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Gayathri R, Abirami K, Kalpana N, Manasa VS, Sudha V, Shobana S, Jeevan RG, Kavitha V, Parkavi K, Anjana RM, Unnikrishnan R, Gokulakrishnan K, Beatrice DA, Krishnaswamy K, Pradeepa R, Mattes RD, Salas-Salvadó J, Willett W, Mohan V. Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial. Front Nutr 2023; 9:1055923. [PMID: 36704786 PMCID: PMC9873375 DOI: 10.3389/fnut.2022.1055923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/07/2022] [Indexed: 01/12/2023] Open
Abstract
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.
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Affiliation(s)
- Rajagopal Gayathri
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,Department of Biochemistry, University of Madras, Chennai, Tamil Nadu, India
| | - Kuzhandhaivelu Abirami
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Natarajan Kalpana
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Valangaiman Sriram Manasa
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Sudha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Raman Ganesh Jeevan
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Kavitha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Karthikeyan Parkavi
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kuppan Gokulakrishnan
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - D. Annette Beatrice
- Department of Home Science, Women’s Christian College, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Pradeepa
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Richard D. Mattes
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Walter Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States,Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,*Correspondence: Viswanathan Mohan, , www.drmohansdiabetes.com
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Mohan V, Gayathri R, Jaacks LM, Lakshmipriya N, Anjana RM, Spiegelman D, Jeevan RG, Balasubramaniam KK, Shobana S, Jayanthan M, Gopinath V, Divya S, Kavitha V, Vijayalakshmi P, Bai R MR, Unnikrishnan R, Sudha V, Krishnaswamy K, Salas-Salvadó J, Willett WC. Cashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial. J Nutr 2018; 148:63-69. [PMID: 29378038 DOI: 10.1093/jn/nxx001] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/17/2017] [Indexed: 02/07/2023] Open
Abstract
Background There is increasing evidence that nut consumption decreases the risk of cardiovascular disease. However, there are few data on the health effects of cashew nuts among adults with type 2 diabetes (T2DM). Objective The study aimed to investigate the effects of cashew nut supplementation on glycemia, body weight, blood pressure, and lipid profile in Asian Indians with T2DM. Methods In a parallel-arm, randomized controlled trial, 300 adults with T2DM [mean ± SD age: 51 ± 9.3 y; body mass index (BMI; in kg/m2): 26.0 ± 3.4; 55% male] were randomly assigned to receive advice to follow a standard diabetic diet (control) or similar advice plus 30 g cashew nuts/d (intervention) for 12 wk. The macronutrient composition of the prescribed diabetic diet was 60-65% energy from carbohydrates, 15-25% from fat, and the rest from protein. Differences between groups in changes in anthropometric and biochemical variables were analyzed using linear models with robust variance estimation under an assumed independence working correlation. Results Participants in the intervention group had a greater decrease in systolic blood pressure from baseline to 12 wk than did controls (-4.9 ± 13.7 compared with -1.7 ± 11.6 mm Hg; P = 0.04) and a greater increase in plasma HDL cholesterol compared with controls (+1.7 ± 5.6 compared with +0.1 ± 4.6 mg/dL; P = 0.01). There were no differences between the groups with respect to changes in body weight, BMI, blood lipid, and glycemic variables. Plasma oleic acid concentrations and self-reported dietary intake of nuts, oleic acid, and monounsaturated fatty acids suggested excellent compliance with the nut consumption. Conclusion Cashew nut supplementation in Asian Indians with T2DM reduced systolic blood pressure and increased HDL cholesterol concentrations with no deleterious effects on body weight, glycemia, or other lipid variables. This study was registered at the clinical trial registry of India as CTRI/2017/07/009022.
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Affiliation(s)
- Viswanathan Mohan
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajagopal Gayathri
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Lindsay M Jaacks
- Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Nagarajan Lakshmipriya
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Donna Spiegelman
- Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Departments of Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Raman Ganesh Jeevan
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kandappa K Balasubramaniam
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Mathialagan Jayanthan
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Viswanathan Gopinath
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Selvakumar Divya
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Kavitha
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Parthasarathy Vijayalakshmi
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Mookambika Ramya Bai R
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Sudha
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Hospital Universitari Sant Joan de Reus, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain, and CIBERobn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Walter C Willett
- Departments of Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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