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Almond/Almond Oil

Scientific Name(s): Prunus dulcis (P. Mill) D.A. Webb
Common Name(s): Almond milk, Almond oil, Amygdale amara, Amygdalin, Bitermandel, Bitter almond, Ku wei bian tao, Laetrile, Oil of almonds, Sweet almond, Vitamin B17, Volatile almond oil

Clinical Overview


Almonds are used as a dietary source of protein, unsaturated fats, minerals, micronutrients, phytochemicals, alpha-tocopheral, and fiber, as well as in confectioneries. The efficacy of almonds in altering the lipid profile is weakly supported by the literature; larger, more robust clinical trials of longer duration are required. The almond derivative laetrile/amygdalin has been used as an alternative cancer treatment, but there is no clinical evidence to support this use. Laetrile is banned by the US Food and Drug Administration (FDA) and in Europe for use in cancer therapy.


Trials of almond dietary supplementation in adults have used 25 to 168 g of almonds per day. The American Heart Association (AHA) recommends the daily intake of nuts (28.35 to 56.7 g) as part of a healthy diet. There is no widely accepted standard for laetrile/amygdalin dosing due to the potential for toxicity and no evidence for efficacy.


Allergy to almonds or its products.


Consumption of bitter almond or laetrile is not recommended in pregnant or breast-feeding women because of insufficient data and a theoretical risk of birth defects. Consumption of sweet almond has generally recognized as safe (GRAS) status when used as food. Avoid dosages above those found in food because safety is unproven.


None well documented.

Adverse Reactions

Adverse reactions similar to those of cyanide poisoning have been reported.


Cyanide poisoning and death have resulted from laetrile and bitter almond consumption.


The almond, apricot, cherry, peach, and plum are members of the Rosaceae (rose) family. The almond is distinct because its seed is edible, while the outer pulp is hard, inedible, and juiceless. The genus Prunus (plum), to which the almond tree belongs, is synonymous with Amygdalus in the US Department of Agriculture's PLANTS database, but the literature remains confusing and often categorizes the sweet and bitter almond in different genera. Synonyms are Amygdalus communis L., Amygdalus dulcis P. Mill, Prunus amygdalus Batsch, Prunus communis (L.) Arcang., and Prunus dulcis (Mill.) D.A. Webb var. amara (DC.) Buchheim.1

The plant, a moderate-sized tree, was probably introduced to the United States from Eastern Europe or western Asia. The United States, especially California, is the world's major producer of almonds.2 Many varieties of the plant differ in flower color and form, as well as in the size of the fruit or shell. Plants with entirely pink flowers produce sweet almonds; those with flowers that are almost white at the tip of the petals and are red/pink at the base produce bitter almonds. When fully ripe, the green outer covering of the fruit dries and splits and the almond shell (endocarp) drops out. The almond seed is rounded at one end and pointed at the other, with a yellow, fibrous outer covering.1


References to the almond are found in Greek mythology, the Bible, and in Shakespeare's writings. In the Middle Ages, almonds already were commercially important.3

Amygdalin was isolated by French chemists in 1830, and reports of its use as an anticancer agent date back to 1845 in Russia. In the United States, records show laetrile was used as a cancer treatment in the 1920s and was patented in the 1950s as a supposedly nontoxic form of amygdalin.4

The FDA has banned the sale of laetrile as a medicinal product; however, it remains available and its use is promoted in Mexico where it often is produced.4 Sweet almond is historically described as Mistura Amygdalae, Pulvis Amygdalae Compositus, and Almond Oil in the British Herbal Pharmacopoeia.


