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Still Nuts About Nuts?

June 30, 2014 Written by JP    [Font too small?]

A reader asks: You’ve written a lot of blogs about nuts and how healthy you believe they are. I’m not convinced though, because you also frequently mention the importance of keeping an eye on one’s omega-6 to omega-3 ratio. My understanding is that most nuts are top heavy in omega-6 fatty acids and mostly devoid of omega-3s. These two recommendations seem to be at odds. Am I missing something? Bottom line, what’s your current stance on eating nuts and how it relates to the whole omega 6/3 ratio issue?

Great question! You’re quite right. Most nuts are significantly higher in omega-6 fatty acids than omega-3 fats. However, you have to look at nuts and seeds as a whole food rather than just a vehicle for essential fatty acids. Nuts and seeds also contain insoluble and soluble fiber, minerals, phytochemicals and protein which are often sorely lacking. Having said that, a considerable amount of scientific evidence points to an imbalance in the omega-6:omega-3 ratio in the modern diet. Part of the reason is a dramatic increase in the intake of grain-fed dairy and meat, packaged foods and vegetable oils. In my opinion, restricting nuts and seeds isn’t the best way to correct this 21st century, dietary faux pas. Instead, limiting refined foods, select vegetable oils (corn, soybean and sunflower) and emphasizing cold water fish (wild black cod, salmon and sardines), grass-fed and/or organic dairy and meat, and omega-3 eggs is a much better way to go. Throwing in some organic chia, flax and hemp seeds where possible will likewise shift the aforementioned, fatty acid ratio to a more optimal spot.

Ultimately, the true test of the health effects of nuts is how they affect real people in real life situations. In order to asses this, it’s vital to look at controlled, scientific studies that investigate this very topic. And, according to the latest batch of studies, nuts come up looking quite fine indeed. For instance, recent trials report that almond consumption enhances exercise performance better than carbohydrate-rich snacks and also improves vascular function. Brazil nuts, which should only be eaten in moderation due to their high-selenium content, decrease oxidative stress and various inflammatory markers (IL-1, IL-6, IFN-y and TNF-a) in healthy adults and those with kidney disease. Pistachios lower post-meal blood sugar spikes, reduce various risk markers associated with metabolic syndrome (high LDL or “bad” cholesterol, systemic inflammation or C-reactive protein and waist circumference) and support the growth of healthy bacteria in the gut via recently discovered prebiotic activity. Lastly, walnuts bolster serum levels of potent antioxidants (catechins and alpha tocopherol or Vitamin E) while lowering cardiovascular threats including, elevated apolipoprotein B and triglycerides. These are some of the reasons why I’m still a believer in the power of nuts!

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Effect of Almond Consumption on Elements of Endurance Exercise (link)

Study 2 – An Almond-Enriched Diet Increases Plasma a-Tocopherol and Improves (link)

Study 3 – Effects of Pistachio Nuts on Body Composition, Metabolic, Inflammatory(link)

Study 4 – Walnut-Enriched Diet Reduces Fasting Non-HDL-Cholesterol and (link)

Study 5 – Effects of Supplementing n-3 Fatty Acid Enriched Eggs and Walnuts on (link)

Study 6 – Effect of a Walnut Meal on Postprandial Oxidative Stress & Antioxidants (link)

Study 7 – Effects of Almond and Pistachio Consumption on Gut Microbiota (link)

Study 8 – Quantification and Bioaccessibility of California Pistachio Bioactives (link)

Study 9 – Brazilian Nut Consumption by Healthy Volunteers Improves (link)

Study 10 – Brazil Nut (Bertholletia Excelsa, H.B.K.) Improves Oxidative Stress and (link)

Almonds Improve Endurance Performance in Cyclists

Source: J Int Soc Sports Nutr. 2014 May 11;11:18. (link)


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Posted in Food and Drink, Heart Health, Nutrition

12 Comments & Updates to “Still Nuts About Nuts?”

  1. JP Says:

    More good news …

    http://www.soc-bdr.org/content/rds/archive/11/2_summer/original_data/pistachio_nut_in_diabetes/index_en.html

    Rev Diabet Stud. 2014 Summer;11(2):190-6.

    Effects of pistachio nut supplementation on blood glucose in patients with type 2 diabetes: a randomized crossover trial.

    BACKGROUND:

    Diabetes is a chronic, potentially debilitating, and often fatal disease. Dietary strategies to reduce postprandial glycemia are important in the prevention and treatment of diabetes. Nuts are rich in mono- and polyunsaturated fatty acids, which may reduce hyperglycemia and improve metabolism.

