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Derbyshire E, Higgs J, Feeney MJ, Carughi A. Believe It or ' Nut': Why It Is Time to Set the Record Straight on Nut Protein Quality: Pistachio ( Pistacia vera L.) Focus. Nutrients 2023; 15:2158. [PMID: 37432263 DOI: 10.3390/nu15092158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 07/12/2023] Open
Abstract
There are growing public health movements to transition towards diets that are plant-based. However, confusion exists with concerns that plant-based proteins (including nuts) may be inferior with respect to protein quality. The present publication evaluates the evolution of protein quality concepts and explains the protein science related to pistachios. Pistachio nuts are a plant-based complete protein providing all nine EAAs in addition to an array of nutrients and phytochemicals. They have a PDCAAS of 73 and 81%, (raw and roasted pistachios, respectively), higher than that of many other tree nuts. From an environmental perspective transitioning towards plant-based diets (including nuts) could have potential to reduce total/green water footprints. Dietary guidelines are evolving yet nuts such as pistachios do not always have a clear place within these. Now appears to be a pertinent time to look at protein quality from the perspective of whole daily diets and dietary patterns, factoring in both health and environmental outcomes. Given updated modes of thinking, nuts such as pistachios have an important role to play in terms of providing ready-to-eat, good-quality, plant-based protein within daily diets.
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Affiliation(s)
| | | | - Mary Jo Feeney
- California Agricultural Boards, Los Altos Hills, CA 94024, USA
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Glenn AJ, Li J, Lo K, Jenkins DJ, Boucher BA, Hanley AJ, Kendall CW, Shadyab AH, Tinker LF, Chessler SD, Howard BV, Liu S, Sievenpiper JL. The Portfolio Diet and Incident Type 2 Diabetes: Findings From the Women's Health Initiative Prospective Cohort Study. Diabetes Care 2023; 46:28-37. [PMID: 36162007 PMCID: PMC9797645 DOI: 10.2337/dc22-1029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/26/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE A plant-based dietary pattern, the Portfolio Diet, has been shown to lower LDL cholesterol and other cardiovascular disease risk factors. However, no study has evaluated the association of this diet with incident type 2 diabetes. RESEARCH DESIGN AND METHODS This analysis included 145,299 postmenopausal women free of diabetes at baseline in the Women's Health Initiative (WHI) Clinical Trials and Observational Study from 1993 to 2021. Adherence to the diet was assessed with a score based on six components (high in plant protein [soy and pulses], nuts, viscous fiber, plant sterols, and monounsaturated fat and low in saturated fat and cholesterol) determined from a validated food-frequency questionnaire. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs of the association of the Portfolio Diet, alongside the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets, with incident type 2 diabetes, with adjustment for potential confounders. RESULTS Over a mean follow-up of 16.0 years, 13,943 cases of incident type 2 diabetes were identified. In comparisons of the highest with the lowest quintiles of adherence, the HRs for risk of incident type 2 diabetes were 0.77 (95% CI 0.72, 0.82) for the Portfolio Diet, 0.69 (0.64, 0.73) for the DASH diet, and 0.78 (0.74, 0.83) for the Mediterranean diet. These findings were attenuated by 10% after additional adjustment for BMI. CONCLUSIONS Greater adherence to the plant-predominant Portfolio, DASH, and Mediterranean diets was prospectively associated with lower risk of type 2 diabetes in postmenopausal women.
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Affiliation(s)
- Andrea J. Glenn
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jie Li
- Global Health Research Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
| | - Kenneth Lo
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - David J.A. Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Division of Endocrinology and Metabolism, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Beatrice A. Boucher
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anthony J. Hanley
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cyril W.C. Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Ontario, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Lesley F. Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Steven D. Chessler
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of California, Irvine, CA
| | - Barbara V. Howard
- MedStar Health Research Institute, Washington, DC
- Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington, DC
| | - Simin Liu
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
- Departments of Surgery and Medicine, Alpert School of Medicine, Brown University, Providence, RI
| | - John L. Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Division of Endocrinology and Metabolism, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Muley A, Fernandez R, Green H, Muley P. Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis. BMJ Open 2022; 12:e059834. [PMID: 36008064 PMCID: PMC9422810 DOI: 10.1136/bmjopen-2021-059834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. Objective: To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM. METHODS Eligibility criteria: Studies that assessed effect of thiamine supplementation in adults with T2DM which measured glycaemic outcomes-HbA1c, fasting blood glucose (FBG) and/or postprandial blood glucose (PPG) were included. Information sources: PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. Risk of bias: It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Synthesis of results: Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible. RESULTS Included studies: Six trials involving 364 participants. Synthesis of results: No significant beneficial effects were observed on glycaemic outcomes with 100-900 mg/day of thiamine or benfotiamine for up to 3 months (HbA1c: MD, -0.02%, 95% CI: -0.35 to 0.31; FBG: MD,-0.20 mmol/L; 95% CI: -0.69 to 0.29; PPG: MD, - 0.20 mmol/L, 95% CI: -2.05 to 1.65 (mean difference, MD)). There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up. Benfotiamine reduced triglyceride level (MD, -1.10; 95% CI: -1.90 to -0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses. DISCUSSION Limitations of evidence: Inclusion of single-centre trials published only in English, small sample sizes of included studies, lack of trials investigating outcomes for same comparisons and varying follow-up periods. Interpretation: Thiamine supplementation does not affect glycaemic outcomes, however reduces triglycerides while increasing HDL. Multicentre well-designed RCT with higher doses of thiamine and a follow-up period of 1-2 years will provide better evidence. PROSPERO REGISTRATION NUMBER CRD42020170520.
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Affiliation(s)
- Arti Muley
- Medicine, PIMSR, Parul University, Vadodara, Gujarat, India
| | - Ritin Fernandez
- Nursing, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
| | - Heidi Green
- Nursing, Centre for Research in Nursing and Health, St George Hospital, Sydney, New South Wales, Australia
| | - Prasad Muley
- Pediatrics, PIMSR, Parul University, Vadodara, Gujarat, India
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Mateos R, Salvador MD, Fregapane G, Goya L. Why Should Pistachio Be a Regular Food in Our Diet? Nutrients 2022; 14:3207. [PMID: 35956383 PMCID: PMC9370095 DOI: 10.3390/nu14153207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
The pistachio is regarded as a relevant source of biologically active components that, compared to other nuts, possess a healthier nutritional profile with low-fat content composed mainly of monounsaturated fatty acids, a high source of vegetable protein and dietary fibre, remarkable content of minerals, especially potassium, and an excellent source of vitamins, such as vitamins C and E. A rich composition in terms of phytochemicals, such as tocopherols, carotenoids, and, importantly, phenolic compounds, makes pistachio a powerful food to explore its involvement in the prevention of prevalent pathologies. Although pistachio has been less explored than other nuts (walnut, almonds, hazelnut, etc.), many studies provide evidence of its beneficial effects on CVD risk factors beyond the lipid-lowering effect. The present review gathers recent data regarding the most beneficial effects of pistachio on lipid and glucose homeostasis, endothelial function, oxidative stress, and inflammation that essentially convey a protective/preventive effect on the onset of pathological conditions, such as obesity, type 2 diabetes, CVD, and cancer. Likewise, the influence of pistachio consumption on gut microbiota is reviewed with promising results. However, population nut consumption does not meet current intake recommendations due to the extended belief that they are fattening products, their high cost, or teething problems, among the most critical barriers, which would be solved with more research and information.
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Affiliation(s)
- Raquel Mateos
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain
| | - María Desamparados Salvador
- Facultad de Ciencias y Tecnologías Químicas, Universidad de Castilla-La Mancha, Camilo José Cela n° 10, 13071 Ciudad Real, Spain
| | - Giuseppe Fregapane
- Facultad de Ciencias y Tecnologías Químicas, Universidad de Castilla-La Mancha, Camilo José Cela n° 10, 13071 Ciudad Real, Spain
| | - Luis Goya
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain
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Xia JY, Yu JH, Xu DF, Yang C, Xia H, Sun GJ. The Effects of Peanuts and Tree Nuts on Lipid Profile in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized, Controlled-Feeding Clinical Studies. Front Nutr 2021; 8:765571. [PMID: 34926548 PMCID: PMC8679310 DOI: 10.3389/fnut.2021.765571] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Type 2 diabetes mellitus was found to be associated with metabolic disorders, particularly abnormal glucose and lipid metabolism. Dietary food choices may have profound effects on blood lipids. The primary objective of this study was to examine the effects of peanuts and tree nuts intake on lipid profile in patients with type 2 diabetes. Methods: According to preferred reporting items for systematic reviews and meta-analysis guidelines, we performed a systematic search of randomized controlled clinical trials and systematic reviews published in PubMed, Web of Science, Embase, Scopus, and Cochrane library, from inception through June 2021. Studies in populations with type 2 diabetes, which compare nuts or peanuts to a controlled-diet group were included. We used the mean difference with 95% CIs to present estimates for continuous outcomes from individual studies. In addition, we used the GRADEpro tool to evaluate the overall quality of evidence. Results: Sixteen studies involving 1,041 participants were eligible for this review. The results showed that peanuts and tree nuts supplementation did not induce significant changes in low-density lipoprotein-cholesterol (LDL-C) (mean difference = −0.11; 95%CI: −0.25 – 0.03, p = 0.117) and high-density lipoprotein-cholesterol (HDL-C) (mean difference = 0.01; 95%CI: −0.01 – 0.04, p = 0.400) in patients with type 2 diabetics. In addition, we found that peanuts and tree nuts intake may cause a significantly reduction in total cholesterol (TC) (mean difference = −0.14; 95%CI: −0.26 – −0.02, p = 0.024) and triglyceride (TG) (mean difference = −0.10; 95%CI: −0.17 – −0.02, p = 0.010). In the subgroup analysis, a significantly greater reduction in TC was observed in studies which duration was <12 weeks (mean difference = −0.22; 95%CI: −0.37 – −0.08, p = 0.002). The quality of the body of evidence was “moderate” for TC and TG, the quality of evidence for LDL-C and HDL-C were “low.” Conclusion: Our findings suggest that consuming peanuts and tree nuts might be beneficial to lower TC concentration and TG concentration in type 2 diabetics subjects. Furthermore, peanuts and tree nuts supplementation could be considered as a part of a healthy lifestyle in the management of blood lipids in patients with type 2 diabetes. Given some limits observed in the current studies, more well-designed trials are still needed.
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Affiliation(s)
- Jia-Yue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Jun-Hui Yu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Deng-Feng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Chao Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Gui-Ju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
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Fernández-Rodríguez R, Martínez-Vizcaíno V, Garrido-Miguel M, Martínez-Ortega IA, Álvarez-Bueno C, Eumann Mesas A. Nut consumption, body weight, and adiposity in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2021; 80:645-655. [PMID: 34338788 DOI: 10.1093/nutrit/nuab053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT It seems that nut consumption does not lead to weight gain in the general population. However, fewer studies have explored this relationship in individuals with type 2 diabetes (T2D). PURPOSE To synthesize evidence on the effects of nut (specifically, tree nuts and peanuts) consumption on adiposity-related measures in individuals diagnosed with T2D. DATA SOURCES AND STUDY SELECTION Four databases were searched up to December 31, 2020. Randomized controlled trials that examined the effects of nut consumption vs a control diet on body weight, body mass index, waist circumference, and percent body fat were included. DATA EXTRACTION The pooled effect sizes (p-ESs) and 95%CIs of nut consumption were estimated using random effects models. DATA SYNTHESIS A total of 15 randomized controlled trials including 899 individuals were included. No significant effects of nut-enriched interventions were found for body weight (p-ES = -0.04; 95%CI: -0.16 to 0.08), body mass index (p-ES = -0.05; 95%CI: -0.17 to 0.08), waist circumference (p-ES = -0.02; 95%CI: -0.20 to 0.15), or percent body fat (p-ES = -0.03; 95%CI: -0.28 to 0.21). CONCLUSION Nut consumption has no effect, positive or negative, on weight or adiposity parameters in people with T2D.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
| | - Vicente Martínez-Vizcaíno
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
| | - Miriam Garrido-Miguel
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
| | - Isabel A Martínez-Ortega
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
| | - Celia Álvarez-Bueno
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
| | - Arthur Eumann Mesas
- R. Fernández-Rodríguez and I.A. Martínez-Ortega are with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain. V. Martínez-Vizcaíno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. M. Garrido-Miguel is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, Spain. C. Álvarez-Bueno is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain and Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay. A. Eumann Mesas is with the Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain, and Universidade Estadual de Londrina, Health Sciences Centre, Londrina, Brazil
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Fernández-Rodríguez R, Mesas AE, Garrido-Miguel M, Martínez-Ortega IA, Jiménez-López E, Martínez-Vizcaíno V. The Relationship of Tree Nuts and Peanuts with Adiposity Parameters: A Systematic Review and Network Meta-Analysis. Nutrients 2021; 13:nu13072251. [PMID: 34208812 PMCID: PMC8308485 DOI: 10.3390/nu13072251] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
The network meta-analysis and systematic review conducted aim to comparatively assess the effects of tree nuts and peanuts on body weight (BW), body mass index (BMI), waist circumference (WC), and body fat percentage (BF%). A systematic search up to 31 December 2020 was performed. A random-effects network meta-analysis was conducted following the PRISMA-NMA statement. A total of 105 randomized controlled trials (RCTs) with measures of BW (n = 6768 participants), BMI (n = 2918), WC (n = 5045), and BF% (n = 1226) were included. The transitivity assumption was met based on baseline characteristics. In the comparisons of nut consumption versus a control diet, there was no significant increase observed in any of the adiposity-related measures examined except for hazelnut-enriched diets, which raised WC. Moreover, almond-enriched diets significantly reduced WC compared to the control diet and to the pistachio-, mixed nuts-, and hazelnut-enriched diets. In subgroup analyses with only RCTs, designed to assess whether nut consumption affected weight loss, almonds were associated with reduced BMI and walnuts with reduced %BF. The evidence supports that: (1) tree nut and peanut consumption do not influence adiposity, and (2) compared to a control diet, the consumption of almond-enriched diets was associated with a reduced waist circumference.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Arthur E. Mesas
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Health Science Centre, Universidade Estadual de Londrina, Londrina 86038-350, Brazil
- Correspondence: ; Tel.: +34-969179100 (ext. 4686)
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Facultad de Enfermería, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Isabel A. Martínez-Ortega
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 1101, Chile
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Muley A, Fernandez R, Ellwood L, Muley P, Shah M. Effect of tree nuts on glycemic outcomes in adults with type 2 diabetes mellitus: a systematic review. JBI Evid Synth 2021; 19:966-1002. [PMID: 33141798 DOI: 10.11124/jbisrir-d-19-00397] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this review was to synthesize the best available research evidence regarding the effectiveness of tree nuts on glycemic outcomes in adults with type 2 diabetes mellitus. INTRODUCTION There has been an increase in the use of complementary therapy, particularly botanical products, for management of type 2 diabetes mellitus. It has been reported that increasing mono- and polyunsaturated fatty acids in diet effectively lowers the risk of development of type 2 diabetes mellitus. Hence, it was hypothesized that consumption of nuts, which are high in polyunsaturated fatty acids and mono-unsaturated fatty acids, may aid in preventing diabetes and reducing levels of blood glucose by reducing glycemic load by displacing dietary carbohydrates present in diet. INCLUSION CRITERIA This systematic review included randomized controlled trials that compared the consumption of any type and form of tree nut with a placebo or any other intervention in adults with type 2 diabetes mellitus. Trials were included if they measured fasting blood glucose, postprandial blood glucose, and/or glycated hemoglobin. Trials that assessed triglyceride levels and weight postintervention were also considered for inclusion. Trials were restricted to the English language. METHODS A three step search of PubMed, CINAHL, Embase, Trip database, and Cochrane Central Register of Controlled Trials (CENTRAL) was done in July 2019. To find unpublished studies, ClinicalTrials.gov and Google Scholar were searched. Studies from the search were reviewed against the inclusion criteria by two reviewers. The JBI critical appraisal checklist for randomized controlled trials was used to assess the potential studies for methodological quality. A meta-analysis and subgroup analysis was conducted among trials with the same type of intervention and outcome measures. Results are presented in a narrative format where statistical pooling was not possible. RESULTS Fifteen trials were included with a total sample size of 667. Consumption of pistachios demonstrated a significant reduction in triglyceride levels (mmol/L) at three month or earlier follow-up (mean difference [MD] -0.28; confidence interval -0.33, -0.23; P <0.00001). The meta-analysis including all tree nuts combined showed reduction in both fasting blood glucose and glycated hemoglobin (MD -0.26 mmol/L and -0.11% respectively) at three month or earlier follow-up. The subgroup analysis demonstrated MD of -0.45, -0.16, and -0.90 mmol/L in fasting blood glucose following ingestion of walnuts, almonds, and hazelnuts, respectively, and -0.17% in glycated hemoglobin following ingestion of walnuts at three month or earlier follow-up. Although not clinically significant, these figures give an indication that further research with larger sample sizes and longer follow-up may show encouraging results. CONCLUSIONS The authors found that pistachio consumption for three months or less significantly reduced triglyceride levels. Other tree nuts (walnuts, almonds, and hazelnuts) reduced fasting blood glucose and glycated hemoglobin levels by varying degrees. Further robust randomized controlled trials with power calculation-based sample size, comparing same type, dose, and method of nut intervention, will provide more evidence. For now, clinical decisions should be based on standard practice local guidelines. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019133558.
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Affiliation(s)
- Arti Muley
- Sumandeep Vidyapeeth Centre for Evidence Based Health Care: A JBI Affiliated Group, Vadodara, India
| | - Ritin Fernandez
- Centre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, Wollongong, NSW, Australia.,Centre for Research in Nursing and Health, St George Hospital, Sydney, NSW, Australia.,School of Nursing, University of Wollongong, Sydney, NSW, Australia
| | - Laura Ellwood
- Centre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, Wollongong, NSW, Australia.,Centre for Research in Nursing and Health, St George Hospital, Sydney, NSW, Australia
| | - Prasad Muley
- Sumandeep Vidyapeeth Centre for Evidence Based Health Care: A JBI Affiliated Group, Vadodara, India
| | - Monali Shah
- Sumandeep Vidyapeeth Centre for Evidence Based Health Care: A JBI Affiliated Group, Vadodara, India
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Jamshidi S, Moradi Y, Nameni G, Mohsenpour MA, Vafa M. Effects of cashew nut consumption on body composition and glycemic indices: A meta-analysis and systematic review of randomized controlled trials. Diabetes Metab Syndr 2021; 15:605-613. [PMID: 33725628 DOI: 10.1016/j.dsx.2021.02.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Present meta-analysis and systematic review was conducted to synthesis a definitive conclusion from previous randomized controlled clinical trials (RCTs). METHODS A comprehensive search was done up to July 2020, in order to extract RCTs which investigated the effect of cashew nut on weight, body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Weighted mean difference (WMD) and 95% confidence interval (CI) were used to estimate effect size. Meta regression analysis was done to identify probable sources of heterogeneity. RESULTS Six clinical trials with 521 participants were included. Combined effect sizes demonstrated no effect of cashew consumption on weight (WMD): 0.02, 95% CI: -1.04, 1.09, P > 0.05), BMI (WMD: 0.1, 95% CI: -0.72, 0.74, P > 0.05), and WC (WMD: -0.13, 95% CI: -1.97, 1.70, P > 0.05). Results were also not significant for FBS (WMD: 3.58, 95% CI: -3.92, 11.08, P > 0.05), insulin (WMD: -0.19, 95% CI: -1.63, 1.25, P > 0.05), and HOMA-IR (WMD: 0.25, 95% CI: -0.55, 1.06, P > 0.05). CONCLUSION The sum up, incorporating cashew into the diet has no significant effect on body composition or modifying glycemic indices.
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Affiliation(s)
- Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghazaleh Nameni
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohsenpour
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Regular Intake of Pistachio Mitigates the Deleterious Effects of a High Fat-Diet in the Brain of Obese Mice. Antioxidants (Basel) 2020; 9:antiox9040317. [PMID: 32326575 PMCID: PMC7222408 DOI: 10.3390/antiox9040317] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/19/2022] Open
Abstract
Obesity has been associated with neurodegeneration and cognitive dysfunctions. Recent data showed that pistachio consumption is able to prevent and ameliorate dyslipidemia, hepatic steatosis, systemic and adipose tissue inflammation in mice fed a high-fat diet (HFD). The present study investigated the neuroprotective effects of pistachio intake in HFD mice. Three groups of mice were fed a standard diet (STD), HFD, or HFD supplemented with pistachio (HFD-P) for 16 weeks. Metabolic parameters (oxidative stress, apoptosis, and mitochondrial dysfunction) were analyzed by using specific assays and biomarkers. The pistachio diet significantly reduced the serum levels of triglycerides and cholesterol in the HFD model. No difference was observed in the index of insulin resistance between HFD and HFD-P. A higher number of fragmented nuclei were found in HFD cerebral cortex compared to STD and HFD-P. A decrease in reactive oxygen species, singlet oxygen and phosphorylated extracellular signal-regulated kinase, and an increase of superoxide dismutase 2 and heme oxygenase expression were found in the brains of the HFD-P samples compared to HFD. Furthermore, the impaired mitochondrial function found in HFD brain was partially recovered in HFD-P mice. These results suggest that the regular intake of pistachio may be useful in preventing obesity-related neurodegeneration, being able to reduce both metabolic and cellular dysfunctions.
