title: The glycemic effect of nut-enriched meals in healthy and diabetic subjects.
abstract: OBJECTIVE
  The intake of nuts has been linked to a reduced risk of cardiovascular disease (CVD) and diabetes in large cohort studies. One potential contributing mechanism may be the ability of nuts to improve post-meal glycemic response. We, therefore, examined the effect of nuts alone and in combination with white bread on postprandial glycemia.
  
  
  RESULTS
  30, 60 and 90 g (approximately 1, 2 and 3 ounces) of mixed nuts were consumed with and without 50 g available carbohydrate from white bread by 10-14 normoglycemic and 5-10 type 2 diabetic subjects. Glycemic response (GR) was assessed by calculating the incremental area under the 2 h blood glucose curve. All three doses of mixed nuts, when fed alone, significantly reduced the glycemic response in both normoglycemic and diabetic patients. Furthermore, in the normoglycemic subjects, adding nuts to white bread progressively reduced the GR of the meal by 11.2 ± 11.6%, 29.7 ± 12.2% and 53.5 ± 8.5% for the 30, 60, and 90 g doses (P = 0.354, P = 0.031 and P < 0.001, respectively), while in subjects with type 2 diabetes, the effect was half of that seen in the non-diabetic subjects (P = 0.474, P = 0.113 and P = 0.015, respectively).
  
  
  CONCLUSIONS
  Nuts alone have little effect on post-meal blood glucose response. Furthermore, when taken with bread, nuts progressively reduce the glycemic response in a dose-dependent manner. While these findings support a short-term benefit for nuts in postprandial glucose response, more studies are required to determine whether these acute benefits result in long-term improvements in glycemic control.
authors.affiliation: Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada. cyril.kendall@utoronto.ca
authors.forename: C W C
authors.initials: CW
authors.lastname: Kendall
authors.forename: A
authors.initials: A
authors.lastname: Esfahani
authors.forename: A R
authors.initials: AR
authors.lastname: Josse
authors.forename: L S A
authors.initials: LS
authors.lastname: Augustin
authors.forename: E
authors.initials: E
authors.lastname: Vidgen
authors.forename: D J A
authors.initials: DJ
authors.lastname: Jenkins
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001939:Bread; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D009754:Nuts; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates