Nutrition 30 (2014) 459–465 Contents lists available at ScienceDirect Nutrition journal homepage: www.nutritionjrnl.com Applied nutritional investigation Brazilian nut consumption by healthy volunteers improves inflammatory parameters ˇ Elisangela Colpo Ph.D. a, c, Carlos Dalton D.A. Vilanova B.Sc. a, Luiz Gustavo B. Reetz M.Sc. b, Marta M.M.F. Duarte Ph.D. a, d, Iria Luiza G. Farias Ph.D. b, Daiane F. Meinerz Ph.D. a, Douglas O.C. Mariano M.Sc. a, Raquel G. Vendrusculo B.Sc. e, Aline A. Boligon Ph.D. f, Cristiane L. Dalla Corte Ph.D. a, ~o Batista T. da Rocha Ph.D. a, * Roger Wagner Ph.D. e, Margareth L. Athayde Ph.D. f, Joa a Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Centers, Federal University of Santa Maria, Santa Maria, Brazil Clinical Laboratory Analysis, University Hospital, Federal University of Santa Maria, Santa Maria, Brazil c Department of Nutrition, Center Franciscan University, Santa Maria, Brazil d Lutheran University of Brazil, Santa Maria, Brazil e Department of Technology and Food and Science, Federal University of Santa Maria, Santa Maria, Brazil f Department of Industrial Pharmacy, Federal University of Santa Maria, Santa Maria, Brazil b a r t i c l e i n f o a b s t r a c t Article history: Received 5 July 2013 Accepted 5 October 2013 Objective: The aim of this study was to investigate the effect of a single dose of Brazil nuts on the inflammatory markers of healthy individuals. Method: A randomized crossover study was conducted with 10 healthy individuals (mean age 24.7  3.4 y). Each individual was tested four times regarding intake of different portions of Brazil nuts: 0, 5, 20 and 50 g. At each testing period, peripheral blood was collected before and at 1, 3, 6, 9, 24, and 48 h after intake of nuts, as well as at 5 and 30 d after intake of various Brazil nut portions. Blood samples were tested for high-sensitivity to C-reactive protein, interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor (TNF)-a, and interferon (IFN)-g, aspartate and alanine aminotransferases, albumin, total protein, alkaline phosphatase, gamma-glutamyltransferase, urea, and creatinine. Results: Consumption of nuts did not affect biochemical parameters for liver and kidney function, indicating absence of hepatic and renal toxicity. A single intake of Brazil nuts (20 or 50 g) caused a significant decrease in serum IL-1, IL-6, TNF-a, and IFN-g levels (P < 0.05), whereas serum levels of IL-10 were significantly increased (P < 0.05). Conclusion: The results indicate a long-term decrease in inflammatory markers after a single intake of large portions of Brazil nuts in healthy volunteers. Therefore, the long-term effect of regular Brazil nut consumption on inflammatory markers should be better investigated. Ó 2014 Elsevier Inc. All rights reserved. Keywords: Human Interleukin Unsaturated fatty acids Selenium C-reactive protein Nutrition Oxidative stress Introduction Nuts are recommended as an important constituent of a healthy diet [1]. They are energy-dense and provide 23.4 to 26.8 kJ/g of food with a high-fat content (45%–75% of weight), but mostly unsaturated fat [2]. For instance, Brazil nuts are a good source of unsaturated fatty acids and selenium [3,4]. The concentration of selenium in Brazil nuts varies from 8 to 83 mg/g and is among the highest found within foods consumed by humans [5,6]. * Corresponding author: Tel.: þ55 32209462; fax: þ55 32209878. E-mail address: Jbtrocha@pq.cnpq.br (J. B. T. da Rocha). 0899-9007/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.nut.2013.10.005 Selenium is an essential nutrient for human health [7] and its biological functions are mediated by the expression of about 20 selenoproteins, which have selenocysteine at their active sites [8, 9]. Some selenoproteins, e.g., the glutathione peroxidase (GPx) and thioredoxin reductase isoforms, are important enzymes involved in the metabolism of reactive oxygen species [10]. However, the physiological role played by various other selenoproteins remains poorly understood. In humans, selenium is implicated as a modulator of the immune function [11]. Accordingly, selenium