Almond Consumption Improves Inflammatory Profiles Independent of Weight Change: A 6-Week Randomized Controlled Trial in Adults with Obesity

Background Obesity is characterized by chronic low-grade systemic inflammation which can contribute to metabolic dysfunction. Diet is a modifiable factor that can help reduce this inflammation. Nuts such as almonds are rich in unsaturated fats, and antioxidant and anti-inflammatory micronutrients, which may work synergistically to attenuate obesity-related inflammation. Objective To investigate whether daily almond consumption improves systemic inflammatory and immune markers in adults with obesity. Methods In this randomized controlled parallel-arm trial, 69 adults (age: 30-45 years) with obesity (BMI: 30-45 kg/m 2 ) were assigned to consume either 58 g/day of almonds (n = 30) or an isocaloric ultra-processed snack (cookie; n = 30) for six weeks. Fasting serum pro-inflammatory cytokines (IL-6, TNF-α, IFN-γ), anti-inflammatory IL-10, innate immune cell counts, body weight, glucose, insulin, and lipid profile were measured at baseline and week six. Dietary intake, food compliance, palatability, acceptance, and appetite ratings were also assessed. Statistical analyses for primary outcomes included mixed model analyses and baseline-adjusted linear models. Results Food compliance was high for both groups with greater acceptance for almonds. Almond consumption significantly decreased serum IL-6, TNF-α, and IFN-γ and increased IL-10 over 6 weeks compared with the cookie group (P < 0.05). No significant group differences were observed for innate immune cell counts, body weight, blood pressure, or serum fasting glucose, insulin, total cholesterol (C), LDL-C, and triglycerides over six weeks. Almond intake also increased monounsaturated fat, fiber, alpha-tocopherol, magnesium, zinc, manganese, and improved HEI, MED, and DASH dietary pattern scores (P<0.05). Conclusion Daily almond consumption for six weeks improved inflammatory cytokine profiles and diet quality in adults with obesity, without changes in body weight under free-living conditions. These findings support almonds as part of healthy dietary patterns to help attenuate obesity-related inflammation. Clinical Trial Registry number ClinicalTrials.gov ID: NCT05530499 Support JD received research support from the Almond Board of California.