Almond consumption and cardiovascular risk factors in adults with prediabetes.
OBJECTIVE
The authors tested the hypothesis that in adults with prediabetes, an almond-enriched American Diabetes Association (ADA) diet improves measures of insulin sensitivity and other cardiovascular risk factors compared with an ADA nut-free diet.


METHODS



METHODS
Randomized parallel-group trial.


METHODS
Outpatient dietary counseling and blood analysis.


METHODS
Sixty-five adult participants with prediabetes.


METHODS
Sixteen weeks of dietary modification featuring an ADA diet containing 20% of energy from almonds (approximately 2 oz per day).


METHODS
Outcomes included fasting glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, TC:HDL-C, and HbA1c, which were measured at weeks 0, 8, and 16. Body weight, body mass index (BMI), waist circumference, blood pressure, and nutrient intake were measured at weeks 0, 4, 8, 12, and 16.


RESULTS
The almond-enriched intervention group exhibited greater reductions in insulin (-1.78 µU/ml vs. +1.47 µU/ml, p  =  0.002), homeostasis model analysis for insulin resistance (-0.48 vs. +0.30, p  =  0.007), and homeostasis model analysis for beta-cell function (-13.2 vs. +22.3, p  =  0.001) compared with the nut-free control group. Clinically significant declines in LDL-C were found in the almond-enriched intervention group (-12.4 mg/dl vs. -0.4 mg/dl) as compared with the nut-free control group. No changes were observed in BMI (-0.4 vs. -0.7 kg/m(2), p  =  0.191), systolic blood pressure (-4.4 mm Hg vs. -3.5 mm Hg, p  =  0.773), or for the other measured cardiovascular risk factors.


CONCLUSIONS
An ADA diet consisting of 20% of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinically significant improvements in LDL-C in adults with prediabetes.
Wien
Michelle
M
University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA. mwien@llu.edu
Bleich
David
D
Raghuwanshi
Maya
M
Gould-Forgerite
Susan
S
Gomes
Jacqueline
J
Monahan-Couch
Lynn
L
Oda
Keiji
K
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009754:Nuts; D008517:Phytotherapy; D028321:Plant Preparations / Q000494:pharmacology / Q000627:therapeutic use*; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D027861:Prunus; D012307:Risk Factors
D008078:Cholesterol, LDL; D007328:Insulin; D028321:Plant Preparations