Almond nuts have a unique fatty acid profile, largely composed of unsaturated fats, some saturated fats, and no cholesterol. In addition to the protein and carbohydrate content, almonds contain large amounts of alpha-tocopherol and arginine, as well as magnesium, potassium, and sodium. Almonds are rich in phytosterols, including beta-sitosterol, stigmasterol, and campesterol.5 The skin of the almond nut accounts for 4% of the total nut weight and is rich in polyphenols, including hydroxybenzoic acids and aldehydes, flavonol and flavanone aglycones, and glycosides.6 Other chemical compounds in the almond include betulinic, oleanic, and ursolic acids. Other acids (corosolic and maslinic) have been identified as aldehydes. Antioxidant flavonoids quercetin, isorhamnetin, quercitrin, kaempferol, and morin have been isolated. Prunasin, a cyanogenic compound, is found only in the vegetative parts of the almond plant.7, 8, 9, 10, 11, 12

Amygdalin exists in the seeds of apricots, cherries, and plums.13 Amygdalin is hydrolyzed to yield glucose, benzaldehyde, and hydrocyanic acid. The production of cyanide defines cyanogenic glycosides. Enzymatic release of cyanide can occur in the presence of beta-glucuronidase, an enzyme found in the seeds and in the human intestine.13 When the cyanide component is removed, the resulting oil is referred to as "bitter almond oil" and consists mostly of benzaldehyde. This oil is toxic when consumed in large amounts.

The term "laetrile" is often used interchangeably with amygdalin, but they are not the same chemical entity. The word was coined from laevorotatory and mandelonitrile and is used to describe a semisynthetic derivative of amygdalin. Most laetrile from Mexico is made from crushed apricot seeds and is a mixture of amygdalin and neoamygdalin, which are mandelonitrile gentiobiosides. Other laetrile products of varying composition are commercially available.14

Uses and Pharmacology


Despite promising in vitro experiments, the use of amygdalin as a cancer treatment has not been validated by any clinical trials. The National Cancer Institute sponsored phase 1 and 2 clinical trials in the 1980s but found no evidence to support the use of laetrile in the treatment of cancer.4 Because a Cochrane review found no clinical trials that met adequate methodological quality, a meta-analysis could not be conducted.14 A further review evaluated all published clinical trial data and found no basis for the health claims of laetrile use in cancer.15 Laetrile has been banned in the United States and Europe for use in cancer therapy; however, interest continues and products are sold via the Internet.14, 15, 16


Animal data

The widespread consumption of nuts as part of a healthy diet and the availability of clinical data make data from animal studies largely irrelevant.

Clinical data

Based on observations of epidemiological data and findings from intervention studies, the AHA recommends the daily intake of nuts (28.35 to 56.7 g) as part of a healthy diet. The FDA allows a qualified claim that eating 42.52 g/day of most nuts as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.5, 17, 18

Specific trials evaluating the efficacy of almonds in reducing cardiovascular risk factors, including reducing hyperlipidemia, are generally lacking and limited methodologically by lack of randomization, small numbers of participants, absence of controls, short washout periods, or short duration.5, 19 A review of available trial data and a meta-analysis of 5 clinical trials found a decrease in total cholesterol with daily consumption of almonds. Trials included in the meta-analysis used a range of 25 to 168 g of almonds per day.5, 19

Almonds, rich in phytosterols, fiber, and alpha-tocopherol, may act via various mechanisms to reduce cholesterol absorption and increase elimination, as well as via interaction at the cellular level with enzymes such as HMG-CoA reductase.5 Increased fiber intake, decreased oxidative stress, decreased lipid peroxidation, and increased serum tocopherol may offer explanation for the observed cardiovascular benefits of almond consumption. Changes in the lipid profile have been demonstrated in some but not all clinical studies.5, 17, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 The reductions in total cholesterol observed in clinical trials due to almond consumption are modest in comparison with the relatively larger benefit observed in cohort studies for risk reduction of cardiovascular disease; other mechanisms may be responsible for the effect.32


Animal data

The widespread consumption of nuts as part of a healthy diet makes data from animal studies largely irrelevant.

Clinical data

Limited studies have been conducted in healthy volunteers and patients with type 2 diabetes with equivocal results. Effects on glycemic index, fasting insulin and glucose, insulin resistance, and 24-hour urinary C-peptide output are unclear.27, 32, 33, 34, 35

Body weight

Animal data

The widespread consumption of nuts as part of a healthy diet makes data from animal studies largely irrelevant.