supplementation has been reported to increase lymphocyte proliferation in response to mitogens [11,12], and the expression of high-affinity interleukin (IL) -2 receptor [11,13]. Selenium can also improve 460 E. Colpo et al. / Nutrition 30 (2014) 459–465 Table 1 Anthropometric measurements and biochemical characteristics of volunteers Parameters Before start of experiment After end of experiment Males (n ¼ 6) Females (n ¼ 4) Males (n ¼ 6) Females (n ¼ 4) Age (y) 27.6  3.1 29.0  4.4 28.0  2.9 29.2  4.8 Body weight (kg) 86.6  12.5 59.5  6.5 86.9  12.5 59.2  6.4 BMI (kg/m2) 26.7  3.5 23.4  1.6 26.8  3.7 23.1  1.4 7.3  0.9 7.3  2.2 7.4  1.9 7.6  1.5 Leukocytes 3 3 (10 /mm ) Erythrocytes 5.4  0.3 4.6  0.2 5.4  0.3 4.6  0.4 (103/mm3) Hemoglobin (g/dL) 14.5  0.6 12.9  1 15.3  0.5 13.2  1.1 Hematocrit (%) 44.6  1.7 39.6  3.3 43.7  1.4 38.4  3.6 Platelet (103/mm3) 250.5  88 279.5  50 260.5  65.5 266.2  10.2 Glucose (mg/dL) 82.4  7.8 82.9  7.4 89.0  9.3 86.9  6.7 AST (UL) 18.6  6.1 19.7  6.6 19.4  5.5 19.2  6.4 ALT (UL) 20.5  8.6 23.2  8.6 21.3  8.7 23.3  9.4 Gamma GT (UL) 9.40  5 10.50  4.6 10.30  4.7 10.40  5 Phosphatase 38.2  12.4 43.9  10.2 38.2  11.5 43.7  7.8 alkaline (UL) Total protein (g/dL) 6.5  0.6 6.8  0.3 6.6  0.6 6.8  0.32 Albumin (g/dL) 4.7  0.4 4.8  0.4 4.7 0.4 4.7  0.32 Urea (mg/dL) 20.0  7.5 20.2  7.3 19.7  6.3 21.4  7.2 Creatinine (mg/dL) 0.75  0.1 0.80  0.1 0.78  0.13 0.77  0.13 C-reactive protein 0.50  0.02 0.52  0.04 0.48  0.08 0.52  0.04 (mg/dL) ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; gamma GT, gamma-glutamyltransferase Data are expressed as means  SD. Test paired (Wilcoxon) in relation to gender lymphocyte-mediated tumor cytotoxicity and killer cells activity [14], and may affect the immune system by regulating peroxide levels in the immune cell microenvironment. Compared with other nuts, Brazil nuts are highly rich in unsaturated fatty acids and they have been associated with improved lipid profile and reduction in blood pressure, insulin resistance, and systemic levels of inflammatory markers [1,15]. Fatty acids from nuts are important contributors to the beneficial health effects, which protect from the development of coronary heart disease [2]. It was previously reported [16] that high monounsaturated fatty acid (MUFA) diets are associated with reduced cardiovascular disease–associated mortality. Recently, we observed that acute ingestion of Brazil nuts was non-toxic and modulated favorably the lipid profile of healthy volunteers, increasing their serum levels of high-density lipoprotein cholesterol and lowering low-density lipoprotein cholesterol [6]. However, blood levels of inflammatory mediators in response to acute consumption of Brazil nuts in humans, has yet to be investigated. Here, we hypothesized that consumption of Brazil nuts would be associated with lower levels of inflammatory markers. Thus, the objective of the present study was to investigate the effect of a single dose of Brazil nuts on inflammatory markers in healthy volunteers. Table 3 Phenolics and flavonoids composition of Brazil nuts (Bertholletia excels) aqueous extracts Compounds Aqueous extract (mg/g) Gallic acid Catechin Resveratrol Ellagic acid Epicatechin Rutin Quercitrin Quercetin Kaempferol 0.35 0.92 1.37 1.74 0.84 0.60 0.64 1.31 0.67          0.1 0.2 0.1 0.2 0.5 0.1 0.4 0.1 0.3 Results are expressed as mean  S.D. of three determinations Materials and methods Study participants The study was a randomized crossover trial with 10 adult volunteers, ages 23 to 34 y. The mean age of the participants was 24.7  3.4 y and 60% were men. Each participant was tested four times after the administration of the different amounts of Brazil nuts: 0, 5, 20, and 50 g. Two Latin squares of 4  4 for the four tests were used to randomize participants into four orders of treatment. Before each treatment, the volunteers underwent a 30-d washout period, to ensure that the active compounds or ingredients in the nuts were completely eliminated [6]. We recommended a balanced diet with daily energy containing about 25 kcal/kg. Furthermore, we requested