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Bairy S, Rao MR, Edla SR, Manthena SR, Tatavarti NVGD. Effect of an Integrated Naturopathy and Yoga Program on Long-Term Glycemic Control in Type 2 Diabetes Mellitus Patients: A Prospective Cohort Study. Int J Yoga 2020; 13:42-49. [PMID: 32030020 PMCID: PMC6937879 DOI: 10.4103/ijoy.ijoy_32_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/31/2019] [Accepted: 09/11/2019] [Indexed: 11/04/2022] Open
Abstract
AIM Lifestyle is an important risk factor for increasing the prevalence of diabetes in the Indian population. In this study, we evaluate the effects of naturopathy treatment, salt-restricted low-calorie diets, and yoga in long-term glycemic control in patients with type 2 diabetes mellitus. METHODS In this prospective, longitudinal, two-arm cohort study, patients with type 2 diabetes mellitus referred from a tertiary care center undergoing a 3-month residential naturopathy treatment were compared with those undergoing only conventional management on glycemic control. Both fasting and postprandial blood glucose (PPBG) levels were assessed at baseline, 3 months following intervention, at 6 months, and 12 months from the study start. Data were analyzed using repeated-measures ANOVA with post hoc Bonferroni correction. RESULTS Naturopathy and yoga intervention significantly reduced PPBG levels (P < 0.001), glycated hemoglobin levels (P < 0.001), and reduced requirement for antidiabetic medications (P < 0.008) in the intervention group compared to controls. The effects were more profound immediately following intervention and lasted up to 6 months from the start of the study. CONCLUSION The results suggest benefit with an intensive residential naturopathy-based lifestyle intervention program. Randomized controlled trials are needed to further validate the findings.
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Affiliation(s)
- Srinivas Bairy
- Manthena Satyanarayana Raju Arogylayam, Guntur, Andhra Pradesh, India
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12
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Kim Y, Keogh JB, Clifton PM. Does Nut Consumption Reduce Mortality and/or Risk of Cardiometabolic Disease? An Updated Review Based on Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244957. [PMID: 31817639 PMCID: PMC6950421 DOI: 10.3390/ijerph16244957] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 11/28/2019] [Accepted: 12/03/2019] [Indexed: 12/26/2022]
Abstract
Aim We aimed to determine if nut consumption decreases mortality and/or the risk of cardiometabolic diseases based on updated meta-analyses of epidemiological and intervention studies. Methods. An updated electronic search was conducted in PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library databases for original meta-analyses to investigate the effects of nut consumption on cardiometabolic disease in humans. Results. Seven new meta-analyses were included in this updated review. Findings similar to our previous review were observed, showing that nut consumption significantly decreased cardiovascular disease (CVD) mortality (−19% to −25%; n = 4), coronary heart disease (CHD) mortality (−24% to −30%; n = 3), stroke mortality (−17% to −18%; n = 3), CVD incidence (−15% to −19 %; n = 4), CHD [or coronary artery disease (CAD)] incidence (−17% to −34%; n = 8), and stroke incidence (−10% to −11%; n = 6) comparing high with low categories of nut consumption. Fasting glucose levels (0.08 to 0.15 mmol/L; n = 6), total cholesterol (TC; 0.021 to 0.30 mmol/L; n = 10), and low-density lipoprotein cholesterol (LDL-C; 0.017 to 0.26 mmol/L; n = 10) were significantly decreased with nut consumption compared with control diets. Body weight and blood pressure were not significantly affected by nut consumption. Conclusion. Nut consumption appears to exert a protective effect on cardiometabolic disease, possibly through improved concentrations of fasting glucose, total cholesterol, and LDL-C.
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Affiliation(s)
- Yoona Kim
- Department of Food and Nutrition/Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea;
| | - Jennifer B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, General Post Office Box 2471, Adelaide, SA 5001, Australia;
| | - Peter M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, General Post Office Box 2471, Adelaide, SA 5001, Australia;
- Correspondence: ; Tel.: +61-8-8302-1357
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Bagetta D, Maruca A, Lupia A, Mesiti F, Catalano R, Romeo I, Moraca F, Ambrosio FA, Costa G, Artese A, Ortuso F, Alcaro S, Rocca R. Mediterranean products as promising source of multi-target agents in the treatment of metabolic syndrome. Eur J Med Chem 2019; 186:111903. [PMID: 31787360 DOI: 10.1016/j.ejmech.2019.111903] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/02/2019] [Accepted: 11/18/2019] [Indexed: 01/19/2023]
Abstract
Alteration of nutritional habits play an essential role on the risk of developing Metabolic Syndrome (MetS). Several epidemiological studies have shown that assuming diets rich of foods included in the Mediterranean diet (MetDiet) pattern like, such as olive oil, nuts, fruit, fiber, vegetables, wine and grain cereals has protective effects on the different risk factors characterizing the MetS. The beneficial effects of the MetDiet in the MetS are mainly due to the antioxidant and anti-inflammatory properties of the most abundant phytochemical components of such foods as polyphenols like resveratrol and oleuropein, allyl sulfides, ellagic acid, mono- and poly-unsaturated fatty acids (MUFA and PUFA), tocopherols and flavonoids like quercetin, which have shown positive results in the prevention of cardiovascular diseases (CVDs), with related risk factors, like hypertension, hypercholesterolemia and obesity. In this review, we highlighted the multi-target activities of the bioactive components contained in some foods typical of the Mediterranean area like olive oil, onion, liquorice, rosemary, oregano, hazelnut, pistachio, "Melannurca" apple, red wine, hot pepper, Citrus sp. fruits, saffron and garlic, with particular focus on their impact on health outcomes in relation to MetS main key factors, such as insulin resistance (IR) and type 2 diabetes mellitus (T2DM), endothelial dysfunctions, inflammatory response, oxidative stress and dyslipidaemic and hypercholesterolemic effects.
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Affiliation(s)
- Donatella Bagetta
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Annalisa Maruca
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Antonio Lupia
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Francesco Mesiti
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Raffaella Catalano
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Isabella Romeo
- Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Department of Chemistry and Chemical Technologies, University of Calabria, via Pietro Bucci, 87036, Arcavacata di Rende, Italy
| | - Federica Moraca
- Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Department of Pharmacy, University of Naples "Federico II", via D. Montesano 49, 80131, Naples, Italy.
| | - Francesca Alessandra Ambrosio
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy.
| | - Giosuè Costa
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Anna Artese
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Francesco Ortuso
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Stefano Alcaro
- Dipartimento di Scienze della Salute, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Roberta Rocca
- Net4Science srl, Università "Magna Græcia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy; Department of Experimental and Clinical Medicine, "Magna Græcia" University, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
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Hwang HJ, Liu Y, Kim HS, Lee H, Lim Y, Park H. Daily walnut intake improves metabolic syndrome status and increases circulating adiponectin levels: randomized controlled crossover trial. Nutr Res Pract 2019; 13:105-114. [PMID: 30984354 PMCID: PMC6449547 DOI: 10.4162/nrp.2019.13.2.105] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/15/2018] [Accepted: 12/17/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/OBJECTIVES Several previous studies have investigated whether regular walnut consumption positively changes heart-health-related parameters. The aim of this study was to investigate the effects of daily walnut intake on metabolic syndrome (MetS) status and other metabolic parameters among subjects with MetS. SUBJECTS/METHODS This study was a two-arm, randomized, controlled crossover study with 16 weeks of each intervention (45 g of walnuts or iso-caloric white bread) with a 6 week washout period between interventions. Korean adults with MetS (n = 119) were randomly assigned to one of two sequences; 84 subjects completed the trial. At each clinic visit (at 0, 16, 22, and 38 weeks), MetS components, metabolic parameters including lipid profile, hemoglobin A1c (HbA1c), adiponectin, leptin, and apolipoprotein B, as well as anthropometric and bioimpedance data were obtained. RESULTS Daily walnut consumption for 16 weeks improved MetS status, resulting in 28.6%-52.8% reversion rates for individual MetS components and 51.2% of participants with MetS at baseline reverted to a normal status after the walnut intervention. Significant improvements after walnut intake, compared to control intervention, in high-density lipoprotein cholesterol (HDL-C) (P = 0.028), fasting glucose (P = 0.013), HbA1c (P = 0.021), and adiponectin (P = 0.019) were observed after adjustment for gender, age, body mass index, and sequence using a linear mixed model. CONCLUSION A dietary supplement of 45 g of walnuts for 16 weeks favorably changed MetS status by increasing the concentration of HDL-C and decreasing fasting glucose level. Furthermore, consuming walnuts on a daily basis changed HbA1c and circulating adiponectin levels among the subjects with MetS. This trial is registered at ClinicalTrials.gov as NCT03267901.
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Affiliation(s)
- Hyo-Jeong Hwang
- ICAN Nutrition Education and Research, 20, Gukjegeumyung-ro 7-gil, Yeongdeungpo-gu, Seoul 07340, Republic of Korea
| | - Yanan Liu
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Republic of Korea
| | - Hyun-Sook Kim
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Republic of Korea
| | - Heeseung Lee
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yunsook Lim
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Hyunjin Park
- ICAN Nutrition Education and Research, 20, Gukjegeumyung-ro 7-gil, Yeongdeungpo-gu, Seoul 07340, Republic of Korea
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Kim Y, Keogh J, Clifton PM. Nuts and Cardio-Metabolic Disease: A Review of Meta-Analyses. Nutrients 2018; 10:E1935. [PMID: 30563231 PMCID: PMC6316378 DOI: 10.3390/nu10121935] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Accumulating epidemiological and intervention evidence suggest that nut consumption is associated with reduced incidence of some cardiometabolic diseases. However, to date no review of meta-analyses of epidemiological and intervention studies has evaluated the effects of nut consumption on cardiometabolic disease. Design/Results: Electronic searches for meta-analyses of epidemiological and intervention studies were undertaken in PubMed®/MEDLINE®. Meta-analyses of prospective studies show that nut consumption appears to be associated with reduced all-cause mortality by 19⁻20% (n = 6), cardiovascular disease (CVD) incidence (19%; n = 3) and mortality (25%; n = 3), coronary heart disease (CHD) incidence (20⁻34%; n = 2) and mortality (27⁻30%; n = 2) and stroke incidence (10⁻11%; n = 7) and mortality (18%; n = 2). No association between nut consumption and the risk of type 2 diabetes mellitus (T2DM) was observed in meta-analyses of prospective studies, whereas a decrease in fasting blood glucose ranging from 0.08 to 0.15 mmol/L was observed in 3 meta-analyses of intervention studies. In the interventions, nut consumption also had favorable effects on total cholesterol (0.021 to 0.28 mmol/L reduction from 8 meta-analyses of interventions) and low-density lipoprotein cholesterol (0.017 to 0.26 mmol/L reduction from 8 meta-analyses of interventions) and endothelial function (0.79 to 1.03% increase in flow-mediated dilation from 4 meta-analyses of interventions). Nut consumption did not significantly affect body weight. Nut consumption had no effect on inflammatory markers in intervention studies. The effect on blood pressure was inconsistent. A higher nut consumption was associated with a lower incidence of hypertension in prospective studies, while nut consumption did not improve blood pressure in intervention studies. CONCLUSIONS Nut consumption appeared to be associated with lower all-cause mortality and CVD and CHD mortality. There was no association between nut consumption and the incidence of T2DM although fasting blood glucose is decreased in intervention studies. In intervention studies nuts lower total cholesterol and low-density lipoprotein cholesterol (LDL-C).
