title: Nut-enriched bread is an effective and acceptable vehicle to improve regular nut consumption.
abstract: OBJECTIVE
  Consuming 30 g of nuts/day is recommended to reduce chronic disease. However, nut consumption appears far from ideal among several populations. A potential strategy to increase consumption is to add nuts to a staple, for example, bread. Whether the health benefits and acceptability of nuts persist in this form is currently unknown. Thus, we examined the effects of consuming three nut-enriched breads on postprandial glycaemia, satiety, gastrointestinal tolerance, dietary intakes, and acceptance.
  
  
  METHODS
  In this controlled, crossover study, 32 participants were randomly allocated to receive one of four breads for 8 days each. Three breads contained either 30 g of finely sliced hazelnuts, 30 g semi-defatted hazelnut flour, or 15 g of each (amounts per 120 g bread) and were compared with a control nut-free bread. Blood glucose response was measured over 120 min, along with ratings of gastrointestinal discomfort. Appetite ratings and diet diaries were completed during each treatment period.
  
  
  RESULTS
  Area under the blood glucose curve was significantly lower for the nut breads compared to the control bread (all P < 0.001), with no significant differences between the nut breads (all P ≥ 0.130). There were no significant differences in satiety (all P ≥ 0.135) or gastrointestinal symptoms (all P ≥ 0.102) between the breads. Acceptance was highest for the finely sliced hazelnut bread. Furthermore, consuming hazelnut-enriched bread improved diet quality, increasing monounsaturated fat, vitamin E, and dietary fibre intakes.
  
  
  CONCLUSIONS
  Bread appears to be an effective and acceptable vehicle for increasing nut consumption, resulting in improved postprandial glycaemia and diet profiles. Long-term studies are now required.
authors.affiliation: Department of Human Nutrition, University of Otago, P O Box 56, Dunedin, New Zealand.
authors.forename: Asika
authors.initials: A
authors.lastname: Devi
authors.affiliation: Department of Human Nutrition, University of Otago, P O Box 56, Dunedin, New Zealand.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Chisholm
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, P O Box 56, Dunedin, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gray
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, 14 Medical Drive, #07-02, Singapore, 117599, Singapore.
authors.forename: Siew Ling
authors.initials: SL
authors.lastname: Tey
authors.affiliation: Department of Human Nutrition, University of Otago, P O Box 56, Dunedin, New Zealand.
authors.forename: Destynee
authors.initials: D
authors.lastname: Williamson-Poutama
authors.affiliation: Department of Human Nutrition, University of Otago, P O Box 56, Dunedin, New Zealand.
authors.forename: Sonya L
authors.initials: SL
authors.lastname: Cameron
authors.affiliation: Department of Human Nutrition, University of Otago, P O Box 56, Dunedin, New Zealand. rachel.brown@otago.ac.nz.
authors.forename: Rachel C
authors.identifier: http://orcid.org/0000-0001-6951-7073
authors.initials: RC
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001066:Appetite; D001786:Blood Glucose / Q000378:metabolism; D001939:Bread / Q000032:analysis*; D003258:Consumer Behavior; D031211:Corylus; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000032:analysis; D004041:Dietary Fats / Q000008:administration & dosage / Q000032:analysis; D004043:Dietary Fiber / Q000008:administration & dosage / Q000032:analysis; D004044:Dietary Proteins / Q000008:administration & dosage / Q000032:analysis; D002149:Energy Intake; D005227:Fatty Acids / Q000008:administration & dosage / Q000032:analysis; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000032:analysis; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage / Q000032:analysis; D005260:Female; D005433:Flour / Q000032:analysis; D005511:Food Handling; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage / Q000032:analysis; D008875:Middle Aged; D015596:Nutrition Assessment; D009754:Nuts; D019518:Postprandial Period; D012527:Satiation; D013649:Taste; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D005227:Fatty Acids; D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated; D018977:Micronutrients
keywords: Acceptance; Appetite; Gastrointestinal tolerance; Nuts; Postprandial glycaemic response; Satiety