Nut Consumption in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus Effects of pistachio nut supplementation on blood glucose in patients with type 2 diabetes: a randomized crossover trial. Nut consumption and risk of type II diabetes in the Physicians’ Health Study Walnut Consumption Is Associated with Lower Risk of Type 2 Diabetes in Women12 Pistachio Nut Consumption Modifies Systemic Hemodynamics, Increases Heart Rate Variability, and Reduces Ambulatory Blood Pressure in Well‐Controlled Type 2 Diabetes: a Randomized Trial Nut Consumption and Risk of Cardiovascular Disease. A pilot, randomized controlled trial to examine the health outcomes of raisin consumption in patients with diabetes. Nut and peanut butter consumption and risk of type 2 diabetes in women. Almond ingestion at mealtime reduces postprandial glycemia and chronic ingestion reduces hemoglobin A(1c) in individuals with well-controlled type 2 diabetes mellitus. Nut consumption and risk of pancreatic cancer in women Effects of hazelnuts consumption on fasting blood sugar and lipoproteins in patients with type 2 diabetes Effect of almonds on insulin secretion and insulin resistance in nondiabetic hyperlipidemic subjects: a randomized controlled crossover trial. Nuts as a Replacement for Carbohydrates in the Diabetic Diet Prospective study of nut consumption, long-term weight change, and obesity risk in women. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance) Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study.
Rationale : The evidence regarding the potential health benefits of nut consumption among individuals with type 2 diabetes mellitus is limited . Objective : To examine intake of total and specific types of nuts , including tree nuts and peanuts , in relation to subsequent risk of cardiovascular disease ( CVD ) , including coronary heart disease and stroke , and all-cause and cause-specific mortality among individuals with diabetes mellitus . Methods and Results : This prospect i ve analysis included 16 217 men and women with diabetes mellitus at baseline or diagnosed during follow-up ( Nurses ’ Health Study : 1980–2014 , Health Professionals Follow-Up Study : 1986–2014 ) .  Nut consumption was assessed using a vali date d food frequency question naire and up date d every 2 to 4 years . During 223 682 and 254 923 person-years of follow-up , there were 3336 incident CVD cases and 5682 deaths , respectively . Higher total nut consumption was associated with a lower risk of CVD incidence and mortality . The multivariate-adjusted hazard ratios ( 95 % CIs ) for participants who consumed 5 or more servings of total nuts per week ( 1 serving=28 g ) , compared with those who consumed < 1 serving per month , were 0.83 ( 0.71–0.98 ; P trend=0.01 ) for total CVD incidence , 0.80 ( 0.67–0.96 ; P trend=0.005 ) for coronary heart disease incidence , 0.66 ( 0.52–0.84 ; P trend < 0.001 ) for CVD mortality , and 0.69 ( 0.61–0.77 ; P trend < 0.001 ) for all-cause mortality .  Total nut consumption was not significantly associated with risk of stroke incidence or cancer mortality . For specific types of nuts , higher tree nut consumption was associated with lower risk of total CVD , coronary heart disease incidence , and mortality because of CVD , cancer , and all causes , whereas peanut consumption was associated with lower all-cause mortality only ( all P trend < 0.001 ) . In addition , compared with participants who did not change the consumption of total nuts from pre- to post-diabetes mellitus diagnosis , participants who increased consumption of total nuts after diabetes mellitus diagnosis had an 11 % lower risk of CVD , a 15 % lower coronary heart disease risk , a 25 % lower CVD mortality , and a 27 % lower all-cause mortality . The associations persisted in subgroup analyses stratified by sex/cohort , body mass index at diabetes mellitus diagnosis , smoking status , diabetes mellitus duration , nut consumption before diabetes mellitus diagnosis , or diet quality . Conclusions : Higher consumption of nuts , especially tree nuts , is associated with lower CVD incidence and mortality among participants with diabetes mellitus . These data provide novel evidence that supports the recommendation of incorporating nuts into healthy dietary patterns for the prevention of CVD complications and premature deaths among individuals with diabetes mellitus BACKGROUND Diabetes is a chronic , potentially debilitating , and often fatal disease . Dietary strategies to reduce postpr and ial glycemia are important in the prevention and treatment of diabetes . Nuts are rich in mono- and polyunsaturated fatty acids , which may reduce hyperglycemia and improve metabolism . OBJECTIVES To evaluate the effectiveness of pistachio nut supplementation on glycemic and inflammatory measures in patients with type 2 diabetes . METHODS In this double-blind , r and omized , placebo-controlled , crossover trial , 48 diabetic patients were equally assigned to groups A and B. Patients in group A received a snack of 25 g pistachio nuts twice a day for 12 weeks and group B received a control meal without nuts . After 12 weeks of intervention , the patients had an 8-week washout . Then the groups were displaced , and group B received the same amount of pistachios for 12 weeks . RESULTS With respect to the total change in variables over both phases , there was a marked decrease in HbA1c ( -0.4 % ) and fasting blood glucose ( FBG ) concentrations ( -16 mg/dl ) in the pistachio group compared with the control group ( p ≤ 0.001 for both ) . There was no overall significant change in BMI , blood pressure , HOMA-IR , and C-reactive protein ( CRP ) concentrations . Analysis of the two phases separately showed a decrease in FBG by 14 mg/dl and in HbA1c by 0.45 % in the treatment group ( A ) after 12 weeks , while no significant differences were seen in group B ( control group ) . In the second phase , FBG decreased from 151.36 ± 39.22 to 137.28 ± 28.65 mg/dl ( -14 mg/dl ) and HbA1c decreased from 7.42 ± 0.97 to 7.15 ± 0.68 mg/dl ( -0.28 % , p = 0.013 and p = 0.033 , respectively ) in the pistachio group ( B ) . Pistachio consumption reduced systolic blood pressure ( p = 0.007 ) , BMI ( p = 0.011 ) , and CRP ( p = 0.002 ) in patients from the treatment groups , but not insulin resistance . CONCLUSIONS Dietary consumption of pistachio nuts as a snack has beneficial effects on glycemic control , blood pressure , obesity , and inflammation markers in diabetic patients Background / Objectives : While type II diabetes ( DM ) is a major cause of morbidity in the United States , limited data are available on the association between nut intake and incident DM . We sought to examine the association between nut consumption and the risk of DM.Subjects/ Methods : Prospect i ve cohort of 20 224 male participants of the Physicians ’ Health Study I.  Nut consumption was estimated using a 19-item brief food frequency question naire , and incident DM was ascertained through yearly follow-up question naires . Cox regression was used to estimate relative risks of DM . Results : The average age of the study participants was 54.4±9.4 years ( range : 40.7–87.1 ) . During a mean follow-up of 19.2 years , 1828 cases of DM occurred . The crude incidence rates of DM were 4.82 , 4.85 , 4.92 , 4.16 , 4.29 and 3.32 cases per 1000 person-years for individuals reporting nut consumption of rarely/never , < 1 , 1 , 2–4 , 5–6 and 7 + servings per week , respectively . While nut consumption was associated with a lower risk of DM in a model adjusted for age ( P for tend 0.017 ) , such relation was attenuated on additional control for other confounders ( multivariable adjusted hazard ratios ( 95 % confidence interval ) for DM were 1.0 ( reference ) , 1.06 ( 0.93–1.20 ) , 1.10 ( 0.95–1.26 ) , 0.97 ( 0.82–1.14 ) , 0.99 ( 0.76–1.30 ) and 0.87 ( 0.61–1.24 ) from the lowest to the highest category of nut consumption , respectively ( P for trend 0.99 ) . No statistically significant association between nut consumption and DM was found in either lean or overweight/obese participants . Conclusions : Our data do not show an association between nut consumption and incident DM in US male physicians Walnuts are rich in polyunsaturated fatty acids and have been shown to improve various cardiometabolic risk factors . We aim ed to investigate the association between walnut intake and incident type 2 diabetes  in 2 large cohort studies : the Nurses ’ Health Study ( NHS ) and NHS II . We prospect ively followed 58,063 women aged 52–77 y in NHS ( 1998–2008 ) and 79,893 women aged 35–52 y in NHS II ( 1999–2009 ) without diabetes , cardiovascular disease , or cancer at baseline .  Consumption of walnuts and other nuts was assessed every 4 y using vali date d food frequency question naires .  Self-reported type 2 diabetes was confirmed by a vali date d supplemental question naire . We documented a total of 5930 incident type 2 diabetes cases during 10 y of follow-up . In the multivariable-adjusted Cox proportional hazards model without body mass index ( BMI ) , walnut consumption was associated with a lower risk of type 2 diabetes , and the HRs ( 95 % CIs ) for participants consuming 1–3 servings/mo ( 1 serving = 28 g ) , 1 serving/wk , and ≥2 servings/wk of walnuts were 0.93 ( 0.88–0.99 ) , 0.81 ( 0.70–0.94 ) , and 0.67 ( 0.54–0.82 ) compared with women who never/rarely consumed walnuts ( P-trend < 0.001 ) . Further adjustment for up date d BMI slightly attenuated the association and the HRs ( 95 % CIs ) were 0.96 ( 0.90–1.02 ) , 0.87 ( 0.75–1.01 ) , and 0.76 ( 0.62–0.94 ) , respectively ( P-trend = 0.002 ) . The consumption of total nuts ( P-trend < 0.001 ) and other tree nuts ( P-trend = 0.03 ) was also inversely associated with risk of type 2 diabetes , and the associations were largely explained by BMI . Our results suggest that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women Background Managing cardiovascular risk factors is important for reducing vascular complications in type 2 diabetes , even in individuals who have achieved glycemic control . Nut consumption is associated with reduced cardiovascular risk ; however , there is mixed evidence about the effect of nuts on blood pressure ( BP ) , and limited research on the underlying hemodynamics . This study assessed the effect of pistachio consumption on BP , systemic hemodynamics , and heart rate variability in adults with well‐controlled type 2 diabetes . Methods and Results We enrolled 30 adults ( 40 to 74 years ) with type 2 diabetes in a r and omized , crossover , controlled feeding study . After a 2‐week run‐in period , participants consumed a low‐fat control diet ( 27 % fat ) containing low‐fat/high‐carbohydrate snacks and a moderate‐fat diet ( 33 % fat ) containing pistachios ( 20 % of total energy ) for 4 weeks each , separated by a 2‐week washout . Following each diet period , we assessed BP , systemic hemodynamics , and heart rate variability at rest and during acute mental stress , and , in a subset of participants ( n=21 ) , 24‐hour ambulatory BP . BP at rest and during stress did not differ between treatments . The pistachio diet significantly reduced total peripheral resistance ( −3.7±2.9 % , P=0.004 ) , increased cardiac output ( 3.1±2.3 % , P=0.002 ) , and improved some measures of heart rate variability ( all P<0.05 ) . Systolic ambulatory BP was significantly reduced by 3.5±2.2 mm Hg ( P=0.046 ) following the pistachio diet , with the greatest reduction observed during sleep ( −5.7±2.6 mm Hg , P=0.052 ) . Conclusions A moderate‐fat diet containing pistachios modestly improves some cardiovascular risk factors  in adults with well‐controlled type 2 diabetes . Clinical Trial Registration URL : www . clinical trials.gov . Unique identifier : NCT00956735 BACKGROUND The associations between specific types of nuts , specifically peanuts and walnuts , and cardiovascular disease remain unclear . OBJECTIVES The authors sought to analyze the associations between the intake of total and specific types of nuts and cardiovascular disease , coronary heart disease , and stroke risk . METHODS The authors included 76,364 women from the Nurses ' Health Study ( 1980 to 2012 ) , 92,946 women from the Nurses ' Health Study II ( 1991 to 2013 ) , and 41,526 men from the Health Professionals Follow-Up Study ( 1986 to 2012 ) who were free of cancer , heart disease , and stroke at baseline .  Nut consumption was assessed using food frequency question naires at baseline and was up date d every 4 years . RESULTS During 5,063,439 person-years of follow-up , the authors documented 14,136 incident cardiovascular disease cases , including 8,390 coronary heart disease cases and 5,910 stroke cases . Total nut consumption was inversely associated with total cardiovascular disease and coronary heart disease after adjustment for cardiovascular risk factors . The pooled multivariable hazard ratios for cardiovascular disease and coronary heart disease among participants who consumed 1 serving of nuts ( 28 g ) 5 or more times per week , compared with the reference category ( never or almost never ) , were 0.86 ( 95 % confidence interval : 0.79 to 0.93 ; p for trend = 0.0002 ) and 0.80 ( 95 % confidence interval : 0.72 to 0.89 ; p for trend < 0.001 ) , respectively . Consumption of peanuts and tree nuts ( 2 or more times/week ) and walnuts ( 1 or more times/week ) was associated with a 13 % to 19 % lower risk of total cardiovascular disease and 15 % to 23 % lower risk of coronary heart disease . CONCLUSIONS In 3 large prospect i ve cohort studies , higher consumption of total and specific types of nuts was inversely associated with total cardiovascular disease and coronary heart disease OBJECTIVES Dried fruits , like their fresh homologues , contain relatively high concentrations of antioxidants . The aim of this study was to determine the health outcomes of raisin consumption on patients with diabetes . METHODS We examined the effects of dried grapes ( Vitis vinifera ) cultivated in Greece , namely Corinthian Raisins ( CR ) on blood pressure , fasting glucose , glucated hemoglobin ( HbA1c ) , lipid peroxidation , high-sensitivity C-reactive protein , antioxidant status , and cytokines in patients with type 2 diabetes mellitus ( T2DM ) . Forty-eight well-controlled patients with T2DM from the diabetes outpatient clinic of our hospital were recruited to a two-armed , r and omized , controlled , 24-wk prospect i ve intervention trial in order to examine the health outcomes of CR consumption . All participants were reported to consume less fruits and vegetables than the recommended amount of five servings daily . Participants in the intervention were instructed to consume CR equal to two fruit servings ( 36 g/d ) , replacing snacks with similar energy density twice during the day . Anthropometric and blood pressure measurements , assessment of dietary intake , and fasting blood draws were conducted at baseline and at week 24 . Also , phenolic compounds present in CR were analyzed in plasma of the patients . t Test for parametric data and Mann-Whitney test or Wilcoxon test for non-parametric data were performed . Significance was set at P < 0.05 . RESULTS Body weight , glycemic control , and lipid profile were not affected in either arm . Patients in the CR arm reduced their diastolic blood pressure and increased their total antioxidant potential significantly compared with baseline . The differences between the two groups at week 24 were significant . No change in high-sensitivity C-reactive protein was observed . A significant difference in plasma circulating p-hydroxybenzoic acid was observed between groups at the end of the trial . CONCLUSIONS Our study shows that naturally CR may improve health features in patients with well-controlled T2DM CONTEXT Nuts are high in unsaturated ( polyunsaturated and monounsaturated ) fat and other nutrients that may improve glucose and insulin homeostasis . OBJECTIVE To examine prospect ively the relationship between nut consumption and risk of  type 2 diabetes .  DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 83 818 women from 11 states in the Nurses ' Health Study . The women were aged 34 to 59 years , had no history of diabetes , cardiovascular disease , or cancer , completed a vali date d dietary question naire at baseline in 1980 , and were followed up for 16 years . MAIN OUTCOME MEASURE Incident cases of type 2 diabetes . RESULTS We documented 3206 new cases of type 2 diabetes .  Nut consumption was inversely associated with risk of type 2 diabetes after adjustment for age , body mass index ( BMI ) , family history of diabetes , physical activity , smoking , alcohol use , and total energy intake . The multivariate relative risks ( RRs ) across categories of nut consumption ( never/almost never , or = 5 times/week ) for a 28-g ( 1 oz ) serving size were 1.0 , 0.92 ( 95 % confidence interval [ CI ] , 0.85 - 1.00 ) , 0.84 ( 0.95 % CI , 0.76 - 0.93 ) , and 0.73 ( 95 % CI , 0.60 - 0.89 ) ( P for trend < .001 ) . Further adjustment for intakes of dietary fats , cereal fiber , and other dietary factors did not appreciably change the results . The inverse association persisted within strata defined by levels of BMI , smoking , alcohol use , and other diabetes risk factors . Consumption of peanut butter was also inversely associated with type 2 diabetes . The multivariate RR was 0.79 ( 95 % CI , 0.68 - 0.91 ; P for trend < .001 ) in women consuming peanut butter 5 times or more a week ( equivalent to > or = 140 g [ 5 oz ] of peanuts/week ) compared with those who never/almost never ate peanut butter . CONCLUSIONS Our findings suggest potential benefits of higher nut and peanut butter consumption in lowering risk of type 2 diabetes in women . To avoid increasing caloric intake , regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats Cohort studies are equivocal regarding a relationship between regular nut consumption and reduced risk of type 2 diabetes mellitus .  Although acute trials show reductions in postpr and ial glycemia in healthy individuals ingesting 60 to 90 g almonds  , trials have not been conducted using a single serving of almonds ( 28 g ) in individuals with type 2 diabetes mellitus . This r and omized crossover trial examined the impact of one serving of almonds at mealtime on postpr and ial glycemia , insulinemia , and plasma glucagon-like peptide-1 in healthy individuals and individuals with type 2 diabetes mellitus . On 2 occasions separated by at least 1 week , 19 adults ( including 7 adults with type 2 diabetes mellitus ) consumed a st and ardized evening meal and fasted overnight before ingesting the test meal ( bagel , juice , and butter ) with or without almonds . A small pilot study ( 6 - 7 subjects per group ) was also conducted to observe whether chronic almond ingestion ( 1 serving 5 d/wk for 12 weeks ) lowered hemoglobin A(1c ) in individuals with type 2 diabetes mellitus . A st and ard serving of almonds reduced postpr and ial glycemia significantly in participants with diabetes ( -30 % , P = .043 ) but did not influence glycemia in participants without diabetes ( -7 % , P = .638 ) . Insulinemia and glucagon-like peptide-1 at 30 minutes postmeal were not impacted by almond ingestion for either group . In the pilot study , regular almond ingestion for 12 weeks reduced hemoglobin A(1c ) by 4 % ( P = .045 for interaction ) but did not influence fasting glucose concentrations . These data show that modest almond consumption favorably improves both short-term and long-term markers of glucose control in individuals with uncomplicated type 2 diabetes mellitus Background : Increasing nut intake has been associated with reduced risk of diabetes mellitus , which is a risk factor for pancreatic cancer . Methods : We prospect ively followed 75 680 women in the Nurses ’ Health Study , and examined the association between nut consumption and pancreatic cancer risk . Participants with a previous history of cancer were excluded .  Nut consumption was assessed at baseline and up date d every 2 to 4 years . Relative risks ( RRs ) and 95 % confidence intervals ( 95 % CIs ) were estimated using Cox proportional hazards models . Results : We documented 466 incident cases of pancreatic cancer . After adjusting for age , height , smoking , physical activity , and total energy intake , women who consumed a 28-g ( 1 oz ) serving size of nuts ⩾2 times per week experienced a significantly lower risk of pancreatic cancer ( RR , 0.65 ; 95 % CI , 0.47–0.92 ; P for trend=0.007 ) when compared with those who largely abstained from nuts . The results did not appreciably change after further adjustment for body mass index ( BMI ) and history of diabetes mellitus ( RR , 0.68 ; 95 % CI , 0.48–0.95 ; P for trend=0.01 ) . The inverse association persisted within strata defined by BMI , physical activity , smoking , and intakes of red meat , fruits , and vegetables . Conclusion : Frequent nut consumption is inversely associated with risk of pancreatic cancer in this large prospect i ve cohort of women , independent of other potential risk factors for pancreatic cancer Background : Previous studies have demonstrated that nuts consumption have beneficial effects on serum lipid profiles in hyperlipidemic or normolipidemic subjects . However , similar studies in diabetes field are quite rare . So , we aim ed to investigate the effects of hazelnut consumption on fasting blood sugar ( FBS ) and lipid profiles in patients with type 2 Diabetes . Material s and Methods : An 8-week controlled r and omized parallel study in patients with type 2 diabetes . Fifty eligible volunteers were assigned to either the control or intervention groups . 10 % of total daily calorie intake was replaced with hazelnuts in intervention group . Blood sample s were collected from fasting patients at the start and at the end of the study . Results : After 8 weeks , there were significant differences in high-density lipoprotein-cholesterol ( HDL-C ) concentrations between two groups , using analyses of covariance ( P = 0.009 ) , which was due to the larger HDL-C reduction in control group ( P = 0.003 ) . Although , Hazelnut group achieved greater reduction in triglyceride ( TG ) concentrations than control group , these changes were not statistically significant . Neither between-group changes nor within-group changes were significant for FBS , total cholesterol ( TC ) , TG , and low-density lipoprotein-cholesterol ( LDL-C ) levels . Conclusion : Results of this study indicated that incorporation of hazelnuts into diet can prevent reduction of HDL-C concentrations in patients with type 2 diabetes , but had no effect on FBS or other lipid profile indices Nuts appear to have a marked effect in cohort studies in reducing the risk of coronary heart disease ( CHD ) , but their demonstrated ability to lower cholesterol can only explain a proportion of the reduction in risk . Our aim was to assess whether improvement in carbohydrate metabolism provides a further explanation for the effect of nuts in reducing CHD . The effects of whole almonds , taken as snacks , were compared with the effects of low saturated fat ( < 5 % energy ) whole-wheat muffins ( control ) in the therapeutic diets of hyperlipidemic subjects . In a r and omized crossover study , 27 hyperlipidemic men and women consumed 3 isoenergetic ( mean , 423 kcal/d ) supplements each for 1 month . Supplements provided 22.2 % of energy and consisted of full-dose almonds ( 73 + /- 3 g/d ) , half-dose almonds plus half-dose muffins , and full-dose muffins . Subjects were assessed at weeks 0 , 2 , and 4 and fasting blood sample s were obtained . Twenty-four-hour urinary output was collected at the end of week 4 on each treatment . Mean body weights differed by less than 300 g between treatments . No differences were seen in baseline or treatment values for fasting glucose , insulin , C-peptide , or insulin resistance as measured by homeostasis model assessment of insulin resistance . However , 24-hour urinary C-peptide output as a marker of 24-hour insulin secretion was significantly reduced on the half- and full-dose almonds by comparison to the control after adjustment for urinary creatinine output ( P = .002 and P = .004 , respectively ) . We conclude that reductions in 24-hour insulin secretion appear to be a further metabolic advantage of nuts that in the longer term may help to explain the association of nut consumption with reduced CHD risk OBJECTIVE Fat intake , especially monounsaturated fatty acid ( MUFA ) , has been liberalized in diabetic diets to preserve HDL cholesterol and improve glycemic control , yet the exact sources have not been clearly defined . Therefore , we assessed the effect of mixed nut consumption as a source of vegetable fat on serum lipids and HbA1c in type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 117 type 2 diabetic subjects were r and omized to one of three treatments for 3 months . Supplements were provided at 475 kcal per 2,000-kcal diet as mixed nuts ( 75 g/day ) , muffins , or half portions of both . The primary outcome was change in HbA1c . RESULTS The relative increase in MUFAs was 8.7 % energy on the full-nut dose compared with muffins . Using an intention-to-treat analysis ( n = 117 ) , full-nut dose ( mean intake 73 g/day ) reduced HbA1c ( −0.21 % absolute HbA1c units , 95 % CI −0.30 to −0.11 , P < 0.001 ) with no change after half-nut dose or muffin . Full-nut dose was significantly different from half-nut dose ( P = 0.004 ) and muffin ( P = 0.001 ) , but no difference was seen between half-nut dose and muffins . LDL cholesterol also decreased significantly after full-nut dose compared with muffin . The LDL cholesterol reduction after half-nut dose was intermediate and not significantly different from the other treatments . Apolipoprotein ( apo ) B and the apoB : apoA1 ratio behaved similarly . Nut intake related negatively to changes in HbA1c ( r = −0.20 , P = 0.033 ) and LDL cholesterol ( r = −0.24 , P = 0.011 ) . CONCLUSIONS Two ounces of nuts daily as a replacement for carbohydrate foods improved both glycemic control and serum lipids in type 2 diabetes BACKGROUND Data concerning the long-term association between nut consumption and weight change in a free-living population are sparse . OBJECTIVE The objective was to determine the relation between nut consumption and long-term weight change . DESIGN The participants were 51,188 women in the Nurses ' Health Study II aged 20 - 45 y , who had no cardiovascular disease , diabetes , or cancer . We prospect ively evaluated the dietary intake of nuts and subsequent weight changes from 1991 to 1999 . RESULTS Women who reported eating nuts > or = 2 times/wk had slightly less mean ( + /- SE ) weight gain ( 5.04 + /- 0.12 kg ) than did women who rarely ate nuts ( 5.55 + /- 0.04 kg ) ( P for trend < 0.001 ) . For the same comparison , when total nut consumption was subdivided into peanuts and tree nuts , the results were similar ( ie , less weight gain in women eating either peanuts or tree nuts > or = 2 times/wk ) . The results were similar in normal-weight , overweight , and obese participants . In multivariate analyses in which lifestyle and other dietary factors were controlled for , we found that greater nut consumption ( > or = 2 times/wk compared with never/almost never ) was associated with a slightly lower risk of obesity ( hazard ratio : 0.77 ; 95 % CI : 0.57 , 1.02 ; P for trend = 0.003 ) . CONCLUSIONS Higher nut consumption was not associated with greater body weight gain during 8 y of follow-up in healthy middle-aged women . Instead , it was associated with a slightly lower risk of weight gain and obesity . The results of this study suggest that incorporating nuts into diets does not lead to greater weight gain and may help weight control 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 : Design : R and omized parallel-group trial . Setting : Outpatient dietary counseling and blood analysis . Subjects : Sixty-five adult participants with prediabetes . Intervention : Sixteen weeks of dietary modification featuring an ADA diet containing 20 % of energy from almonds ( approximately 2 oz per day ) . Measures of Outcome : 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 . Clinical ly 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/m2 , 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 clinical ly significant improvements in LDL-C in adults with prediabetes Purpose Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia , including type 2 diabetes , obesity , sedentary lifestyle , and high glycemic load diet . Nut intake has been associated with a lower risk of type 2 diabetes , metabolic syndrome , and insulin resistance . However , the effect of nut intake on colon cancer recurrence and survival is not known . Patients and Methods We conducted a prospect i ve , observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency question naires while enrolled onto a r and omized adjuvant chemotherapy trial .  Using Cox proportional hazards regression , we assessed associations of nut intake with cancer recurrence and mortality . Results After a median follow-up of 6.5 years , compared with patients who abstained from nuts , individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio ( HR ) for disease-free survival of 0.58 ( 95 % CI , 0.37 to 0.92 ; Ptrend = .03 ) and an HR for overall survival of 0.43 ( 95 % CI , 0.25 to 0.74 ; Ptrend = .01 ) . In subgroup analysis , the apparent benefit was confined to  tree nut intake ( HR for disease-free survival , 0.54 ; 95 % CI , 0.34 to 0.85 ; Ptrend = .04 ; and HR for overall survival , 0.47 ; 95 % CI , 0.27 to 0.82 ; Ptrend = .04 ) . The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality . Conclusion Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality . The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation . We conducted a population -based prospect i ve investigation on 19 386 subjects enrolled in the Moli-sani study . Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ . C-reactive protein , leucocyte and platelet counts and the neutrophil : lymphocyte ratio were used as biomarkers of low- grade inflammation . Hazard ratios ( HR ) were calculated using multivariable Cox proportional hazard models . During a median follow-up of 4·3 years , 334 all-cause deaths occurred . As compared with subjects who never ate nuts , rare intake ( ≤2 times/month ) was inversely associated with mortality ( multivariable HR=0·68 ; 95 % CI 0·54 , 0·87 ) . At intake ≥8 times/month , a greater protection was observed ( HR=0·53 ; 0·32 , 0·90 ) . Nut intake ( v. no intake ) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet ( MD ) . A significant reduction in cancer deaths ( HR=0·64 ; 95 % CI 0·44 , 0·94 ) was also observed , whereas the impact on CVD deaths was limited to an inverse , but not significant , trend . Biomarkers of low- grade inflammation were reduced in nut consumers but did not account for the association with mortality . In conclusion , nut intake was associated with reduced cancer and total mortality . The protection was stronger in individuals with lower adherence to MD , whereas it was similar in high-risk groups ( diabetics , obese , smokers or those with the metabolic syndrome ) , as compared with low-risk subjects . Inflammation did not explain the observed relationship
No significant treatment effects were observed for fasting insulin and HOMA-IR , however the direction of effect favoured tree nuts .
Pooled analyses show that tree nuts improve glycemic control in individuals with type 2 diabetes , supporting their inclusion in a healthy diet .
BACKGROUND Tree nut consumption has been associated with reduced diabetes risk , however , results from r and omized trials on glycemic control have been inconsistent .
OBJECTIVE To provide better evidence for diabetes guidelines development , we conducted a systematic review and meta- analysis of r and omized controlled trials to assess the effects of tree nuts on markers of glycemic control in individuals with diabetes .