Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial

Background

Asian Indians have an increased susceptibility to type 2 diabetes and premature coronary artery disease. Nuts, like almonds, are rich in unsaturated fat and micronutrients with known health benefits.

Objectives

This study aimed to assess the efficacy of almonds for reduction of insulin resistance and improving lipid profile in overweight Asian Indian adults.

Methods

This parallel-arm, randomized, controlled trial was conducted in Chennai, India on 400 participants aged 25-65 years with a body mass index ≥ 23 kg/m². The intervention group received 43 g of almonds/day for 12 weeks, while the control group was advised to consume a customary diet but to avoid nuts. Anthropometric, clinical, and dietary data were assessed at periodic intervals. Glucose tolerance, serum insulin, glycated hemoglobin, C-peptide and lipid profile were assessed at baseline and end of the study. Insulin resistance (homeostasis assessment model-HOMA IR) and oral insulin disposition index (DIo) were calculated.

Results

A total of 352 participants completed the study. Significant improvement was seen in DIo [mean (95% CI) = + 0.7 mmol/L (0.1, 1.3); p = 0.03], HOMA IR (-0.4 (-0.7, -0.04; p = 0.03) and total cholesterol (-5.4 mg/dl (-10.2, -0.6); p = 0.03) in the intervention group compared to the control group. Incremental area under the curve (IAUC) and mean amplitude of glycemic excursion (MAGE) assessed using continuous glucose monitoring systems were also significantly lower in the intervention group. Dietary 24-h recalls showed a higher significant reduction in carbohydrate and increase in mono unsaturated fatty acid (MUFA) and polyunsaturated fatty acids (PUFA) intake in the intervention group compared to the control group.

Conclusion

Daily consumption of almonds increased the intake of MUFA with decrease in carbohydrate calories and decreases insulin resistance, improves insulin sensitivity and lowers serum cholesterol in Asian Indians with overweight/obesity. These effects in the long run could aid in reducing the risk of diabetes and other cardiometabolic disease.

Antepartum cardiorespiratory fitness (CRF) quantification by estimation of maximal oxygen consumption (Vo2 max) in pregnant South Indian women

The aim of the study was to calculate the maximal oxygen consumption (Vo2max) for pregnant women of varying trimesters and to quantify the cardiorespiratory fitness (CRF)with the objective of being able to determine the exercise dose for antenatal women which can be prescribed to achieve optimal exercise benefits during various trimesters. A study group comprising 64 pregnant women with uncomplicated singleton pregnancy and control group with 77 non-pregnant women were subjected to Cooper's 12 minutes walk test. From the distance covered in 12 minutes, Vo2max was calculated. The Vo2max values were statistically analysed between the non-pregnant and pregnant and also its variability among the trimesters. Percentile tables of Vo2max were drawn and multiple comparisons were applied. Results show that the Vo2max values among non-pregnant and first trimester ranges between 18 and 22 ml/kg/minute. Trimesters II and III had a range of Vo2max values between 16-20 and 14-18 ml/kg/minute respectively. The CRF of pregnant women significantly reduced to 6%, 9% and 18% in each trimester respectively when compared with the reference table framed out of non-pregnant Vo2max values. Among the study group the reduction in Vo2max values had no statistical significance between first 2 trimesters but trimester III significantly differs from other trimesters. The exercise prescription cannot be the same for pregnant and non-pregnant women. Even among the pregnant women, III trimester needs separate exercise prescription from the other two trimesters as CRF is markedly compromised towards term.