, at 45 °C with a flow rate of 1 mL/min. The detection of analytes was performed in the multiple reaction monitoring (MRM) mode for the quantification of phytosterols, positive ion detection, using an ion trap mass spectrometer equipped with an atmospheric pressure chemical ionization (APCI) source (capillary -4000 V, nebulizer 60 psi (nitrogen), vaporizer 400 °C, dry gas nitrogen at 7 L/min, dry gas temperature 325 °C).
  • 50. 50 Marius Emil Rusu Four external standards were used for quantification: β-sitosterol, stigmasterol, campesterol, and ergosterol. The identified phytosterols (β-sitosterol and campesterol) were quantified on the basis of their peak areas and comparison with a calibration curve of their corresponding standards. The results were expressed as milligrams phytosterols per gram of dry weight of septum extract. 2.2.5. Antioxidant activity assays ABTS radical cation scavenging activity The antiradical activity of WS extracts was determined according to the trolox equivalent antioxidant capacity (TEAC) assay described previously 159. The scavenging activity against ABTS radical cation (2,2′-azino-bis(3-ethylbenzothiazoline)-6- sulphonic acid) was assessed and used to plot the trolox calibration curve. The total antioxidant activity (TAA) according to TEAC assay was expressed as trolox equivalents (TE) per gram of dry lyophilized extract (mg TE/g dw extract). This assay was used during the screening phase of the study for the evaluation of total antioxidant activity of the 23 samples obtained by either maceration or UTE method. DPPH radical scavenging activity The antiradical activity of WS extracts was assessed using a method previously described 160. The capacity to scavenge the free radical DPPH was determined in a 96 well plate mixing 30 μL of sample solution with a 0.004% methanolic solution of DPPH for 30 min in the dark. The absorbance at 517 nm was measured against a solvent blank. Trolox was used as a reference standard and the results were expressed as trolox equivalents per gram of dry lyophilized extract (mg TE/g dw extract). This assay was performed on the richest polyphenolic WS extract. FRAP assay The reduction capacity of the WS extract was evaluated by FRAP (ferric reducing antioxidant power) assay that analyzes the blue-colored Fe2+-TPTZ formed by the reduction of Fe3+-TPTZ. A method previously described 161 was used with slight modifications. In brief, 25 μL of sample were incubated with 175 μL FRAP reagent (300 mM acetate buffer, pH 3.6 : 10 mM TPTZ in 40 mM HCl : 20 mM FeCl3 .6H2O in 40 mM HCl, 10:1:1, v/v/v) in a 96 well plate for 30 min in the dark. Trolox was used as an external standard (calibration curve obtained for 0.01-0.10 mg/mL) and the absorbance was measured at 593 nm. The results were expressed as trolox equivalents per gram of dry lyophilized extract (mg TE/g dw extract). This assay was done on the richest polyphenolic WS extract. 2.2.6. Tyrosinase inhibitory activity The tyrosinase inhibitory activity of WS extract was evaluated by a 96-well microplate method previously described 162 with slight changes. Briefly, four wells
  • 51. 51 Analytical and biological studies of several bioactive compounds of the most used tree nuts and the positive impact on health were designated (WS lyophilized extract dissolved in water containing 5% DMSO) as follows: (A) 66 mM phosphate buffer, pH 6.6 (PB) (120 μL) and mushroom tyrosinase in the same buffer, 46 U/mL (MT) (40 μL); (B) only PB (160 μL); (C) PB (80 μL), MT (40 μL) and the sample (40 μL); (D) PB (120 μL) and the sample (40 μL). After 10 min incubation at room temperature, 2.5 mM L-DOPA prepared in PB (40 μL) was added in all wells. The microplate was kept again at room temperature for 20 min and the absorbance was measured at 475 nm. The tyrosinase inhibitory activity was assessed using kojic acid as an external standard (0.01-0.10 mg/mL). The inhibition percentage of enzymatic activity was calculated by the following equation: [(A-B)-(C-D)]*100/(A- B). The results were expressed as milligram kojic acid equivalents per gram of dry lyophilized extract (mg KAE/g dw extract). This evaluation was carried out for the richest polyphenolic WS extract. 2.2.7. Experimental conditions for phytochemical-rich extracts During the screening step, the quantifiable responses TPC, TFC, CTC, TAA according to TEAC assay, were analyzed by the Modde software, version 11.0, to identify the optimal extraction conditions. For the optimization step, individual phenolic and phytosterol levels were evaluated and the independent factors investigated were working temperature, organic solvent, and percentage of water in solvent mixture. The responses were identification and quantification of each quantified phytochemical compound: epicatechin, catechin, syringic acid, gallic acid, protocatechuic acid, vanillic acid, hyperoside, isoquercitrin, quercitrin, campesterol, and β-sitosterol. 2.2.8. Statistical analysis All samples were analyzed in triplicate (n = 3) and the results were expressed as the mean ± Standard Deviation (SD). 2.3. Results and discussion 2.3.1. Fitting the experimental data with the models The independent and dependent variables of experimental design evaluated for WS extraction yield during the screening step are shown in Table VI. The independent variables (factors) were the extraction method, working temperature, organic solvent, and percent of water in solvent mixture. The dependent variables (responses) were TPC, TFC, CTC, and TAA. The matrix of the experimental design generated by the Modde software, version 11.0, along with the responses obtained after performing all the experimental runs are given in Table VIII. As it can be observed from the results, the extraction yields of TPC, TFC, CTC, as well as the TAA, were influenced by the extraction method and factors evaluated in the experimental design.