Effects of Nut Intake on Gut Microbiome Composition and Gut Function in Adults: A Systematic Review and Meta-analysis

Abstract

The reduced risk of chronic diseases such as cardiovascular disease and type 2 diabetes associated with nut consumption may occur via modulation of the gut microbiota, although this has not been comprehensively assessed. This systematic review of clinical trials aimed to assess the effects of nuts on gut microbiota composition and metabolites, as well as their effects on gut function and symptoms in adults. The systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD42023451282). Outcomes included microbiota diversity, specific bacterial abundances, gastrointestinal symptoms, intestinal permeability, fecal pH, fecal moisture, and short-chain fatty acid (SCFA) concentrations. We performed meta-analyses to assess the overall effect of nuts on fecal moisture, pH, intestinal permeability, and SCFA concentrations. Among the 28 intervention trials included in this review, almonds were the most commonly studied (12 trials), whereas other nuts, such as walnuts, peanuts, pistachios, and Brazil nuts, were also examined. Nineteen articles reported the effects of almond, walnut, peanut, or mixed nuts on the microbiota composition. Additionally, 6 trials used interventions involving a mixture of different nuts. A total of 19 trials assessed the community structure of the gut microbiota by evaluating α-diversity and β-diversity metrics, with most finding no significant differences following the nut intervention. Regarding taxonomic changes, the majority of studies reported no significant changes across nut interventions. However, several studies noted increases in Clostridium and Roseburia species, with mixed results for Bifidobacterium species abundance following almond or walnut intervention. Five studies assessed fecal SCFA concentrations, with positive effects of nut interventions on propionate. There were no effects of nut interventions on fecal pH and intestinal permeability, with an unfavorable effect on fecal moisture. In summary, the available evidence indicates that nuts have modest effect on gut health, but the substantial heterogeneity between studies may hinder further conclusions. This trial was registered at PROSPERO as CRD42023451282.