volunteers avoid the ingestion of foods containing high quantities of selenium (eggs, egg yolks, garlic, Brazil nuts, whole wheat cereal, viscera, shellfish, and fish). We applied 24-h dietary recall and food frequency questionnaires after the last blood sampling to verify the types of foods consumed during the study period [6]. The volunteers always reported not ingesting the restricted foods. This study has been reviewed and approved by the Universidade Federal de Santa Maria’s Internal Review Board (No. 0240.0.243.000-11) and informed consent was obtained from all participants. Body weight was measured to the nearest 0.01 kg using a digital scale, and height was measured to the nearest 0.1 cm using a wall-mounted stadiometer. The body mass index was calculated and the participants were classified according to World Health Organization guidelines [17]. According to the U.S. Department of Agriculture, Brazil nuts contain (per 100 g) 14.5 g of proteins, 15.1 g of carbohydrates, 63.7 g of total fats (15.3 g saturated fatty acids, 27.4 g MUFAs, 21 g polyunsaturated fatty acids [PUFAs]), as well as 7.9 g of dietary fibers, for a total of 2.690 kJ [18]. Corroborating earlier studies, Brazil nuts given to the participants contained 31.25  18.7 mg/g of selenium [6]. Fatty acid determination Brazil nuts The extraction of Brazil nut lipids was performed according to a previously described method [19], grinding a known amount of Brazil nuts in the presence Table 2 Fatty acids composition of the Brazil nut Fatty acid g/100 g C14:0 C16:0 C16:1 C17:0 C18:0 C18:1n9 C18:2n6 C20:0 C20:1n9 C18:3n3 0.07 16.74 0.43 0.14 9.97 28.52 36.04 0.17 0.09 0.11 Results are expressed as mean  SD of three determinations           0.03 1.06 0.09 0.15 1.42 1.99 2.26 0.05 0.02 0.03 Fig. 1. Representative high performance liquid chromatography profile of Bertholletia excelsa aqueous extract. Gallic acid (peak 1), catechin (peak 2), resveratrol (peak 3), ellagic acid (peak 4), epicatechin (peak 5), rutin (peak 6), quercitrin (peak 7), quercetin (peak 8), and kaempferol (peak 9). E. Colpo et al. / Nutrition 30 (2014) 459–465 Table 4 GPx erythrocytes activity of healthy volunteers after consumption of the Brazil nut GPx (nmol NADPHmLmin erythrocytes) Basal 1h 3h 6h 24 h 48 h 30 d 0 g Brazil nut 5 g Brazil nut 20 g Brazil nut 50 g Brazil nut 12.5 12.4 12.7 13.6 11.2 12.7 12.1 12.0 11.8 12.1 13.0 10.8 10.8 12.0 12.0 12.6 13.0 12.5 12.2 11.5 12.5 12.4 12.5 13.3 12.7 12.1 11.5 12.2  1.4  2.1  1.5  2.2  2.2  2.0 0.9        1.5 1.5 1.5 0.8 1.2 1.2 1.2        1.1 2.1 1.8 1.8 2.0 1.7 1.6        1.2 2.2 2.4 1.4 0.9 0.9 1.5 GPx, glutathione peroxidase Data are expressed as means  SD 461 kaempferol, quercetin, quercitrin, and rutin; and 0.025 to 0.250 mg/mL for rosmarinic acid, ellagic acid, gallic acid, catechin, and epicatechin. Chromatography peaks were confirmed by comparing its retention time with those of reference standards and by DAD spectra (200–600 nm). Calibration curve for gallic acid: Y ¼ 12574 x þ 1350.7 (r ¼ 0.9999); catechin: Y ¼ 12605 x þ 1367.5 (r ¼ 0.9998); epicatechin: Y ¼ 11948 x þ 1376.4 (r ¼ 0.9995); rosmarinic acid: Y ¼ 13728 x þ 1257.9 (r ¼ 0.9993); quercitrin: Y ¼ 12591 x þ 1205.9 (r ¼ 0.9997); ellagic acid: Y ¼ 13050 x þ 1284.1 (r ¼ 0.9993); rutin: Y ¼ 11983 x þ 1321.5 (r ¼ 0.9997); quercetin: Y ¼ 12667 x þ 1352.4 (r ¼ 0.9991) and kaempferol: Y ¼ 13085 x þ 1253.6 (r ¼ 0.9999). All chromatography operations were carried out at ambient temperature and in triplicate. The limit of detection (LOD) and limit of quantification (LOQ) were calculated based on the SD of the responses and the slope using three independent analytical curves. LOD and LOQ were calculated as 3.3 and 10 s/S, respectively, where s is the SD of the response and S is the slope of the calibration curve [23]. Selenium determination Brazil nuts of a methanol/chloroform (1: 2 v/v) mixture at 15 mL/g of fresh weight. The fatty acid methyl esters were obtained using a saponification and esterification procedure described previously [20] and analyzed by a gas chromatograph equipped with flame ionization detector. The