According to the American Heart Association (AHA), heart disease is the leading cause of mortality in the United States, which accounted for nearly 610,000 deaths in 2015.

The AHA noted that suboptimal diet quality led to 678, 000 annual deaths in 2010, while a 2016 report said one of the major dietary contributors was low nut consumption.

“The PREDIMED (Prevencion con Dieta Mediterranea) trial showed that a Mediterranean diet supplemented with mixed nuts (15 g/d walnuts, 7.5 g/d hazelnuts, and 7.5 g/d almonds) reduced the incidence of major cardiovascular events by 28%, compared with the control group that received recommendations to consume a lower-fat control diet,” according to the AHA.

A new study – the Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial – which appears in the Journal of the American Heart Association - concluded that: “Consumption of almonds alone (42.5 g/d) or combined with dark chocolate (43 g/d) and cocoa (18 g/d) for 4 weeks improved lipid/lipoprotein profiles, when compared with an average American diet with no treatment foods.”

A recent meta-analysis of 18 randomized controlled trials, according to the AHA, “Has shown that intake of almonds improved the lipid profile by decreasing total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides. Furthermore, almonds improve other cardiovascular risk factors, including insulin resistance, endothelial dysfunction, inflammation, and oxidative stress.”

As for dark chocolate, the AHA notes, dark chocolate has a higher amount of flavonoids per weight than red wine, black tea, cranberry juice, and apples. The flavonoids, particularly flavanols (ie, catechin, epicatechin, and procyanidins), in dark chocolate may contribute to cardioprotective benefits.

The AHA says these conclusions were reached as follows: A randomized controlled, 4-period, crossover, feeding trial was conducted in overweight and obese individuals aged 30 to 70 years. Forty-eight participants were randomized, and 31 participants completed the entire study. Each diet period was 4 weeks long, followed by a 2-week compliance break. Participants consumed each of 4 Iso-caloric, weight maintenance diets: (1) no treatment foods (average American diet), (2) 42.5 g/d of almonds (almond diet [ALD]), (3) 18 g/d of cocoa powder and 43 g/d of dark chocolate (Chocolate diet [CHOC]), or (4) all 3 foods (CHOC+ALD).

The combined consumption of almonds, dark chocolate, and cocoa resulted in a significant reduction in small dense low-density lipoprotein particles that are recognized as a risk factor for coronary heart disease. However, neither almonds nor dark chocolate and cocoa affected the markers of vascular health and oxidative stress. These findings were specific to overweight and obese individuals aged 30 to 70 years.

Our results demonstrate that consumption of almonds alone or combined with dark chocolate under controlled- feeding conditions improves lipid profiles. Incorporating almonds, dark chocolate, and cocoa into a typical American diet without exceeding energy needs may reduce the risk of coronary heart disease.