    OBJECTIVES:

    To evaluate the effectiveness of pistachio nut supplementation on glycemic and inflammatory measures in patients with type 2 diabetes.

    METHODS:

    In this double-blind, randomized, placebo-controlled, crossover trial, 48 diabetic patients were equally assigned to groups A and B. Patients in group A received a snack of 25 g pistachio nuts twice a day for 12 weeks and group B received a control meal without nuts. After 12 weeks of intervention, the patients had an 8-week washout. Then the groups were displaced, and group B received the same amount of pistachios for 12 weeks.

    RESULTS:

    With respect to the total change in variables over both phases, there was a marked decrease in HbA1c (-0.4%) and fasting blood glucose (FBG) concentrations (-16 mg/dl) in the pistachio group compared with the control group (p ≤ 0.001 for both). There was no overall significant change in BMI, blood pressure, HOMA-IR, and C-reactive protein (CRP) concentrations. Analysis of the two phases separately showed a decrease in FBG by 14 mg/dl and in HbA1c by 0.45% in the treatment group (A) after 12 weeks, while no significant differences were seen in group B (control group). In the second phase, FBG decreased from 151.36 ± 39.22 to 137.28 ± 28.65 mg/dl (-14 mg/dl) and HbA1c decreased from 7.42 ± 0.97 to 7.15 ± 0.68 mg/dl (-0.28%, p = 0.013 and p = 0.033, respectively) in the pistachio group (B). Pistachio consumption reduced systolic blood pressure (p = 0.007), BMI (p = 0.011), and CRP (p = 0.002) in patients from the treatment groups, but not insulin resistance.

    CONCLUSIONS:

    Dietary consumption of pistachio nuts as a snack has beneficial effects on glycemic control, blood pressure, obesity, and inflammation markers in diabetic patients.

    Be well!

    JP

  2. JP Says:

    Update: Nuts & peanuts may lower all-cause mortality …

    http://archinte.jamanetwork.com/article.aspx?articleid=2173094

    Prospective Evaluation of the Association of Nut/Peanut Consumption With Total and Cause-Specific Mortality

    Importance: High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status.

    Objective: To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China.

    Design, Setting, and Participants: Three large cohorts were evaluated in the study. One included 71 764 US residents of African and European descent, primarily of low SES, who were participants in the Southern Community Cohort Study (SCCS) in the southeastern United States (March 2002 to September 2009), and the other 2 cohorts included 134 265 participants in the Shanghai Women’s Health Study (SWHS) (December 1996 to May 2000) and the Shanghai Men’s Health Study (SMHS) (January 2002 to September 2006) in Shanghai, China. Self-reported nut consumption in the SCCS (approximately 50% were peanuts) and peanut-only consumption in the SMHS/SWHS were assessed using validated food frequency questionnaires.

    Main Outcomes and Measures: Deaths were ascertained through linkage with the National Death Index and Social Security Administration mortality files in the SCCS and annual linkage with the Shanghai Vital Statistics Registry and by biennial home visits in the SWHS/SMHS. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs.

    Results: With a median follow-up of 5.4 years in the SCCS, 6.5 years in the SMHS, and 12.2 years in the SWHS, 14 440 deaths were identified. More than half of the women in the SCCS were ever smokers compared with only 2.8% in the SWHS. The ever-smoking rate for men was 77.1% in the SCCS and 69.6% in the SMHS. Nut intake was inversely associated with risk of total mortality in all 3 cohorts (all P < .001 for trend), with adjusted HRs associated with the highest vs lowest quintiles of intake being 0.79 (95% CI, 0.73-0.86) and 0.83 (95% CI, 0.77-0.88), respectively, for the US and Shanghai cohorts. This inverse association was predominantly driven by cardiovascular disease mortality (P < .05 for trend in the US cohort; P < .001 for trend in the Shanghai cohorts). When specific types of cardiovascular disease were examined, a significant inverse association was consistently seen for ischemic heart disease in all ethnic groups (HR, 0.62; 95% CI, 0.45-0.85 in blacks; HR, 0.60; 95% CI, 0.39-0.92 in whites; and HR, 0.70; 95% CI, 0.54-0.89 in Asians for the highest vs lowest quintile of nut intake). The associations for ischemic stroke (HR, 0.77; 95% CI, 0.60-1.00 for the highest vs lowest quintile of nut intake) and hemorrhagic stroke (HR, 0.77; 95% CI, 0.60-0.99 for the highest vs lowest quintile of nut intake) were significant only in Asians. The nut-mortality association was similar for men and women and for blacks, whites, and Asians and was not modified by the presence of metabolic conditions at study enrollment. Conclusions and Relevance: Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health. Be well! JP