Clinical data

Most studies find no increase in body weight associated with increased consumption of almonds22, 31, 36 and epidemiological studies suggest an inverse association may exist between frequency of nut consumption and body mass index.37

Other uses

A study evaluated the effect of dietary almonds on markers of inflammation, finding decreases in C-reactive protein but no effect on interleukin or fibrinogen. No dose response was found.38

Assessment of data from 6,705 participants without baseline atrial fibrillation in the PREDIMED trial revealed a significant relevant reduction in risk of atrial fibrillation (38%) with the Mediterranean diet supplemented with extravirgin olive oil (50 g/day or more) but not with the Mediterranean diet supplemented with nuts (almonds, hazelnuts, walnuts).44

Almond oil has been used with phenol to treat rectal prolapse in infants39 and either alone or as a carrier of other essential oils in massage therapy.


Trials of almond dietary supplementation in adults have used 25 to 168 g of almonds per day.5, 19

The AHA recommends the daily intake of nuts (28.35 to 56.7 g) as part of a healthy diet.17

Almonds are considered a good source of tocopherol to meet the recommended daily allowance for vitamin E, now increased to 15 mg/day.24

There is no widely accepted standard for laetrile/amygdalin dosing due to the potential for toxicity and no evidence for efficacy.4, 14, 15

Pregnancy / Lactation

Consumption of bitter almond or laetrile is not recommended in pregnant or breast-feeding women because of insufficient data and a theoretical risk of birth defects.

Cyanide has not been reported as a direct cause of birth defects in humans. Birth defects, harmful effects on the reproductive system, and skeletal abnormalities have been reported in mice fed water containing sodium cyanide and in hamsters given oral laetrile.40

Children born to mothers exposed to cyanide and thiocyanate during pregnancy have exhibited thyroid disease.40


Coadministration of high-dose vitamin C and almonds may result in symptoms of cyanide toxicity.4

Adverse Reactions

Allergies to nuts are common, affecting an estimated 0.5% of the US population.2, 41 Adverse reactions similar to those of cyanide poisoning have been reported.4 The protein component is primarily composed of amadin, which confers the antigenicity of the nut in IgE-mediated allergy.2

Almond-based diets are possibly deficient in selenium, riboflavin, and pantothenic and folic acids.42 Published case reports have shown that infants fed almond milk exhibited hypoalbuminemia and consequent peripheral edema, as well as deficiencies in calcium and iron.43


Cyanide poisoning and death have resulted from laetrile and bitter almond consumption.13 A minimum lethal dose of cyanide is estimated at 50 mg (or 0.5 mg/kg body weight).13 Oral amygdalin/laetrile is considered 40 times more toxic than the intravenous form because of its conversion to hydrogen cyanide by enzymes in the intestine.4, 13 Symptoms of cyanide poisoning (eg, coma, cyanosis, dizziness, headache, hypotension, nausea, neuropathy, ptosis, vomiting) may be potentiated by eating foods containing beta-glucosidase (eg, bean sprouts, carrots, celery, peaches) or by taking high doses of vitamin C.4


1. Prunas dulcis (Mill.) D.A. Webb. USDA, NRCS. 2012. The PLANTS Database (, 8 March 2012). National Plant Data Team, Greensboro, NC 27401-4901 USA. Accessed March 8, 2012.
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3. Almonds. In: Grieve M. A Modern Herbal. 1931. Accessed March 8, 2012.
4. National Cancer Institute. U.S. National Institutes of Health. Laetrile/Amygdalin (PDQ). Health Professional Version. Accessed March 8, 2012.
5. Berryman CE, Preston AG, Karmally W, Deckelbaum RJ, Kris-Etherton PM. Effects of almond consumption on the reduction of LDL-cholesterol: a discussion of potential mechanisms and future research directions. Nutr Rev. 2011;69(4):171-185.21457263
6. Bartolomé B, Monagas M, Garrido I, et al. Almond (Prunus dulcis (Mill.) D.A. Webb) polyphenols: from chemical characterization to targeted analysis of phenolic metabolites in humans. Arch Biochem Biophys. 2010;501(1):124-133.20361924
7. Amico V, Barresi V, Condorelli D, Spatafora C, Tringali C. Antiproliferative terpenoids from almond hulls (Prunus dulcis): identification and structure-activity relationships. J Agric Food Chem. 2006;54(3):810-814.16448187
8. Frison S, Sporns P. Variation in the flavonol glycoside composition of almond seedcoats as determined by maldi-tof mass spectrometry. J Agric Food Chem. 2002;50(23):6818-6822.12405781
9. Wijeratne SS, Abou-Zaid MM, Shahidi F. Antioxidant polyphenols in almond and its coproducts. J Agric Food Chem. 2006;54(2):312-318.16417285
10. Takeoka GR, Dao LT. Antioxidant constituents of almond [Prunus dulcis (Mill.) D.A. Webb] hulls. J Agric Food Chem. 2003;51(2):496-501.12517116
11. Sang S, Lapsley K, Rosen RT, Ho CT. New prenylated benzoic acid and other constituents from almond hulls (Prunus amygdalus Batsch). J Agric Food Chem. 2002;50(3):607-609.11804537
12. Dicenta F, Martínez-Gómez P, Grané N, et al. Relationship between cyanogenic compounds in kernels, leaves, and roots of sweet and bitter kernelled almonds. J Agric Food Chem. 2002;50(7):2149-2152.11902971
13. Shragg TA, Albertson TE, Fisher CJ Jr. Cyanide poisoning after bitter almond ingestion. West J Med. 1982;136(1):65-69.7072244
14. Milazzo S, Ernst E, Lejeune S, Schmidt K. Laetrile treatment for cancer. Cochrane Database Syst Rev. 2006;(2):CD005476.16625640
15. Milazzo S, Lejeune S, Ernst E. Laetrile for cancer: a systematic review of the clinical evidence. Support Care Cancer. 2007;15(6):583-95.17106659
16. Meijer E. Sale over the Internet of substances for human consumption which are regarded as harmful in America. OJ (Official Journal of the European Communities). 2001;(2001/C 151 E/071).
17. Torabian S, Haddad E, Rajaram S, Banta J, Sabaté J. Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation. J Hum Nutr Diet. 2009;22(1):64-71.19192028
18. US Food and Drug Administration. Qualified Health Claims: Letter of Enforcement Discretion - Nuts and Coronary Heart Disease (Docket No 02P-0505). Rockville, MD: US FDA. 2003:1-4.
19. Phung OJ, Makanji SS, White CM, Coleman CI. Almonds have a neutral effect on serum lipid profiles: a meta-analysis of randomized trials. J Am Diet Assoc. 2009;109(5):865-873.19394473
20. Spiller GA, Miller A, Olivera K, et al. Effects of plant-based diets high in raw or roasted almonds, or roasted almond butter on serum lipoproteins in humans. J Am Coll Nutr. 2003;22(3):195-200.12805245
21. Jenkins DJ, Kendall CW, Marchie A, et al. Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation. 2002;106(11):1327-1332.12221048
22. Fraser GE, Bennett HW, Jaceldo KB, Sabaté J. Effect on body weight of a free 76 Kilojoule (320 calorie) daily supplement of almonds for six months. J Am Coll Nutr. 2002;21(3):275-283.12074256
23. Hyson DA, Schneeman BO, Davis PA. Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women. J Nutr. 2002;132(4):703-707.11925464