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Affiliation(s)
- Yoona Kim
- Department of Food and Nutrition/Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea.
| | - Jennifer Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, General Post Office Box 2471, Adelaide, SA 5001, Australia.
| | - Peter M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, General Post Office Box 2471, Adelaide, SA 5001, Australia.
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Anekwe TD, Rahkovsky II. Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2. Am J Public Health 2018. [DOI: 10.2105/ajph.2013.301661s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tobenna D. Anekwe
- Servicio de Investigaciones Económicas, Departamento de Agricultura de los Estados Unidos, Washington, D. C., Estados Unidos de América
| | - IIya Rahkovsky
- Servicio de Investigaciones Económicas, Departamento de Agricultura de los Estados Unidos, Washington, D. C., Estados Unidos de América
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Barreira E, Novo A, Vaz JA, Pereira AMG. Dietary program and physical activity impact on biochemical markers in patients with type 2 diabetes: A systematic review. Aten Primaria 2018; 50:590-610. [PMID: 29061310 PMCID: PMC6836882 DOI: 10.1016/j.aprim.2017.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/26/2017] [Accepted: 06/13/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over. DESIGN Systematic review. DATA SOURCE PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included. STUDY SELECTION A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over. RESULTS The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes. CONCLUSIONS Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus.
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Affiliation(s)
- Eduarda Barreira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal.
| | - André Novo
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CINTESIS-Research Center on Health Technologies and Services, Porto, Portugal
| | - Josiana A Vaz
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CIMO-Mountain Research Centre, Polytechnic Institute of Bragança, Campus de Santa Apolónia, Bragança, Portugal
| | - Ana M G Pereira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal
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Anekwe TD, Rahkovsky I. The Association Between Food Prices and the Blood Glucose Level of US Adults With Type 2 Diabetes. Am J Public Health 2018. [DOI: 10.2105/ajph.2013.301661r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objectives. We estimated the association between the price of healthy and less-healthy food groups and blood sugar among US adults with type 2 diabetes. Methods. We linked 1999–2006 National Health and Nutrition Examination Survey health information to food prices contained in the Quarterly Food-at-Home Price Database. We regressed blood sugar levels on food prices from the previous calendar quarter, controlling for market region and a range of other covariates. We also examined whether the association between food prices and blood sugar varies among different income groups. Results. The prices of produce and low-fat dairy foods were associated with blood sugar levels of people with type 2 diabetes. Specifically, higher prices for produce and low-fat dairy foods were associated with higher levels of glycated hemoglobin and fasting plasma glucose 3 months later. Food prices had a greater association with blood sugar for low-income people than for higher-income people, and in the expected direction. Conclusions. Higher prices of healthy foods were associated with increased blood sugar among people with type 2 diabetes. The association was especially pronounced among low-income people with type 2 diabetes.
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Affiliation(s)
- Tobenna D. Anekwe
- The authors are with the Economic Research Service, US Department of Agriculture, Washington, DC
| | - Ilya Rahkovsky
- The authors are with the Economic Research Service, US Department of Agriculture, Washington, DC
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Jenkins DJA, Kendall CWC, Lamarche B, Banach MS, Srichaikul K, Vidgen E, Mitchell S, Parker T, Nishi S, Bashyam B, de Souza RJ, Ireland C, Pichika SC, Beyene J, Sievenpiper JL, Josse RG. Nuts as a replacement for carbohydrates in the diabetic diet: a reanalysis of a randomised controlled trial. Diabetologia 2018; 61:1734-1747. [PMID: 29789878 PMCID: PMC6061153 DOI: 10.1007/s00125-018-4628-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 02/07/2018] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS In line with current advice, we assessed the effect of replacing carbohydrate consumption with mixed nut consumption, as a source of unsaturated fat, on cardiovascular risk factors and HbA1c in type 2 diabetes. The data presented here are from a paper that was retracted at the authors' request ( https://doi.org/10.2337/dc16-rt02 ) owing to lack of adjustment for repeated measures in the same individual. Our aim, therefore, was to fix the error and add new complementary data of interest, including information on clotting factors and LDL particle size. METHODS A total of 117 men and postmenopausal women with type 2 diabetes who were taking oral glucose-lowering agents and with HbA1c between 47.5 and 63.9 mmol/mol (6.5-8.0%) were randomised after stratification by sex and baseline HbA1c in a parallel design to one of three diets for 3 months: (1) 'full-dose nut diet' (n = 40): a diet with 2.0 MJ (477 kcal) per 8.4 MJ (2000 kcal) energy provided as mixed nuts (75 g/day); (2) 'full-dose muffin diet' (n = 39): a diet with 1.97 MJ (471 kcal) per 8.4 MJ (2000 kcal) energy provided as three whole-wheat muffins (188 g/day), with a similar protein content to the nuts, and the same carbohydrate-derived energy content as the monounsaturated fatty acid-derived energy content in the nuts; or (3) 'half-dose nut diet' (n = 38): a diet with 1.98 MJ (474 kcal) per 8.4 MJ (2000 kcal) energy provided as half portions of both the nuts and muffins. The primary outcome was change in HbA1c. The study was carried out in a hospital clinical research centre and concluded in 2008. Only the statistician, study physicians and analytical technicians could be blinded to the group assessment. RESULTS A total of 108 participants had post-intervention data available for analysis (full-dose nut group, n = 40; full-dose muffin group, n = 35; half-dose nut group, n = 33). Compared with the full-dose muffin diet, the full-dose nut diet provided 9.2% (95% CI 7.1, 11.3) greater total energy intake from monounsaturated fat. The full-dose nut diet (median intake, 75 g/day) also reduced HbA1c compared with the full-dose muffin diet by -2.0 mmol/mol (95% CI -3.8, -0.3 mmol/mol) (-0.19% [95% CI -0.35%, -0.02%]), (p = 0.026). Estimated cholesterol levels in LDL particles with a diameter <255 ångström [LDL-c<255Å]) and apolipoprotein B were also significantly decreased after the full-dose nut diet compared with the full-dose muffin diet. According to the dose response, the full-dose nut diet is predicted to reduce HbA1c (-2.0 mmol/mol [-0.18%]; p = 0.044), cholesterol (-0.25 mmol/l; p = 0.022), LDL-cholesterol (-0.23 mmol/l; p = 0.019), non-HDL-cholesterol (-0.26 mmol/l; p = 0.020), apolipoprotein B (-0.06 g/l, p = 0.013) and LDL-c<255Å (-0.42 mmol/l; p < 0.001). No serious study-related adverse events occurred, but one participant on the half-dose nut diet was hospitalised for atrial fibrillation after shovelling snow. CONCLUSIONS/INTERPRETATION Nut intake as a replacement for carbohydrate consumption improves glycaemic control and lipid risk factors in individuals with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT00410722 FUNDING: The study was funded by the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Loblaw Companies and the Canada Research Chairs Program of the Government of Canada.
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Affiliation(s)
- David J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada.
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
- Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada.
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Benoît Lamarche
- School of Nutrition, Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - Monica S Banach
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Korbua Srichaikul
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- Division of Family and Community Medicine, St Michael's Hospital, Toronto, ON, Canada
| | - Edward Vidgen
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Sandy Mitchell
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Tina Parker
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Stephanie Nishi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Balachandran Bashyam
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Russell J de Souza
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Christopher Ireland
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Sathish C Pichika
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- Department of Mathematics and Statistics, University of Windsor, Windsor, ON, Canada
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 5th Floor, Medical Science Building (MSB), 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
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Zhu R, Fan Z, Dong Y, Liu M, Wang L, Pan H. Postprandial Glycaemic Responses of Dried Fruit-Containing Meals in Healthy Adults: Results from a Randomised Trial. Nutrients 2018; 10:E694. [PMID: 29848962 PMCID: PMC6024783 DOI: 10.3390/nu10060694] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to explore the glycaemic response (GR) patterns of four dried fruits (DF) and the mixed meals containing dried fruits, rice and almonds. Dried apples (DApp), dried jujubes (DJ), raisins (Ra) and dried apricots (DApr) were tested in eleven healthy subjects in random order. Test meals included the following 3 groups: (1) dried fruits containing 50 g available carbohydrates; (2) mixed meals consisting of DF and rice (DF + R), each contributing 25 g available carbohydrates; (3) Group (2) supplemented with 30 g almonds (DF + R + A). The postprandial GR and other characteristics in 240 min were investigated. The GI values of 4 DFs were 43 for DApp, 55 for DJ, 56 for both Ra and DApr. The DApp displayed the smallest amplitude of glycaemic excursion within 240 min (MAGE0⁻240). Compared with rice, the DApp + R meal elicited a significantly reduced GR and a smaller MAGE0⁻240 (GI 81 vs. 65). With the addition of almonds, the GIs and MAGE0⁻240 decreased significantly in all DF + A + R combinations except DApp + R + A. The ratio of total fructose/glucose contents of test meals were negatively correlated to GIs. Dried fruits and nuts may have the potential to mitigate the postprandial GR when jointly introduced into glycaemic management diets.
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Affiliation(s)
- Ruixin Zhu
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Zhihong Fan
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Yang Dong
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Manman Liu
- Department of Food Science and Engineering, College of Biological Science and Technology, Beijing Forestry University, Beijing 100083, China.
| | - Linlin Wang
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Haikun Pan
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
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21
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Roncero-Ramos I, Rangel-Zuñiga OA, Lopez-Moreno J, Alcala-Diaz JF, Perez-Martinez P, Jimenez-Lucena R, Castaño JP, Roche HM, Delgado-Lista J, Ordovas JM, Camargo A, Lopez-Miranda J. Mediterranean Diet, Glucose Homeostasis, and Inflammasome Genetic Variants: The CORDIOPREV Study. Mol Nutr Food Res 2018; 62:e1700960. [PMID: 29573224 DOI: 10.1002/mnfr.201700960] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/17/2018] [Indexed: 12/16/2022]
Abstract
SCOPE Insulin resistance (IR) and chronic low-grade inflammation are hallmarks of type 2 diabetes mellitus (T2DM). The "NOD-like receptor pyrin domain containing-3" (NLRP3) inflammasome component of innate immunity is a metabolic stress sensor modulated by dietary and genetics factors. The aim of this study was to evaluate the effects of the consumption of two diets for 3 years, Mediterranean (Med) and low fat, on glucose homeostasis in the 1002 coronary heart disease patients of the CORDIOPREV study, according to a genetic variant of NLRP3 inflammasome. METHODS AND RESULTS The study was conducted in the framework of the CORDIOPREV study, a randomized dietary intervention with Med and low-fat diets. Single nucleotide polymorphisms (SNPs) located at inflammasome NLRP3 gene were genotyped by OpenArray platform. Nondiabetic CT+TT carriers of the rs4612666 SNP and AG+AA carriers of the rs10733113 SNP increased insulin sensitivity index (ISI) after 3 years of dietary intervention, whereas no effect was observed in diabetic patients. Further analysis by diet showed that the improvement of the ISI in nondiabetic rs10733113 AG+AA carriers was specific to the consumption of the Med diet. CONCLUSION Our results show that the benefits associated with a Med diet regarding glucose homeostasis in non-T2DM patients depend on genetic variation in the inflammasome.