results were expressed as concentration of each fatty acid per gram of lipid [21]. The levels of selenium in Brazil nuts were determined according to a modified version of a procedure previously described [24]. Samples of 0.5 g of the Brazil nuts were weighed and digested with 5.5 mL of HNO3 acid (65%) and heating at 100 C for 12 h. Digested samples were diluted 10 times with ultrapure water before analysis using a Multitype ICP Emission Spectrometer (ICPE-9000, Shimadzu). Chemicals, apparatus, and general procedures for quantification polyphenols Laboratory measurements All chemicals were of analytical grade. Methanol, acetic acid, gallic acid, rosmarinic acid and ellagic acid purchased from Merck (Darmstadt, Germany). Catechin, epicatechin, quercetin, quercitrin, rutin, and kaempferol were acquired from Sigma Chemical Co. (St. Louis, MO, USA). High-performance liquid chromatography diode array detector (HPLC-DAD) was performed with a Shimadzu Prominence Auto Sampler (SIL-20 A) HPLC system (Shimadzu, Kyoto, Japan), equipped with Shimadzu LC-20 AT reciprocating pumps connected to a DGU 20 A5 degasser with a CBM 20 A integrator, SPD-M20 A DAD and LC solution 1.22 SP1 software. Quantification of compounds by HPLC-DAD Reverse phase chromatographic analyses were carried out under gradient conditions using C18 column (4.6  150 mm) packed with 5 mm diameter particles; the mobile phase was water containing 2% acetic acid (A) and methanol (B), and the composition gradient was: 5% (B) for 2 min; 25% (B) until 10 min; 40%, 50%, 60%, 70%, and 80% (B) every 10 min; following the method described previously [22] with slight modifications. Bertholletia excelsa (aqueous extract) and mobile phase were filtered through 0.45 mm membrane filter (Millipore) and then degassed by ultrasonic bath before use, the fennel aqueous extract was analyzed at a concentration of 50 mg/mL. The flow rate was 0.6 mL/min, injection volume 50 ml and the wavelength were 254 for gallic acid, 280 for catechin and epicatechin, 325 nm for ellagic and rosmarinic acids, and 365 nm for quercetin, quercitrin, rutin, and kaempferol. All samples and mobile phase were filtered through 0.45 mm membrane filter (Millipore) and then degassed by ultrasonic bath before use. Stock solutions of standards references were prepared in the HPLC mobile phase at a concentration range of 0.030 to 0.400 mg/mL for Ten mL of venous blood samples were collected before and at 1, 3, 6, 9, 24, 48 h, and 5 and 30 d after the ingestion of the nuts. Except for the 6- and 9-h time points, all volunteers were at a 12-h fasting period for the collection of blood. Blood samples were collected by venous puncture technique into VacutainersÒ (BD Diagnostics, Plymouth, UK) tubes with EDTA plus sodium fluoride, sodium citrate, or no anticoagulants. Specimens were routinely centrifuged at 2500 g for 15 min at 4 C. Plasma (EDTA þ sodium fluoride) was used to measure the levels of fasting glucose and serum was used to access the levels of high-sensitivity C-reactive protein (hs-CRP), IL-1, IL-6, IL-10, tumor necrosis factor (TNF)-a, and interferon (IFN)-g. Hemoglobin levels and hematocrit were determined in a Cobas Micros system (Hematology Analyzer, Roche DiagnosticsÒ). Fasting glucose, aspartate and alanine aminotransferases, alkaline phosphatase, gamma-glutamyltransferase, urea, creatinine, albumin, total protein, and hs-CRP concentrations were measured with standard enzymatic methods by use of Ortho-Clinical DiagnosticsÒ reagents on the fully automated analyzer (Vitros 950Ò dry chemistry system; Johnson & Johnson, Rochester, NY, USA). Cytokines were quantified by enzyme-linked immunosorbent assay with commercial kits for human IL-1, IL-6, IL-10, TNF-a, and IFN-g, (eBIOSCIENCE, San Diego, CA, USA), according to manufacturer’s instructions. Serum and plasma samples were stored at 80 C for up to 4 wk before analyses. GPx Assay The analysis of plasma glutathione peroxidase (GSH-Px) (EC 1.11.1.9) activity was assayed as described previously [25]. In brief, erythrocytes (100 mL, diluted Fig. 2. Seric levels of IL-1 in healthy volunteers after consumption of Brazil nuts. (A) With basal. (B) Difference to the basal. Wilcoxon test. *P < 0.05 compared with basal. 