  3. JP Says:

    Update 06/04/15:

    http://www.nutritionj.com/content/pdf/s12937-015-0043-y.pdf

    Nutrition Journal 2015, 14:54

    Improvement of antioxidant status after Brazil nut intake in hypertensive and dyslipidemic subjects

    Objectives: To investigate the effect of partially defatted Granulated Brazil nut (GBN) on biomarkers of oxidative stress and antioxidant status of hypertensive and dyslipidemic patients on nutrition and drug approaches.

    Methods: Ninety one hypertensive and dyslipidemic subjects of both genders (51.6 % men), mean age 62.1 ± 9.3 years, performed a randomized crossover trial, double-blind, placebo controlled. Subjects received a diet and partially defatted GBN 13 g per day (≈227.5 μg/day of selenium) or placebo for twelve weeks with four-week washout interval. Anthropometric, laboratory and clinic characteristics were investigated at baseline. Plasma selenium (Se), plasma glutathione peroxidase (GPx3) activity, total antioxidant capacity (TAC), 8-epi PGF2α and oxidized LDL were evaluated at the beginning and in the end of each intervention.

    Results: GBN intake significantly increased plasma Se from 87.0 ± 16.8 to 180.6 ± 67.1 μg/L, increased GPx3 activity in 24,8 % (from 112.66 ± 40.09 to 128.32 ± 38.31 nmol/min/mL, p < 0,05), and reduced 3.25 % of oxidized-LDL levels (from 66.31 ± 23.59 to 60.68 ± 20.88 U/L, p < 0.05). An inverse association between GPx3 and oxidized LDL levels was observed after supplementation with GBN by simple model (β -0.232, p = 0.032) and after adjustment for gender, age, diabetes and BMI (β -0.298, p = 0.008). There wasn’t association between GPx3 and 8-epi PGF2α (β -0.209, p = 0.052) by simple model.

    Conclusion: The partially defatted GBN intake has a potential benefit to increase plasma selenium, increase enzymatic antioxidant activity of GPx3 and to reduction oxidation in LDL in hypertensive and dyslipidemic patients.

    Be well!

    JP

  4. JP Says:

    Update 06/04/15:

    http://link.springer.com/article/10.1007%2Fs00394-014-0829-2

    Eur J Nutr. 2015 Jan 8.

    Effects of Brazil nut consumption on selenium status and cognitive performance in older adults with mild cognitive impairment: a randomized controlled pilot trial.

    PURPOSE: Oxidative stress is closely related to cognitive impairment, and the antioxidant system may be a potential therapeutic target to preserve cognitive function in older adults. Selenium plays an important antioxidant role through selenoproteins. This controlled trial aimed to investigate the antioxidant and cognitive effects of the consumption of Brazil nuts, the best selenium food source.

    METHODS: We enrolled 31 older adults with mild cognitive impairment (MCI) who were randomly assigned to ingestion of Brazil nuts or to the control group. Participants of the treatment group consumed one Brazil nut daily (estimated 288.75 µg/day) for 6 months. Blood selenium concentrations, erythrocyte glutathione peroxidase (GPx) activity, oxygen radical absorbance capacity, and malondialdehyde were evaluated. Cognitive functions were assessed with the CERAD neuropsychological battery.

    RESULTS: Eleven participants of the treated group and nine of the control group completed the trial. The mean age of the participants was 77.7 (±5.3) years, 70 % of whom were female. We observed increased selenium levels after the intervention, whereas the control group presented no change. Among the parameters related to the antioxidant system, only erythrocyte GPx activity change was significantly different between the groups (p = 0.006). After 6 months, improvements in verbal fluency (p = 0.007) and constructional praxis (p = 0.031) were significantly greater on the supplemented group when compared with the control group.

    CONCLUSION: Our results suggest that the intake of Brazil nut restores selenium deficiency and provides preliminary evidence that Brazil nut consumption can have positive effects on some cognitive functions of older adults with MCI.

    Be well!

    JP

  5. JP Says:

    Update 06/21/15:

    http://www.nutritionj.com/content/14/1/61

    Nutr J. 2015 Jun 17;14(1):61. doi: 10.1186/s12937-015-0049-5.