24. Jambazian PR, Haddad E, Rajaram S, Tanzman J, Sabaté J. Almonds in the diet simultaneously improve plasma alpha-tocopherol concentrations and reduce plasma lipids. J Am Diet Assoc. 2005;105(3):449-454.15746835
25. Damasceno NR, Pérez-Heras A, Serra M, et al. Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers. Nutr Metab Cardiovasc Dis. 2011;21(suppl 1):S14-S20.21421296
26. Li N, Jia X, Chen CY, et al. Almond consumption reduces oxidative DNA damage and lipid peroxidation in male smokers. J Nutr. 2007;137(12):2717-2722.18029489
27. Li SC, Liu YH, Liu JF, Chang WH, Chen CM, Chen CY. Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism. 2011;60(4):474-479.20580779
28. Jenkins DJ, Kendall CW, Marchie A, et al. Almonds reduce biomarkers of lipid peroxidation in older hyperlipidemic subjects. J Nutr. 2008;138(5):908-913.18424600
29. Jalali-Khanabadi BA, Mozaffari-Khosravi H, Parsaeyan N. Effects of almond dietary supplementation on coronary heart disease lipid risk factors and serum lipid oxidation parameters in men with mild hyperlipidemia. J Altern Complement Med. 2010;16(12):1279-1283.21114415
30. Kalgaonkar S, Almario RU, Gurusinghe D, et al. Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. Eur J Clin Nutr. 2011;65(3):386-393.21157477
31. Zaveri S, Drummond S. The effect of including a conventional snack (cereal bar) and a nonconventional snack (almonds) on hunger, eating frequency, dietary intake and body weight. J Hum Nutr Diet. 2009;22(5):461-468.19743983
32. Jenkins DJ, Kendall CW, Marchie A, et al. Effect of almonds on insulin secretion and insulin resistance in nondiabetic hyperlipidemic subjects: a randomized controlled crossover trial. Metabolism. 2008;57(7):882-887.18555827
33. Lovejoy JC, Most MM, Lefevre M, Greenway FL, Rood JC. Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. Am J Clin Nutr. 2002;76(5):1000-1006.12399271
34. Josse AR, Kendall CW, Augustin LS, Ellis PR, Jenkins DJ. Almonds and postprandial glycemia--a dose-response study. Metabolism. 2007;56(3):400-404.17292730
35. Cohen AE, Johnston CS. Almond ingestion at mealtime reduces postprandial glycemia and chronic ingestion reduces hemoglobin A(1c) in individuals with well-controlled type 2 diabetes mellitus. Metabolism. 2011;60(9):1312-1317.21489570
36. Hollis J, Mattes R. Effect of chronic consumption of almonds on body weight in healthy humans. Br J Nutr. 2007;98(3):651-656.17445351
37. Cassady BA, Hollis JH, Fulford AD, Considine RV, Mattes RD. Mastication of almonds: effects of lipid bioaccessibility, appetite, and hormone response. Am J Clin Nutr. 2009;89(3):794-800.19144727
38. Rajaram S, Connell KM, Sabaté J. Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. Br J Nutr. 2010;103(6):907-912.19874636
39. Sasaki Y, Iwai N, Kimura O, Hibi M. The treatment of rectal prolapse in children with phenol in almond oil injection. Eur J Pediatr Surg. 2004;14(6):414-417.15630644
40. Agency for Toxic Substances and Disease Registry (ATSDR). Division of Toxicology and Environmental Medicine TOXFAQs. Cyanide. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. July 2006. Accessed March 8, 2012.
41. Roux KH, Teuber SS, Robotham JM, Sathe SK. Detection and stability of the major almond allergen in foods. J Agric Food Chem. 2001;49(5):2131-2136.11368566
42. Jaceldo-Siegl K, Sabaté J, Rajaram S, Fraser GE. Long-term almond supplementation without advice on food replacement induces favourable nutrient modifications to the habitual diets of free-living individuals. Br J Nutr. 2004;92(3):533-540.15469659
43. Doron D, Hershkop K, Granot E. Nutritional deficits resulting from an almond-based infant diet. Clin Nutr. 2001;20(3):259-261.11407873
44. Martinez-Gonzalez MA, Toledo E, Aros F, et al. Extravirgin olive oil consumption reduces risk of atrial fibrillation – the PREDIMED (prevencion con dieta mediterranea) trial. Circulation. 2014;130:18-26.24787471


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