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Affiliation(s)
- Irene Roncero-Ramos
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Oriol A Rangel-Zuñiga
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Javier Lopez-Moreno
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Juan F Alcala-Diaz
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Pablo Perez-Martinez
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Rosa Jimenez-Lucena
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Justo P Castaño
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain.,Department of Cell Biology, Physiology, and Immunology, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain
| | - Helen M Roche
- Nutrigenomics Research Group, UCD Conway Institute of Biomolecular Research, and School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 02111, USA.,Madrid Institute of Advanced Studies (IMDEA) Alimentacion, Madrid, 28049, Spain.,Spanish National Centre for Cardiovascular Research (CNIC), Madrid, 28029, Spain
| | - Antonio Camargo
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
| | - Jose Lopez-Miranda
- Lipids and Atherosclerosis Unit, GC9 Nutrigenomics, Institute Maimonides for Biomedical Research of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, 14004, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Cordoba, 14004, Spain
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Effects of nut consumption on selected inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Nutrition 2018; 54:129-143. [PMID: 29852452 DOI: 10.1016/j.nut.2018.02.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/12/2018] [Accepted: 02/04/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Several randomized controlled trials (RCTs) have assessed the effects of nut consumption on inflammatory markers. However, the results have been inconsistent. The aim of this meta-analysis of RCTs was to quantitatively evaluate the effects of nut consumption on selected inflammatory markers. METHODS PubMed, Embase, Cochrane Library database, and Google Scholar were searched for published RCTs that reported the effects of nuts on inflammatory markers as primary or secondary outcomes in an adult population (aged ≥18 y). Summary estimates of weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. RESULTS Twenty-three RCTs met the inclusion criteria. Overall, nut consumption significantly reduced the levels of intercellular adhesion molecule (ICAM)-1 (WMD, -0.17; 95% CI, -0.32 to -0.03; P = 0.01), but had no significant effect on other inflammatory markers. In the subgroup analyses by nut types, mixed nuts had a significant effect on ICAM-1 reduction. The significant effect of nuts on ICAM-1 reduction was only observed in parallel, but not crossover RCTs. Additionally, nut consumption significantly reduced ICAM-1 and vascular cell adhesion molecule-1 levels in long-term (≥12 wk), but not short-term (<12 wk) RCTs. No significant heterogeneity or publication bias was observed in the studies included. CONCLUSIONS Nut consumption significantly reduced ICAM-1 levels, but had no effect on other inflammatory markers. More studies are needed to assess the effects of nuts on inflammation.
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23
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Dietary management of dyslipidaemias. Is there any evidence for cardiovascular benefit? Maturitas 2018; 108:45-52. [DOI: 10.1016/j.maturitas.2017.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/15/2022]
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25
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Ribeiro PVM, Silva A, Almeida AP, Hermsdorff HH, Alfenas RC. Effect of chronic consumption of pistachios (Pistacia vera L.) on glucose metabolism in pre-diabetics and type 2 diabetics: A systematic review. Crit Rev Food Sci Nutr 2017; 59:1115-1123. [DOI: 10.1080/10408398.2017.1392290] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- P. V. M. Ribeiro
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - A. Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - A. P. Almeida
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - H. H. Hermsdorff
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - R. C. Alfenas
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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MacLeod J, Franz MJ, Handu D, Gradwell E, Brown C, Evert A, Reppert A, Robinson M. Academy of Nutrition and Dietetics Nutrition Practice Guideline for Type 1 and Type 2 Diabetes in Adults: Nutrition Intervention Evidence Reviews and Recommendations. J Acad Nutr Diet 2017; 117:1637-1658. [DOI: 10.1016/j.jand.2017.03.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Indexed: 12/17/2022]
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27
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Academy of Nutrition and Dietetics Nutrition Practice Guideline for Type 1 and Type 2 Diabetes in Adults: Systematic Review of Evidence for Medical Nutrition Therapy Effectiveness and Recommendations for Integration into the Nutrition Care Process. J Acad Nutr Diet 2017; 117:1659-1679. [DOI: 10.1016/j.jand.2017.03.022] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Indexed: 01/03/2023]
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Asghari G, Ghorbani Z, Mirmiran P, Azizi F. Nut consumption is associated with lower incidence of type 2 diabetes: The Tehran Lipid and Glucose Study. DIABETES & METABOLISM 2017; 43:18-24. [DOI: 10.1016/j.diabet.2016.09.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/19/2022]
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Gulati S, Misra A, Pandey RM. Effect of Almond Supplementation on Glycemia and Cardiovascular Risk Factors in Asian Indians in North India with Type 2 Diabetes Mellitus: A 24-Week Study. Metab Syndr Relat Disord 2017; 15:98-105. [PMID: 28051354 PMCID: PMC5333560 DOI: 10.1089/met.2016.0066] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Type 2 diabetes (T2D) statistics have reached menacing proportions in India. Appropriate dietary intervention, as part of healthy lifestyle, is imperative to curb further spread of this disease. Objectives: This pre–post intervention study was conducted in New Delhi, India, to investigate the effects of daily consumption of almonds for 24 weeks in T2D subjects, specifically on measures of glycemia and cardiovascular disease (CVD) risk factors. Methods and Study Design: In this study, the 24-week intervention period was preceded by a control diet and exercise run-in period of 3 weeks. Raw almonds (20% of energy intake) were provided to the patients for consumption along with diet and physical activity counseling. Patients were assessed for anthropometry, blood pressure, measures of glycemia (fasting blood glucose, glycosylated hemoglobin), lipids [total cholesterol (TC), triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, lipoprotein(a)], surrogate marker of atherosclerosis (Pulse wave velocity), and marker of inflammation (high sensitivity C-reactive protein [hs-CRP]) at baseline and after the intervention period. Results: Statistically significant improvement in mean values for various parameters post intervention was as follows: waist circumference (P < 0.03), waist-to-height ratio (P < 0.005), TC (P < 0.002), serum triglycerides (P < 0.004), low-density lipoprotein cholesterol (P < 0.01), glycosylated hemoglobin (P < 0.04), and hs-CRP (P < 0.01). A trend toward improvement in pulse wave velocity (P < 0.06) was also observed. Conclusion: The study findings illustrate that incorporation of almonds in a well-balanced healthy diet leads to multiple beneficial effects on glycemic and CVDs risk factors in Asian Indian patients with T2D.
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Affiliation(s)
- Seema Gulati
- 1 Diabetes Foundation (India), SDA , New Delhi, India .,2 National Diabetes , Obesity and Cholesterol Foundation (N-DOC), New Delhi, India .,3 Center of Nutrition & Metabolic Research (C-NET) , New Delhi, India
| | - Anoop Misra
- 1 Diabetes Foundation (India), SDA , New Delhi, India .,2 National Diabetes , Obesity and Cholesterol Foundation (N-DOC), New Delhi, India .,3 Center of Nutrition & Metabolic Research (C-NET) , New Delhi, India .,4 Fortis C-DOC Center of Excellence for Diabetes , Metabolic Diseases and Endocrinology, New Delhi, India .,5 Fortis Flt. Lt. Rajan Dhall Hospital , Vasant Kunj, New Delhi, India
| | - Ravindra M Pandey
- 6 All India Institute of Medical Sciences (AIIMS) , New Delhi, India
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Gupta L, Khandelwal D, Singla R, Gupta P, Kalra S. Pragmatic dietary advice for diabetes during Navratris. Indian J Endocrinol Metab 2017; 21:231-237. [PMID: 28217524 PMCID: PMC5240068 DOI: 10.4103/2230-8210.196009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Navratri is one of the most common religious fasts observed among Hindus. A large number of people with diabetes follow Navratris fast irrespective of its health implications, often without proper education and medical advice. The quest for the scientific research on dietary advices for Hindu fasts including Navratris shows paucity of literature comparative to the dietary advices advocated during Ramadan. The eating and physical activity patterns during different fasts vary a lot depending up on social and cultural factors. Even eating pattern is not uniform among all persons following Navratris and is modified as per their region, local culture, and religious beliefs. Dietary advice during Navratris depends upon pattern of fasting, religious beliefs, and local sociocultural factors. In this review, efforts are made to provide pragmatic dietary advice for people with diabetes, modifications in the menus and cooking practices, and timings of the meals for successful blood glucose management during Navratris. This review will also help plan diet and physical activity advice for persons observing other fasts as well.
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Affiliation(s)
- Lovely Gupta
- Department of Dietetics, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Deepak Khandelwal
- Department of Endocrinology, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Rajiv Singla
- Department of Endocrinology, Kalpavriksh Superspeciality centre, Dwarka, New Delhi, India
| | - Piyush Gupta
- Department of Pediatrics, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and Bharti Research Institute of Diabetes and Endocrinology, Karnal, Haryana, India
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Lutz M, Álvarez K, Loewe V. Chemical composition of pine nut (Pinus pinea L.) grown in three geographical macrozones in Chile. CYTA - JOURNAL OF FOOD 2016. [DOI: 10.1080/19476337.2016.1250109] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mariane Lutz
- Centro de Investigación y Desarrollo de Alimentos Funcionales CIDAF, Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - Katherine Álvarez
- Centro de Investigación y Desarrollo de Alimentos Funcionales CIDAF, Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - Verónica Loewe
- Instituto Forestal INFOR, Ministerio de Agricultura, Santiago, Chile
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Abstract
AbstractPlasma apoB is a more accurate marker of the risk of CVD and type 2 diabetes (T2D) than LDL-cholesterol; however, nutritional reviews targeting apoB are scarce. Here we reviewed eighty-seven nutritional studies and present conclusions in order of strength of evidence. Plasma apoB was reduced in all studies that induced weight loss of 6–12 % using hypoenergetic diets (seven studies; 5440–7110 kJ/d; 1300–1700 kcal/d; 34–50 % carbohydrates; 27–39 % fat; 18–24 % protein). When macronutrients were compared in isoenergetic diets (eleven studies including eight randomised controlled trials (RCT); n 1189), the diets that reduced plasma apoB were composed of 26–51 % carbohydrates, 26–46 % fat, 11–32 % protein, 10–27 % MUFA, 5–14 % PUFA and 7–13 % SFA. Replacement of carbohydrate by MUFA, not SFA, decreased plasma apoB. Moreover, dietary enriching with n-3 fatty acids (FA) (from fish: 1·1–1·7 g/d or supplementation: 3·2–3·4 g/d EPA/DHA or 4 g/d EPA), psyllium (about 8–20 g/d), phytosterols (about 2–4 g/d) or nuts (30–75 g/d) also decreased plasma apoB, mostly in hyperlipidaemic subjects. While high intake of trans-FA (4·3–9·1 %) increased plasma apoB, it is unlikely that these amounts represent usual consumption. Inconsistent data existed on the effect of soya proteins (25–30 g/d), while the positive association of alcohol consumption with low plasma apoB was reported in cross-sectional studies only. Five isoenergetic studies using Mediterranean diets (including two RCT; 823 subjects) reported a decrease of plasma apoB, while weaker evidence existed for Dietary Approaches to Stop Hypertension (DASH), vegetarian, Nordic and Palaeolithic diets. We recommend using a Mediterranean dietary pattern, which also encompasses the dietary components reported to reduce plasma apoB, to target hyperapoB and reduce the risks of CVD and T2D.