    Effect of almond consumption on vascular function in patients with coronary artery disease: a randomized, controlled, cross-over trial.

    OBJECTIVE: Almonds reduce cardiovascular disease risk via cholesterol reduction, anti-inflammation, glucoregulation, and antioxidation. The objective of this randomized, controlled, cross-over trial was to determine whether the addition of 85 g almonds daily to a National Cholesterol Education Program (NCEP) Step 1 diet (ALM) for 6 weeks would improve vascular function and inflammation in patients with coronary artery disease (CAD).

    RESEARCH DESIGN AND METHODS: A randomized, controlled, crossover trial was conducted in Boston, MA to test whether as compared to a control NCEP Step 1 diet absent nuts (CON), incorporation of almonds (85 g/day) into the CON diet (ALM) would improve vascular function and inflammation. The study duration was 22 weeks including a 6-weeks run-in period, two 6-weeks intervention phases, and a 4-weeks washout period between the intervention phases. A total of 45 CAD patients (27 F/18 M, 45-77 y, BMI = 20-41 kg/m(2)) completed the study. Drug therapies used by patients were stable throughout the duration of the trial.

    RESULTS: The addition of almonds to the CON diet increased plasma α-tocopherol status by a mean of 5.8 %, reflecting patient compliance (P ≤0.05). However, the ALM diet did not alter vascular function assessed by measures of flow-mediated dilation, peripheral arterial tonometry, and pulse wave velocity. Further, the ALM diet did not significantly modify the serum lipid profile, blood pressure, C-reactive protein, tumor necrosis factor-α or E-selectin. The ALM diet tended to decrease vascular cell adhesion molecule-1 by 5.3 % (P = 0.064) and increase urinary nitric oxide by 17.5 % (P = 0.112). The ALM intervention improved the overall quality of the diet by increasing calcium, magnesium, choline, and fiber intakes above the Estimated Average Requirement (EAR) or Recommended Dietary Allowance (RDA).

    CONCLUSIONS: Thus, the addition of almonds to a NECP Step 1 diet did not significantly impact vascular function, lipid profile or systematic inflammation in CAD patients receiving good medical care and polypharmacy therapies but did improve diet quality without any untoward effect.

    Be well!

    JP

  6. JP Says:

    Update 06/21/15:

    http://www.nutritionj.com/content/pdf/s12937-015-0036-x.pdf

    Nutr J. 2015 Jun 16;14(1):59.

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

    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 (Bertholletiaexcelsa) 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 FT3 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 inblood pressure and serum lipids between Brazil nut and placebo group.

    CONCLUSIONS: Despite the reduction in energy intake, the consumption of Brazil nut did not affect FT3 levels, yet contributed to a reduction in serum cholesterol in euthyroid, hypercholesterolemic patients during the intervention period.

    Be well!

    JP

  7. JP Says:

    Update 06/30/15:

    http://www.nutritionj.com/content/14/1/64

    Nutrition Journal 2015, 14:64

    Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005–2010

    Introduction: Previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS).

    Objective: To determine the association of tree nut consumption with risk factors for CVD and for MetS in adults.

    Methods: NHANES 2005–2010 data were used to examine the associations of tree nut consumption with health risks in adults 19+ years (n = 14,386; 51 % males). Tree nuts were: almonds, Brazil nuts, cashews, filberts [hazelnuts], macadamias, pecans, pine nuts, pistachios, and walnuts. Group definitions were non-consumers <  ¼ ounce/day and consumers of ≥ ¼ ounce/day tree nuts using data from 24-h dietary recalls. Means and ANOVA (covariate adjusted) were determined using appropriate sample weights. Using logistic regression, odds ratios of being overweight (OW)/obese (OB) (body mass index [BMI] >25/<30 and ≥30, respectively) and having CVRF or MetS, were determined.

    Results: Tree nut consumption was associated with lower BMI (p = 0.004), waist circumference (WC) (p = 0.008), systolic blood pressure (BP) (p = 0.001), Homeostatic Model Assessment—Insulin Resistance (p = 0.043), and higher high density lipoprotein-cholesterol (p = 0.022), compared with no consumption, and a lower likelihood of OB (−25 %), OW/OB (−23 %), and elevated WC (−21 %).

    Conclusions: Tree nut consumption was associated with better weight status and some CVRF and MetS components.

    Be well!

    JP

  8. JP Says:

    Updated 11/10/15:

    http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10031743&fileId=S0007114515004316

    Br J Nutr. 2015 Nov 9:1-14.

