title: Effects of pistachios on the lipid/lipoprotein profile, glycemic control, inflammation, and endothelial function in type 2 diabetes: A randomized trial.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Sauder
authors.affiliation: Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA.
authors.forename: Cindy E
authors.initials: CE
authors.lastname: McCrea
authors.affiliation: Department of Biobehavioral Health, 219 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA, 16802, USA.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Ulbrecht
authors.affiliation: Department of Nutritional Sciences, 110 Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
authors.forename: Penny M
authors.initials: PM
authors.lastname: Kris-Etherton
authors.affiliation: 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. Electronic address: sgw2@psu.edu.
authors.forename: Sheila G
authors.initials: SG
authors.lastname: West
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008875:Middle Aged; D027927:Pistacia
chemical_list: D001786:Blood Glucose; D008055:Lipids; D008074:Lipoproteins
keywords: Cholesterol; Endothelial function; Glycemia; Nuts; Pistachios