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Dhillon J, Tan SY, Mattes RD. Almond Consumption during Energy Restriction Lowers Truncal Fat and Blood Pressure in Compliant Overweight or Obese Adults. J Nutr 2016; 146:2513-2519. [PMID: 27807041 DOI: 10.3945/jn.116.238444] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/04/2016] [Accepted: 10/05/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The inclusion of almonds in an energy-restricted diet has been reported both to enhance or to have no effect on weight loss. Their effects specifically on visceral body fat stores during energy restriction have not been widely examined. In addition, almond consumption has been associated with reduced blood pressure (BP), but whether this is linked to or independent of changes in body composition has to our knowledge not been examined. OBJECTIVE We evaluated the effects of consuming almonds as part of an energy-restricted diet on body composition, specifically visceral adipose tissue (VAT) and BP, compared to a nut-free energy-restricted diet. METHODS A randomized controlled 12-wk clinical trial of 86 healthy adults [body mass index (in kg/m2): 25-40] was conducted. Participants were randomly assigned to 1 of 2 energy-restricted (500-kcal deficit/d) diets: an almond-enriched diet (AED) (15% energy from almonds) or a nut-free diet (NFD). A linear mixed-model analysis on primary outcomes such as body weight, body fat, VAT, and BP was performed on all participants [intention-to-treat (ITT) analysis] and compliant participants (complier analysis). RESULTS Body weight, truncal and total fat percentage, VAT, and systolic BP decreased after 12 wk of energy restriction in both the ITT and complier analyses (P < 0.05). The complier analysis (but not the ITT analysis) indicated a greater mean ± SEM reduction in truncal fat (AED: -1.21% ± 0.26%; NFD: -0.48% ± 0.24%; P = 0.025), total fat (AED: -1.79% ± 0.36%; NFD: -0.74% ± 0.33%; P = 0.035), and diastolic BP (AED: -2.71 ± 1.2 mm Hg; NFD: 0.815 ± 1.1 mm Hg; P = 0.029), and a greater tendency for VAT loss (AED: -8.19 ± 1.8 cm2; NFD: -3.99 ± 1.7 cm2; P = 0.09) over time in the AED group than the NFD group. CONCLUSIONS Moderate almond consumption by compliant overweight and obese individuals during energy restriction results in greater proportional reductions of truncal and total body fat as well as diastolic BP and hence may help to reduce metabolic disease risk in obesity. This trial was registered at clinicaltrials.gov as NCT02360787.
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Affiliation(s)
- Jaapna Dhillon
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Sze-Yen Tan
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Jayalath VH, Ireland C, Fleshner NE, Hamilton RJ, Jenkins DJA. The Relationship Between Metformin and Serum Prostate-Specific Antigen Levels. Prostate 2016; 76:1445-53. [PMID: 27403913 PMCID: PMC5053259 DOI: 10.1002/pros.23228] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 06/14/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metformin is the first-line oral antihyperglycemic of choice for individuals with type 2 diabetes. Recent evidence supports a role for metformin in prostate cancer chemoprotection. However, whether metformin indeed influences prostate biology is unknown. We aimed to study the association between metformin and serum prostate-specific antigen (PSA) levels-the primary prostate cancer biomarker. METHODS We conducted a cross-sectional study of 326 prostate cancer-free men with type 2 diabetes were recruited between 2004 and 2013 at St. Michael's Hospital. Men were excluded if they had a PSA ≥10-ng/ml, or used >2,550-mg/d metformin or supplemental androgens. Multivariate linear regressions quantified the association between metformin dose and log-PSA. Secondary analyses quantified the association between other antihyperglycemics (sulfonylureas, thiazolidinediones) and PSA; sensitivity analyses tested covariate interactions. RESULTS Median PSA was 0.9-ng/ml (IQR: 0.5-1.6-ng/ml). Metformin dose associated positively with BMI, HbA1c, diabetes duration, and number of statin, acetylsalicylic acid, diuretic users, and number of antihyperglycemics used, and negatively with LDL-C. In multivariate models, PSA changed by -8% (95%CI: -13 to -2%, P = 0.011) per 500-mg/d increase in metformin. Men with diabetes for ≥6 years (n = 163) saw a greater difference in PSA per 500-mg/d metformin (-12% [95% CI: -19 to -4%, P = 0.002], P-interaction = 0.018). Serum PSA did not relate with sulfonylureas, thiazolidinediones, or total number of antihyperglycemic agents used. Our findings are limited by the cross-sectional design of this study. CONCLUSIONS Metformin dose-dependently inversely associated with serum PSA, independent of other antihyperglycemic medications. Whether metformin confers a dose-dependent benefit on prostate tumorigenesis and progression warrants investigation. Prostate 76:1445-1453, 2016. © 2016 The Authors. The Prostate published by Wiley Periodicals, Inc.
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Affiliation(s)
- Viranda H Jayalath
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Christopher Ireland
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
- Department of Surgery-Urology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert J Hamilton
- Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
- Department of Surgery-Urology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David J A Jenkins
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada.
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
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Zibaeenezhad M, Aghasadeghi K, Hakimi H, Yarmohammadi H, Nikaein F. The Effect of Walnut Oil Consumption on Blood Sugar in Patients With Diabetes Mellitus Type 2. Int J Endocrinol Metab 2016; 14:e34889. [PMID: 28115966 PMCID: PMC5219895 DOI: 10.5812/ijem.34889] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prevalence of diabetes mellitus type 2 (DM) is increasing globally. Considering the potential role of poly-unsaturated fatty acids in prevention of DM type 2 and lipid profiles improvement, some studies have been carried out on walnut. However, there are no studies on control of blood sugar in DM type 2 patients using walnut. OBJECTIVES The current study aimed to evaluate the effect of walnut oil on blood sugar in DM type 2 patients. METHODS This randomized control clinical trial was performed on 100 patients with DM type 2. For the experiment group (n = 50), walnut oil (15 g/day for three months) was added to their diet, while the control group (n = 50) did not undergo any interventions. Before initiation of the experiment and after the experiment, the systolic and diastolic blood pressure (SBP and DBP) levels, fasting blood sugar (FBS) and HbA1c were measured. RESULTS The two groups were not significantly different for SBP, DBP, body weight, and Body Mass Index. HbA1c level decreased significantly in the experiment group by 7.86% ± 21.97 (P = 0.005) from 7.00 ± 1.08 before the intervention to 6.37 ± 1.29 after the intervention. Also, FBS level decreased significantly by 8.24% ± 16.77 (P = 0.001); from 158.37 ± 48.16 before the intervention to 137.91 ± 23.24 after the intervention in the experimental group. These changes in the control group were not significant. CONCLUSIONS Consumption of walnut oil (15 g/day for three months) was shown to improve blood glucose level but, no changes were noted for bodyweight and blood pressure in type two diabetic patients.
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Affiliation(s)
| | - Kamran Aghasadeghi
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Hossein Hakimi
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Hassan Yarmohammadi
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Farzad Nikaein
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Farzad Nikaein, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9175550409, E-mail:
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Abstract
Human beings have known about pistachio nuts since 6000 bc. Since then, pistachios have been systematically incorporated into the diet of various cultures. They are nutrient-dense nuts with a healthy nutritional profile that contains fiber, unsaturated fatty acids and antioxidant compounds.
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Carughi A, Feeney MJ, Kris-Etherton P, Fulgoni V, Kendall CWC, Bulló M, Webb D. Pairing nuts and dried fruit for cardiometabolic health. Nutr J 2016; 15:23. [PMID: 26944400 PMCID: PMC4779204 DOI: 10.1186/s12937-016-0142-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/24/2016] [Indexed: 01/04/2023] Open
Abstract
Certain dietary patterns, in which fruits and nuts are featured prominently, reduce risk of diabetes and cardiovascular disease. However, estimated fruit consumption historically in the U.S. has been lower than recommendations. Dried fruit intake is even lower with only about 6.9 % of the adult population reporting any consumption. The 2015 Dietary Guidelines Advisory Committee identified a gap between recommended fruit and vegetable intakes and the amount the population consumes. Even fewer Americans consume tree nuts, which are a nutrient-dense food, rich in bioactive compounds and healthy fatty acids. Consumption of fruits and nuts has been associated with reduced risk of cardiometabolic disease. An estimated 5.5 to 8.4 % of U.S. adults consume tree nuts and/or tree nut butter. This review examines the potential of pairing nuts and dried fruit to reduce cardiometabolic risk factors and focuses on emerging data on raisins and pistachios as representative of each food category. Evidence suggests that increasing consumption of both could help improve Americans’ nutritional status and reduce the risk of chronic diseases.
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Affiliation(s)
- Arianna Carughi
- Sun-Maid Growers of California, 13525 S. Bethel Ave., Kingsburg, CA, 93631, USA.
| | - Mary Jo Feeney
- Consultant to the Food and Agriculture Industries, 11030 Mora Dr, Los Altos, CA, 94024, USA.
| | - Penny Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, 319 Chandlee Laboratory, University Park, PA, 16802, USA.
| | - Victor Fulgoni
- Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI, 49014, USA.
| | - Cyril W C Kendall
- Department of Nutrition Sciences, Faculty of Medicine, University of Toronto, 32 Ridley Gardens, Toronto, ON, M6R 2T8, Canada.
| | - Mònica Bulló
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Rovira i Virgili University, Sant Llorenç, 21, 43201, Reus, Spain.
| | - Densie Webb
- Health and Nutrition Communications, 8014 Greenslope Drive, Austin, TX, 78759, USA.
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Blanco-Rojo R, Alcala-Diaz JF, Wopereis S, Perez-Martinez P, Quintana-Navarro GM, Marin C, Ordovas JM, van Ommen B, Perez-Jimenez F, Delgado-Lista J, Lopez-Miranda J. The insulin resistance phenotype (muscle or liver) interacts with the type of diet to determine changes in disposition index after 2 years of intervention: the CORDIOPREV-DIAB randomised clinical trial. Diabetologia 2016; 59:67-76. [PMID: 26474775 DOI: 10.1007/s00125-015-3776-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 09/08/2015] [Indexed: 01/16/2023]
Abstract
AIMS/HYPOTHESIS The aim of the study was to determine whether basal insulin resistance (IR) phenotype (muscle and/or liver) determines the effect of long-term consumption of a Mediterranean diet or a low-fat diet on tissue-specific IR and beta cell function. METHODS The study was performed in 642 patients included in The effect of an olive oil rich Mediterranean diet on type 2 diabetes mellitus risk and incidence study (CORDIOPREV-DIAB). A total of 327 patients were randomised to a Mediterranean diet (35% fat; 22% from monounsaturated fatty acids) and 315 to a low-fat diet (<28% fat). At baseline, the patients were classified into four phenotypes according to the type of IR: (1) no IR; (2) muscle IR; (3) liver IR; (4) muscle + liver IR. The hepatic insulin resistance index (HIRI), muscular insulin sensitivity index (MISI) and disposition index were analysed at baseline and after 2 years of follow-up. RESULTS At baseline, 322 patients presented no IR, 106 presented muscle IR, 109 presented liver IR, and 105 presented muscle + liver IR. With both dietary interventions, HIRI decreased in all patients (p < 0.001) and MISI increased in muscle IR and muscle + liver IR patients (p < 0.01). Long-term intake of the Mediterranean diet increased the disposition index and insulinogenic index in the muscle IR patients (p = 0.042 and p = 0.044, respectively) and the disposition index in the muscle + liver IR patients (p = 0.048), whereas the low-fat diet increased the disposition index in the liver IR patients (p = 0.017). CONCLUSIONS/INTERPRETATION Although both diets improve insulin sensitivity, there are differences based on basal IR phenotypes. Moreover, according to insulinogenic and disposition index data, a low-fat diet might be more beneficial to patients with liver IR, whereas patients with muscle IR and muscle + liver IR might benefit more from a Mediterranean diet. Trial registration ClinicalTrials.gov NCT00924937 FUNDING: The study was supported by the Ministerio de Economia y Competitividad (AGL2012/39615) and by the Ministerio de Ciencia e Innovacion (PIE14/00005 and PI13/00023).
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Affiliation(s)
- Ruth Blanco-Rojo
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Juan F Alcala-Diaz
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | | | - Pablo Perez-Martinez
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Gracia M Quintana-Navarro
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Carmen Marin
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- IMDEA Food Institute, Madrid, Spain
| | | | - Francisco Perez-Jimenez
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain
- Department of Medicine, University of Cordoba, Cordoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)
| | - Jose Lopez-Miranda
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain.
- Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain.
- Department of Medicine, University of Cordoba, Cordoba, Spain.
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), .
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A systematic review and meta-analysis of nut consumption and incident risk of CVD and all-cause mortality. Br J Nutr 2015; 115:212-25. [DOI: 10.1017/s0007114515004316] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDietary 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, Phet=0·04, I2=43 %), CVD mortality (five studies; RR 0·73; 95 % CI 0·68, 0·78; Phet=0·31, I2=16 %), all CHD (three studies; RR 0·66; 95 % CI 0·48, 0·91; Phet=0·0002, I2=88 %) and CHD mortality (seven studies; RR 0·70; 95 % CI 0·64, 0·76; Phet=0·65, I2=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; Phet=0·03, I2=72 %) and stroke mortality (three studies; RR 0·83; 95 % CI 0·69, 1·00; Phet=0·54, I2=0 %). No evidence of association was found for total stroke (two studies; RR 1·05; 95 % CI 0·69, 1·61; Phet=0·04, I2=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.
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Sauder KA, McCrea CE, Ulbrecht JS, Kris-Etherton PM, West SG. Effects of pistachios on the lipid/lipoprotein profile, glycemic control, inflammation, and endothelial function in type 2 diabetes: A randomized trial. Metabolism 2015; 64:1521-9. [PMID: 26383493 PMCID: PMC4872503 DOI: 10.1016/j.metabol.2015.07.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/13/2015] [Accepted: 07/22/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The health benefits of regular nut consumption have been well-documented; however, effects on cardiovascular risk in diabetes are emerging. This study examined the effects of daily pistachio consumption on the lipid/lipoprotein profile, glycemic control, markers of inflammation, and endothelial function in adults with type 2 diabetes. MATERIALS/METHODS We enrolled 30 adults (40-74 years) with well-controlled type 2 diabetes (mean glycated hemoglobin 6.2%) in a randomized, crossover, controlled feeding study. After a 2-week run-in period, participants consumed nutritionally-adequate diets with pistachios (contributing 20% of total energy) or without pistachios for 4 weeks each, separated by a 2-week washout. We assessed fasting lipids/lipoproteins, glycemic measures (while fasted and during a 75 g oral glucose tolerance test), inflammatory markers, and endothelial function after each diet period. RESULTS Total cholesterol and the ratio of total to HDL cholesterol were significantly lower (p<0.05) following the pistachio diet (4.00 mmol/L and 4.06 mmol/L, respectively) compared to the control diet (4.15 mmol/L and 4.37 mmol/L, respectively). Triglycerides were significantly lower (p=0.003) following the pistachio diet (1.56 mmol/L) compared to the control diet (1.84 mmol/L). There were no treatment differences in fasting glucose and insulin, but fructosamine was significantly lower (p=0.03) following the pistachio diet (228.5 μmol/l) compared to the control diet (233.5 μmol/l). Inflammatory markers and endothelial function were unchanged. CONCLUSION Daily pistachio consumption can improve some cardiometabolic risk factors in adults with well-controlled type 2 diabetes. Our findings support recommendations that individuals with diabetes follow healthy dietary patterns that include nuts.
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Affiliation(s)
- Katherine A Sauder
- Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Cindy E McCrea
- Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Jan S Ulbrecht
- Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, 110 Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Sheila G West
- Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA; Department of Nutritional Sciences, 110 Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
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Martin N, Germanò R, Hartley L, Adler AJ, Rees K. Nut consumption for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2015; 2015:CD011583. [PMID: 26411417 PMCID: PMC9798256 DOI: 10.1002/14651858.cd011583.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nuts contain a number of nutritional attributes which may be cardioprotective. A number of epidemiological studies have shown that nut consumption may have a beneficial effect on people who have cardiovascular disease (CVD) risk factors. However, results from randomised controlled trials (RCTs) are less consistent. OBJECTIVES To determine the effectiveness of nut consumption for the primary prevention of CVD. SEARCH METHODS We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Web of Science Core Collection, CINAHL, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and Health Economics Evaluations Database (HEED) up to 30 July 2015. We searched trial registers and reference lists of reviews for further studies. We did not apply any language restrictions. SELECTION CRITERIA We included RCTs of dietary advice to increase nut consumption or provision of nuts to increase consumption lasting at least three months and including healthy adults or adults at moderate and high risk of CVD. The comparison group was no intervention or minimal intervention. The outcomes of interest were CVD clinical events and CVD risk factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, abstracted the data and assessed the risk of bias in included trials. MAIN RESULTS We included five trials (435 participants randomised) and one ongoing trial. One study is awaiting classification. All trials examined the provision of nuts to increase consumption rather than dietary advice. None of the included trials reported on the primary outcomes, CVD clinical events, but trials were small and short term. All five trials reported on CVD risk factors. Four of these trials provided data in a useable format for meta-analyses, but heterogeneity precluded meta-analysis for most of the analyses. Overall trials were judged to be at unclear risk of bias.There were variable and inconsistent effects of nut consumption on CVD risk factors (lipid levels and blood pressure). Three trials monitored adverse events. One trial reported an allergic reaction to nuts and three trials reported no significant weight gain with increased nut consumption. None of the included trials reported on other secondary outcomes, occurrence of type 2 diabetes as a major risk factor for CVD, health-related quality of life and costs. AUTHORS' CONCLUSIONS Currently there is a lack of evidence for the effects of nut consumption on CVD clinical events in primary prevention and very limited evidence for the effects on CVD risk factors. No conclusions can be drawn and further high quality longer term and adequately powered trials are needed to answer the review question.
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Affiliation(s)
- Nicole Martin
- University College LondonFarr Institute of Health Informatics Research222 Euston RoadLondonUKNW1 2DA
| | - Roberta Germanò
- University of Naples Federico IIDivision of Nutrition, Department of Clinical Medicine and SurgeryNaplesItaly
| | - Louise Hartley
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
| | - Alma J Adler
- London School of Hygiene & Tropical MedicineDepartment of Non‐communicable Disease EpidemiologyKeppel StreetLondonUKWC1E 7HT
| | - Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
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Brown RC, Tey SL, Gray AR, Chisholm A, Smith C, Fleming E, Parnell W. Association of Nut Consumption with Cardiometabolic Risk Factors in the 2008/2009 New Zealand Adult Nutrition Survey. Nutrients 2015; 7:7523-42. [PMID: 26371037 PMCID: PMC4586546 DOI: 10.3390/nu7095351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/12/2015] [Accepted: 08/21/2015] [Indexed: 01/02/2023] Open
Abstract
Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ). The associations between nut consumption and cardiometabolic risk factors among New Zealanders were examined. Data from the 24-h diet recalls of 4721 participants from the NZ Adult Nutrition Survey 2008/2009 (2008/2009 NZANS) were used to determine whole and total nut intake. Anthropometric data and blood pressure were collected, as well as blood samples analysed for total cholesterol (total-C) and HDL cholesterol (HDL-C), glycated haemoglobin (HbA1c), C-reactive protein (CRP) and folate. Participants were classified according to their five-year cardiovascular disease (CVD) risk. Both whole and total nut consumers had significantly lower weight, body mass index (BMI), waist circumference and central adiposity than non-nut consumers (all p ≤ 0.044). Whole blood, serum and red blood cell folate concentrations were significantly higher among whole nut consumers compared to non-whole nut consumers (all p ≤ 0.014), with only serum folate higher in total nut consumers compared to non-total nut consumers (p = 0.023). There were no significant differences for blood pressure, total-C, HDL-C and HbA1c; however, significant negative associations between total nut consumption and CVD risk category (p < 0.001) and CRP (p = 0.045) were apparent. Nut consumption was associated with more favourable body composition and a number of risk factors, which could collectively reduce chronic disease.
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Affiliation(s)
- Rachel C Brown
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054 New Zealand.
- Nutrition Society of New Zealand, Whanganui 4543, New Zealand.
| | - Siew Ling Tey
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, 14 Medical Drive, #07-02, Singapore 117599, Singapore.
| | - Andrew R Gray
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Alexandra Chisholm
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054 New Zealand.
| | - Claire Smith
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054 New Zealand.
- Nutrition Society of New Zealand, Whanganui 4543, New Zealand.
| | - Elizabeth Fleming
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054 New Zealand.
| | - Winsome Parnell
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054 New Zealand.
- Nutrition Society of New Zealand, Whanganui 4543, New Zealand.
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Barbour JA, Howe PRC, Buckley JD, Bryan J, Coates AM. Effect of 12 Weeks High Oleic Peanut Consumption on Cardio-Metabolic Risk Factors and Body Composition. Nutrients 2015; 7:7381-98. [PMID: 26404365 PMCID: PMC4586538 DOI: 10.3390/nu7095343] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/13/2015] [Accepted: 08/21/2015] [Indexed: 01/25/2023] Open
Abstract
Epidemiological evidence indicates an inverse association between nut consumption and obesity, inflammation, hyperlipidaemia and glucose intolerance. We investigated effects of high oleic peanut consumption vs. a nut free diet on adiposity and cardio-metabolic risk markers. In a randomised cross-over design, 61 healthy subjects (65 ± 7 years, body mass index (BMI) 31 ± 4 kg/m²) alternated either high oleic peanuts (15%-20% of energy) or a nut free diet for 12 weeks. Body composition and mass, waist circumference, C-reactive protein (CRP), lipids, glucose and insulin were assessed at baseline and after each phase. Repeated measures analysis of variance (ANOVA) compared the two diets. Consistent with other nut studies, there were no differences in lipids, CRP, glucose and insulin with peanut consumption. In contrast, some reports have demonstrated benefits, likely due to differences in the study cohort. Energy intake was 10% higher (853 kJ, p < 0.05), following peanut consumption vs. control, attributed to a 30% increase in fat intake (p < 0.001), predominantly monounsaturated (increase 22 g, p < 0.05). Despite greater energy intake during the peanut phase, there were no differences in body composition, and less than predicted increase (0.5 kg) in body weight for this additional energy intake, possibly due to incomplete nutrient absorption and energy utilisation.
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Affiliation(s)
- Jayne A Barbour
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Peter R C Howe
- Clinical Nutrition Research Centre, University of Newcastle (PRCH), University Drive Callaghan, New South Wales 2308, Australia.
| | - Jonathan D Buckley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Janet Bryan
- Department of Psychology, Social Work and Social Policy, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Alison M Coates
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
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Augustin LSA, Kendall CWC, Jenkins DJA, Willett WC, Astrup A, Barclay AW, Björck I, Brand-Miller JC, Brighenti F, Buyken AE, Ceriello A, La Vecchia C, Livesey G, Liu S, Riccardi G, Rizkalla SW, Sievenpiper JL, Trichopoulou A, Wolever TMS, Baer-Sinnott S, Poli A. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015; 25:795-815. [PMID: 26160327 DOI: 10.1016/j.numecd.2015.05.005] [Citation(s) in RCA: 387] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. METHODS International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). RESULTS The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. CONCLUSIONS Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.
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Affiliation(s)
- L S A Augustin
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.
| | - C W C Kendall
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada; University of Saskatchewan, Saskatoon, Canada
| | - D J A Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - W C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - A Astrup
- Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A W Barclay
- Glycemic Index Foundation, Sydney, Australia
| | - I Björck
- Food for Health Science Centre, Lund University, Lund, Sweden
| | - J C Brand-Miller
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - F Brighenti
- Department of Food Sciences, University of Parma, Parma, Italy
| | - A E Buyken
- Department of Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - A Ceriello
- Institut d' Investigación Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - G Livesey
- Independent Nutrition Logic, Wymondham, UK
| | - S Liu
- Department of Epidemiology and Medicine, Brown University, Providence, USA
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - S W Rizkalla
- Institute Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie, Pitié Salpêtrière Hospital, Paris, France; National Institute of Health and Medical Research (INSERM), University Pierre et Marie Curie and Pitié Salpêtrière Hospital, Paris, France
| | - J L Sievenpiper
- Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - A Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - T M S Wolever
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | | | - A Poli
- Nutrition Foundation of Italy, Milan, Italy
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Van Blarigan EL, Kenfield SA, Yang M, Sesso HD, Ma J, Stampfer MJ, Chan JM, Chavarro JE. Fat intake after prostate cancer diagnosis and mortality in the Physicians' Health Study. Cancer Causes Control 2015; 26:1117-26. [PMID: 26047644 PMCID: PMC4499006 DOI: 10.1007/s10552-015-0606-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 05/28/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Diet after prostate cancer diagnosis may impact disease progression. We hypothesized that consuming saturated fat after prostate cancer diagnosis would increase risk of mortality, and consuming vegetable fat after diagnosis would lower the risk of mortality. METHODS This was a prospective study among 926 men with non-metastatic prostate cancer in the Physicians' Health Study who completed a food frequency questionnaire a median of 5 years after diagnosis and were followed for a median of 10 years after the questionnaire. We examined post-diagnostic saturated, monounsaturated, polyunsaturated, and trans fat, as well as animal and vegetable fat, intake in relation to all-cause and prostate cancer-specific mortality. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated using multivariate Cox proportional hazards regression. RESULTS We observed 333 deaths (56 prostate cancer deaths) during follow-up. Men who obtained 5 % more of their daily calories from saturated fat and 5 % less of their daily calories from carbohydrate after diagnosis had a 1.8-fold increased risk of all-cause mortality (HR 1.81; 95 % CI 1.20, 2.74; p value 0.005) and a 2.8-fold increased risk of prostate cancer-specific mortality (HR 2.78; 95 % CI 1.01, 7.64; p value 0.05). Men who obtained 10 % more of their daily calories from vegetable fats and 10 % less of their daily calories from carbohydrates had a 33 % lower risk of all-cause mortality (HR 0.67; 95 % CI 0.47, 0.96; p value 0.03). CONCLUSIONS Among men with non-metastatic prostate cancer, saturated fat intake may increase risk of death and vegetable fat intake may lower risk of death.
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Affiliation(s)
- Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, Mission Hall: Global Health and Clinical Sciences Building, 550 16th St. 2nd Flr., UCSF Box 0560, San Francisco, CA, 94158, USA,
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46
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Abstract
Nuts are nutrient-dense foods with complex matrices rich in unsaturated fatty acids and other bioactive compounds, such as l-arginine, fibre, healthful minerals, vitamin E, phytosterols and polyphenols. By virtue of their unique composition, nuts are likely to beneficially affect cardiovascular health. Epidemiological studies have associated nut consumption with a reduced incidence of CHD in both sexes and of diabetes in women, but not in men. Feeding trials have clearly demonstrated that consumption of all kinds of nuts has a cholesterol-lowering effect, even in the context of healthy diets. There is increasing evidence that nut consumption has a beneficial effect on oxidative stress, inflammation and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Contrary to expectations, epidemiological studies and clinical trials suggest that regular nut consumption is not associated with undue weight gain. Recently, the PREvención con DIeta MEDiterránea randomised clinical trial of long-term nutrition intervention in subjects at high cardiovascular risk provided first-class evidence that regular nut consumption is associated with a 50 % reduction in incident diabetes and, more importantly, a 30 % reduction in CVD. Of note, incident stroke was reduced by nearly 50 % in participants allocated to a Mediterranean diet enriched with a daily serving of mixed nuts (15 g walnuts, 7·5 g almonds and 7·5 g hazelnuts). Thus, it is clear that frequent nut consumption has a beneficial effect on CVD risk that is likely to be mediated by salutary effects on intermediate risk factors.
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47
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Abstract
Epidemiological and/or clinical trials have suggested that nut consumption has a beneficial impact on health outcomes such as hypertension, diabetes, CVD, cancer, other inflammatory conditions and total mortality. Nuts are nutrient-dense foods with a healthy fatty acid profile, as well as provide other bioactive compounds with recognised health benefits. Among nuts, pistachios have a lower fat and energy content and the highest levels of K, γ-tocopherol, vitamin K, phytosterols, xanthophyll carotenoids, certain minerals (Cu, Fe and Mg), vitamin B6 and thiamin. Pistachios have a high antioxidant and anti-inflammatory potential. The aforementioned characteristics and nutrient mix probably contribute to the growing body of evidence that consumption of pistachios improves health. The present review examines the potential health effects of nutrients and phytochemicals in pistachios, as well as epidemiological and clinical evidence supporting these health benefits.
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48
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O'Neil CE, Fulgoni VL, Nicklas TA. Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005-2010. Nutr J 2015; 14:64. [PMID: 26123047 PMCID: PMC4484644 DOI: 10.1186/s12937-015-0052-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/19/2015] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Carol E O'Neil
- Louisiana State University Agricultural Center, 261 Knapp Hall, 110 LSU Union Square, Baton Rouge, LA, 70803, USA.
| | - Victor L Fulgoni
- Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI, 49014, USA.
| | - Theresa A Nicklas
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
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49
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Abstract
This article covers some important concepts and controversies in modern nutritional science. It describes a diet style designed to maximize health, longevity, and disease reversal—foundationally structured on the quality and comprehensive adequacy of nutrients rather than the balance of macronutrients, as is more popular today. I call such a diet, which attempts to optimize micronutrients, a nutritarian diet. I will review a small case series demonstrating typical results in diabetics and some of my clinical observations over the last 25 years treating people with a nutritarian diet, which could be either vegan or flexitarian. I will also discuss health concerns observed from an unsupplemented vegan diet, specifically the risk of depression and later life dementia in individuals with enhanced need for long-chain omega-3 fatty acids.
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Affiliation(s)
- Joel Fuhrman
- Nutritional Research Foundation, Flemington, New Jersey (JF)
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50
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Mohammadifard N, Salehi-Abargouei A, Salas-Salvadó J, Guasch-Ferré M, Humphries K, Sarrafzadegan N. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr 2015; 101:966-82. [PMID: 25809855 DOI: 10.3945/ajcn.114.091595] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 03/04/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although several studies have assessed the effects of nut consumption (tree nuts, peanuts, and soy nuts) on blood pressure (BP), the results are conflicting. OBJECTIVE The aim was to conduct a systematic review and meta-analysis of published randomized controlled trials (RCTs) to estimate the effect of nut consumption on BP. DESIGN The databases MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched for RCTs carried out between 1958 and October 2013 that reported the effect of consuming single or mixed nuts (including walnuts, almonds, pistachios, cashews, hazelnuts, macadamia nuts, pecans, peanuts, and soy nuts) on systolic BP (SBP) or diastolic BP (DBP) as primary or secondary outcomes in adult populations aged ≥18 y. Relevant articles were identified by screening the abstracts and titles and the full text. Studies that evaluated the effects for <2 wk or in which the control group ingested different healthy oils were excluded. Mean ± SD changes in SBP and DBP in each treatment group were recorded for meta-analysis. RESULTS Twenty-one RCTs met the inclusion criteria. Our findings suggest that nut consumption leads to a significant reduction in SBP in participants without type 2 diabetes [mean difference (MD): -1.29; 95% CI: -2.35, -0.22; P = 0.02] but not in the total population. Subgroup analyses of different nut types suggest that pistachios, but not other nuts, significantly reduce SBP (MD: -1.82; 95% CI: -2.97, -0.67; P = 0.002). Our study suggests that pistachios (MD: -0.80; 95% CI: -1.43, -0.17; P = 0.01) and mixed nuts (MD: -1.19; 95% CI: -2.35, -0.03; P = 0.04) have a significant reducing effect on DBP. We found no significant changes in DBP after the consumption of other nuts. CONCLUSIONS Total nut consumption lowered SBP in participants without type 2 diabetes. Pistachios seemed to have the strongest effect on reducing SBP and DBP. Mixed nuts also reduced DBP.
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Affiliation(s)
- Noushin Mohammadifard
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Amin Salehi-Abargouei
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Jordi Salas-Salvadó
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Marta Guasch-Ferré
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Karin Humphries
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Nizal Sarrafzadegan
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
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