    A systematic review and meta-analysis of nut consumption and incident risk of CVD and all-cause mortality.

    Dietary patterns containing nuts are associated with a lower risk of CVD mortality, and increased nut consumption has been shown to have beneficial effects on CVD risk factors including serum lipid levels. Recent studies have reported on the relationship between nut intake and CVD outcomes and mortality. Our objective was to systematically review the literature and quantify associations between nut consumption and CVD outcomes and all-cause mortality. Five electronic databases (through July 2015), previous reviews and bibliographies of qualifying articles were searched. In the twenty included prospective cohort studies (n 467 389), nut consumption was significantly associated with a lower risk of all-cause mortality (ten studies; risk ratio (RR) 0·81; 95 % CI 0·77, 0·85 for highest v. lowest quantile of intake, P het=0·04, I 2=43 %), CVD mortality (five studies; RR 0·73; 95 % CI 0·68, 0·78; P het=0·31, I 2=16 %), all CHD (three studies; RR 0·66; 95 % CI 0·48, 0·91; P het=0·0002, I 2=88 %) and CHD mortality (seven studies; RR 0·70; 95 % CI 0·64, 0·76; P het=0·65, I 2=0 %), as well as a statistically non-significant reduction in the risk of non-fatal CHD (three studies; RR 0·71; 95 % CI 0·49, 1·03; P het=0·03, I 2=72 %) and stroke mortality (three studies; RR 0·83; 95 % CI 0·69, 1·00; P het=0·54, I 2=0 %). No evidence of association was found for total stroke (two studies; RR 1·05; 95 % CI 0·69, 1·61; P het=0·04, I 2=77 %). Data on total CVD and sudden cardiac death were available from one cohort study, and they were significantly inversely associated with nut consumption. In conclusion, we found that higher nut consumption is associated with a lower risk of all-cause mortality, total CVD, CVD mortality, total CHD, CHD mortality and sudden cardiac death.

    Be well!

    JP

  9. JP Says:

    Updated 1/17/16:

    http://www.nrjournal.com/article/S0271-5317%2815%2900282-1/fulltext

    Nutr Res. 2016 Jan;36(1):80-89.

    Diet quality improves for parents and children when almonds are incorporated into their daily diet: a randomized, crossover study.

    The health benefits of nuts may, in part, be due to the fiber that provides substrate for the maintenance of a healthy and diverse microbiota. We hypothesized that consuming almonds would benefit immune status through improving diet quality and modulation of microbiota composition in parents and their children, while improving gastrointestinal function. In a crossover trial, 29 parents (35 ± 0.6 years) and their children (n = 29; 4 ± 0.2 years; pairs) consumed 1.5 and 0.5 oz, respectively, of almonds and/or almond butter or control (no almonds) for 3 weeks followed by 4-week washouts. Parents completed daily questionnaires of stool frequency and compliance with nut intake. The Gastrointestinal Symptom Response Scale was administered weekly. Participants provided stools for microbiota analysis and saliva for secretory immunoglobulin A. Serum antioxidant/proinflammatory balance was determined in parents. From weekly dietary recalls (Automated Self-Administered 24-Hour Dietary Recall), nutrient and energy intake were assessed and Healthy Eating Index-2010 scores were calculated. Consuming almonds increased total Healthy Eating Index score from 53.7 ± 1.8 to 61.4 ± 1.4 (parents) and 53.7 ± 2.6 to 61.4 ± 2.2 (children; P < .001). Minimal changes in gastrointestinal symptoms and no change in stool frequency were noted with the almond intervention. Microbiota was stable at the phylum and family level, but genus-level changes occurred with nut intake, especially in children. No differences were observed for immune markers. Although higher intakes of almonds or longer interventions may be needed to demonstrate effects on immune status, a moderate intake of almonds improves diet quality in adults and their young children and modulates microbiota composition. Be well! JP

  10. JP Says:

    Updated 01/24/17:

    http://www.jabfm.org/content/29/6/759.long

    J Am Board Fam Med. 2016 11/12;29(6):759-766.

    Almond “Appetizer” Effect on Glucose Tolerance Test (GTT) Results.

    BACKGROUND: The extent to which glucose intolerance can be acutely improved with dietary modification is unclear. The purpose of this study was to test the effect of ingesting a low-calorie almond preload (“appetizer”) 30 minutes before oral glucose tolerance testing in glucose-intolerant individuals without diabetes.

