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Objective  Thyroid hormones can lower levels of atherogenic lipoproteins, and selenium is important in thyroid hormone homeostasis. We aimed to investigate the effects of a healthy diet associated with the Brazil nut ( Bertholletia excelsa ) in dyslipidemic and hypertensive patients.    Methods  This study was a randomized, placebo-controlled, double-blind trial. Seventy-seven dyslipidemic and hypertensive patients already receiving lipid-lowering drugs received either a dietary treatment associated with partially defatted Brazil nut flour (13 g/day providing 227,5 μg of selenium/day),or with dyed cassava flour as a placebo. All patients received a personalized dietary guideline with nutritional recommendations for dyslipidemia and hypertension and were followed for 90 days.    Results  The Brazil nut group showed reductions in total cholesterol (−20.5 ± 61.2 mg/dL,  P  = 0.02), non HDL-cholesterol (−19.5 ± 61.2 mg/dL,  P  = 0.02) and Apo A-1 (−10.2 ± 26.7 mg/dL,  P  = 0.03) without significant alterations in the Apo B/Apo A-1 ratio. The placebo group showed a reduction in FT 3  levels (−0.1 ± 0.4,  P  = 0.03) and increased Lp(a) levels (5.9 ± 18.0 mg/dL,  P  = 0.02). There were no statistical differences in blood pressure and serum lipids between Brazil nut and placebo group.    Conclusions  Supplementation with Brazil nuts seems to favor the maintenance of FT 3  levels and contributes to lipemia reduction in hypercholesterolemic and euthyroid patients.Trial registration  ClinicalTrials.gov Identifier  NCT01990391

Intake of partially defatted Brazil nut flour reduces serum cholesterol in hypercholesterolemic patients- a randomized controlled trial