Effects of pistachios on anthropometric indices, inflammatory markers, endothelial function and blood pressure in adults: a systematic review and meta-analysis of randomised controlled trials

Abstract

Evidence suggests that eating nuts may reduce the risk of CVD. This study was intended to pool the data of all randomised controlled trials (RCT) available to determine if pistachios confer a beneficial effect on anthropometric indices, inflammatory markers, endothelial dysfunction and blood pressure. Without language restriction, PubMed, Scopus, Cochrane Library and Web of Science were searched for articles published from the earliest records to June 2019 investigating the effect of pistachio consumption on inflammation, endothelial dysfunction and hypertension. Mean difference (MD) was pooled using a random effects model. The Cochrane risk of bias tool was used to evaluate the quality of the studies. The meta-analysis of thirteen RCT with 563 participants indicated that pistachio consumption significantly decreased systolic blood pressure (SBP) (MD: -2 center dot 12 mmHg, 95 CI -3 center dot 65, -0 center dot 59, P = 0 center dot 007), whereas changes in flow-mediated dilation (MD: 0 center dot 94 , 95 CI -0 center dot 99, 2 center dot 86, P = 0 center dot 813), diastolic blood pressure (MD: 0 center dot 32 mmHg, 95 CI -1 center dot 37, 2 center dot 02, P = 0 center dot 707), C-reactive protein (MD: 0 center dot 00 mg/l, 95 CI -0 center dot 21, 0 center dot 23, P = 0 center dot 942), TNF-alpha (MD: -0 center dot 09 pg/ml, 95 CI -0 center dot 38, 0 center dot 20, P = 0 center dot 541), body weight (MD: 0 center dot 09 kg, 95 CI -0 center dot 38, 0 center dot 69, P = 0 center dot 697), BMI (MD: 0 center dot 07 kg/m(2), 95 CI -0 center dot 16, 0 center dot 31, P = 0 center dot 553) and waist circumference (MD: 0 center dot 77 cm, 95 CI -0 center dot 09, 1 center dot 64, P = 0 center dot 140) were not statistically significant. This systematic review and meta-analysis suggested the efficacy of pistachio consumption to reduce SBP levels. However, further large-scale studies are needed to confirm these results.