462 E. Colpo et al. / Nutrition 30 (2014) 459–465 Fig. 3. Seric levels of IL-6 in healthy volunteers after consumption of Brazil nuts. (A) With basal. (B) Difference to the basal. Wilcoxon test. *P < 0.05 compared with basal. 1/100) were added to the assay mixture (total volume of 1000 mL) and the reaction started by the addition of H2O2 to give a final concentration of 0.4 mM. Conversion of NADPH (final concentration of 0.15 mM) to NADPþ was monitored continuously for 2 min at 340 nm. GSH-Px activity was expressed as micromole of NADPH oxidized per min/mL of plasma, using an extinction coefficient of 6.22  106 for NADPH. Statistical analysis Data are expressed as mean  SD. The statistical analysis was performed by analysis of variance and non-parametric test (Wilcoxon). Descriptive statistics was performed for all baseline characteristics. Differences were considered significant at P < 0.05. Results Anthropometric measurements and biochemical characteristics of the volunteers are listed in Table 1. The biochemical parameters of liver, kidney function, hemogram, and anthropometric measurements in healthy volunteers, were not modified by ingestion of nuts, indicating an absence of hepatic and renal toxicity in response to high intake of Brazil nuts. There was no change in hs-CRP levels after ingestion of Brazil nuts, as shown in Table 1. The estimated fat intake from nuts is shown in Table 2. The quantity of the polyphenolic constituents found in Brazil nuts is presented in Table 3. The average selenium concentration in Brazil nuts was 34.8  3.2 mg/g. HPLC fingerprinting of Brazil nuts aqueous extracts revealed the presence of the following polyphenolic constituents: Gallic acid (tR ¼ 10.05 min; peak 1), catechin (tR ¼ 14.97 min; peak 2), resveratrol (tR ¼ 24.85; peak 3), ellagic acid (tR ¼ 32.45 min; peak 4), epicatechin (tR ¼ 37.81 min; peak 5), rutin (tR ¼ 42.18 min; peak 6), quercitrin (tR ¼ 46.25 min; peak 7), quercetin (tR ¼ 48.61 min; peak 8), and kaempferol (tR ¼ 60.13 min; peak 9; Fig. 1). The erythrocytic glutathione peroxidase (Table 4) and DNA damage, measured by the comet assay (data not shown) in healthy volunteers was unaffected by ingestion of Brazil nuts. A single ingestion of Brazil nuts (20 or 50 g) caused a significant decrease in serum IL-1 levels, starting at 24 h, remaining stable for up to 30 d after the ingestion. The decrease in IL-1 caused by 5 g of nuts was less pronounced than that observed with 20 and 50 g (Fig. 2). Serum levels of IL-6 were markedly decreased in individuals who consumed 50 g of Brazil nuts from 24 h up to 30 d after consumption of nuts (P < 0.05; Fig. 3). In contrast, in the group that received 20 g of Brazil nuts, the decrease in IL-6 was apparent 5 and 30 d after ingestion (P < 0.05). Serum levels of TNF-a and IFN-g were decreased in individuals who consumed 20 or 50 g of Brazil nuts. This significant decrease was observed from 24 h up to 30 d after nut Fig. 4. Seric levels of TNF-a in healthy volunteers after consumption of Brazil nuts. (A) With basal. (B) Difference to the basal. Wilcoxon test. *P < 0.05 compared with basal. E. Colpo et al. / Nutrition 30 (2014) 459–465 463 Fig. 5. Seric levels of IFN-g in healthy volunteers after consumption of Brazil nuts. (A) With basal. (B) Difference to the basal. Wilcoxon test. *P < 0.05 compared with basal. consumption (P < 0.05; Figs. 4 and 5, respectively). Serum levels of IL-10 were significantly increased in individuals consuming 20 or 50 g of Brazil nuts from 9 h up to 30 d (Fig. 6; P < 0.05). d-Aminolevulinato dehydratase activity, a marker of oxidative stress was not modified by Brazil nut ingestion (data not shown). Discussion The results of our study with healthy volunteers indicated a long-term decrease in inflammatory markers after a single ingestion of high quantities of Brazil nuts. This positive effect may be related to the high amounts of selenium and unsaturated fatty acids and PUFAs present in Brazil nuts [4,16,26,27]. Several acute [28–30] and chronic [31,32] human clinical trials have demonstrated lower concentrations of circulating levels of proinflammatory cytokines or endothelial cell adhesion molecules in individuals consuming nuts or olive oil (Mediterranean diet) compared with those consuming other types of oils or fat sources. In agreement, the consumption of the Mediterranean diet has been associated with a reduction in inflammatory markers in blood [33–35]. It has been shown that the content of saturated fatty acids from Brazil nuts was about 20%, with higher concentrations of palmitic and stearic acids [6]. For MUFA, this value was about 30%, representing mostly oleic aciddu-9. The content of PUFAs was about 25%, representing mostly linoleic aciddu-6. Earlier data indicate that MUFA and PUFAs can exhibit antiinflammatory properties in different experimental models of inflammation [36]. The mechanisms by which dietary fatty acids inhibit cytokine production are unknown, but may be related to inhibition of the inflammatory cascade at the level of cyclooxygenase (COX) and lipoxygenase (LOX) [37]. Consequently, the beneficial effect of different types of nut consumption has been described in pathologic conditions, such as cardiovascular disease [2,6,16,27,32,38,39], dyslipidemia [6,31,40], diabetes mellitus [41], hypertension, [42] and other chronic diseases [1,26,43]. Moreover, moderate selenium supplementation has been shown to cause beneficial effects in immune function and a decrease in oxidative stress [11,16,33,44]. Modulation of oxidative stress (particularly a reduction of peroxide levels) can decrease inflammation [45]. Notably, fatty acid levels and selenium status are important modulators of the expression of GPx that may influence the levels of oxidative stress and fatty acid metabolism in the endothelium [46]. Human clinical trials have reported an increase in the antioxidant defense mechanism after tree nut consumption due to an increase in erythrocyte catalase activity and a decrease in reduced glutathione to oxidized glutathione ratio [47]. In the present study, the content of selenium in Brazil nuts may have contributed to the diminished inflammatory response, in the absence of modified of GPx activity. Fig. 6. Seric levels of IL-10 in healthy volunteers after consumption of Brazil nuts. (A) With basal. (B) Difference to the basal. Wilcoxon test. *P < 0.05 compared with basal. 464 E. Colpo et al. / Nutrition 30 (2014) 459–465 Various polyphenolic compounds have been identified in Brazil nuts [48]. In accordance with previous results here we demonstrated the presence of similar quantities of total polyphenolic contents in Brazil nuts. Additionally, we demonstrated here the presence of the following main components: resveratrol, ellagic acid, quercetin, catechin, epicatechin, kaempferol, quercitrin, and rutin. The phenolic compounds present in foods can have antioxidant and anti-inflammatory properties [49], and may be one of the active compounds responsible for the beneficial effects of Brazil nuts reported here. Furthermore, specific phenolic compounds can inhibit both COX and LOX pathways, thus decreasing the production of inflammatory metabolites [50]. In summary, a single consumption of 20 to 50 g of nuts decrease inflammatory markers in healthy individuals up to 30 d after ingestion. The results presented here raise the following questions: Is it better to ingest a single large portion of Brazil nuts intermittently? Or is it better to ingest small portions of Brazil nuts daily or chronically? Furthermore, we propose that long-term effects of regular or intermittent consumption of Brazil nuts on the course of dyslipidemia should be further investigated. Acknowledgments This work was financed by grants received from the National Counsel of Technological and Scientific Development (CNPq). On behalf of all authors, the corresponding author states that there is no conflict of interest. We would like to thank Dr. Michael Aschner who advised us on the correction of English language. 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