    METHODS: Twenty adults with prediabetes or isolated 1-hour glucose ≥160 mg/dL underwent 2 fasting oral glucose tolerance tests (GTTs)-1 standard GTT and 1 GTT 30 minutes after eating a half ounce (12) of dry-roasted almonds. Fourteen participants met 1 or more prediabetes diagnostic criteria; 6 had only elevated 1-hour glucose ≥160 mg/dL.

    RESULTS: The mean 1-hour plasma glucose after the almond preload was 37.1 mg/dL (19.4%) lower (154.6 vs 191.7; P < .001) than in the standard GTT. The almond preload reduced the area under the glucose curve by 15.5% (P < .001). Eight individuals had a marked hypoglycemic effect (glucose reduced by 45 to 110 mg/dL); 4 had a moderate hypoglycemic effect (22-32 mg/dL). CONCLUSION: A low-calorie almond "appetizer" showed promise as an option for decreasing postprandial hyperglycemia in individuals with prediabetes or isolated 1-hour postprandial hyperglycemia. Further study is needed to confirm and refine the role of such a premeal appetizer in the self-care of prediabetes. Be well! JP

  11. JP Says:

    Updated 06/16/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28610906

    Appetite. 2017 Jun 10.

    A walnut-containing meal had similar effects on early satiety, CCK, and PYY, but attenuated the postprandial GLP-1 and insulin response compared to a nut-free control meal.

    Regular nut consumption is associated with lower adiposity and reduced weight gain in adulthood. Walnut feeding studies have observed minimal effect on body weight despite potential additional energy intake. Several mechanisms may explain why consuming nuts promotes weight control, including increased early phase satiety, possibly reflected in postprandial response of gastrointestinal and pancreatic peptides hypothesized to affect appetite. The purpose of this study was to compare postprandial insulin, glucagon and gastrointestinal peptide response and satiety following a meal with ∼54% of energy from walnuts or cream cheese, using a within-subject crossover study design in overweight/obese adults (N = 28). Sixty minutes after the walnut-containing meal, glucagon-like peptide-1 was lower than after the reference meal (p=0.0433), and peptide YY, cholecystokinin and ghrelin did not differ after the two meals. Sixty and 120 min after the walnut-containing meal, pancreatic polypeptide (p = 0.0014 and p = 0.0002) and glucose-dependent insulinotropic peptide (p < 0.0001 and p = 0.0079) were lower than after the reference meal, and 120 min after the walnut-containing meal, glucagon was higher (p=0.0069). Insulin and C-peptide increased at 60 min in response to both meals but were lower at 120 min after the walnut-containing meal (p=0.0349 and 0.0237, respectively). Satiety measures were similar after both meals. These findings fail to support the hypothesis that acute postprandial gastrointestinal peptide response to a walnut-containing meal contributes to increased satiety. However, inclusion of walnuts attenuated the postprandial insulin response, which may contribute to the more favorable lipid profile observed in association with regular walnut consumption. Be well! JP

  12. JP Says:

    Updated 11/06/17:

    http://www.mdpi.com/2072-6643/9/11/1219/htm

    Nutrients 2017, 9(11), 1219

    Associations between Nut Consumption and Health Vary between Omnivores, Vegetarians, and Vegans

    Abstract: Regular nut consumption is associated with reduced risk factors for chronic disease; however, most population-based studies lack consideration of effect modification by dietary pattern. The UK Women’s Cohort Study (UKWCS) provides an ideal opportunity to examine relationships between nut consumption and chronic disease risk factors in a large sample with diverse dietary patterns. Nut and nutrient intake from 34,831 women was estimated using a food frequency questionnaire among self-identified omnivores, vegetarians and vegans. In this cross-sectional analysis, higher nut consumption was associated with lower body weight (difference between highest and lowest consumption categories from adjusted model: 6.1 kg; 95% CI: 4.7, 7.6) body mass index (BMI, 2.4 units difference; 95% CI: 1.9, 2.9), and waist circumference (2.6 cm difference; 95% CI: 1.4, 3.8) (all p for linear trend < 0.001). Higher nut consumption was also associated with reduced prevalence of high cholesterol and high blood pressure; having a history of heart attack, diabetes and gallstones; and markers of diet quality (all adjusted p for linear trend ≤ 0.011). Higher nut consumption appeared overall to be associated with greater benefits amongst omnivores compared to vegetarians and vegans. Findings support existing literature around beneficial effects of nut consumption and suggest that benefits may be larger among omnivores. Nut promotion strategies may have the highest population impact by specifically targeting this group. Be well! JP

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