(Source: https://www.news-medical.net/news)
Type 2 diabetes is a metabolic disorder that affects one in ten people
worldwide. There has been an alarming increase of 16% in the global prevalence of type 2 diabetes over the
past two years. Diabetes is also associated with other health complications,
such as neuropathy, retinopathy, chronic kidney disease, and cardiovascular
disease. Recently, scientists reviewed the role of nuts in the management of
type 2 diabetes. This review is available in the journal Nutrients.
Background
Around 11% of adults across the world have impaired glucose tolerance.
This group is at a high risk of developing type 2 diabetes (T2D). Diabetes can
be managed through lifestyle changes, particularly adherence to healthy diets
and regular exercise. As per the recent diabetes guidelines, the Mediterranean
diet, which involves high consumption of fruits, vegetables, nuts, seeds, olive
oils, fish, and eggs, and a low intake of red meat, has been recommended for
diabetes patients.
Different tree nuts include cashew, hazelnuts, Brazil nuts, almonds,
pecans, pine nuts, pistachios, walnuts, and macadamias. Although peanuts are
considered nuts, they are technically a legume. Nuts are considered
nutrient-dense foods that provide unsaturated fatty acids, non-sodium minerals,
phenolics, plant protein, and other important bioactive metabolites.
The authors collected relevant articles from PubMed and Cochrane's
databases related to T2D and nut consumption for this review article. Both
peanut and tree nuts were considered in this study.
How does Nut Consumption Affect
Glucose Metabolism?
Few epidemiological studies have evaluated how nut consumption affects
glycemic control markers. A previously conducted Tehran Lipid and Glucose Study
(TLGS) revealed lower fasting serum glucose levels after higher nut
consumption. Several cross-sectional studies have highlighted an association
between nut intake and glucose/insulin homeostasis markers. A higher nut intake
has been linked to significantly low levels of all diabetes-related biomarkers,
such as plasma insulin, blood glucose, homeostasis model assessment-insulin
resistance (HOMA-IR), glycated hemoglobin (HbA1c), oral glucose tolerance test
(OGTT), and HOMA-β.
The effect of nut consumption frequency on insulin resistance was
assessed based on HOMA-IR. This study revealed that consumption of more than
five servings (1 serving = 15 g) of nuts per week, compared to less than one
serving a month, leads to lower HOMA-IR. This observation was found to be predominantly
true among women participants aged less than 40 years.
Based on clinical trial evidence, nut consumption alone lowered
postprandial glycemia in participants associated with high glycemic index (GI)
food intake. In healthy individuals, the consumption of almonds with white
bread significantly lowered postprandial glycemia.
A five-arm, randomized crossover trial was conducted involving
individuals with impaired glucose tolerance. Participants were randomly divided
into different groups, and each group was administered whole almonds, defatted
almond flour, almond butter, almond oil, or no almonds. The whole
almond-consuming group observed a significant decrease in blood glucose levels.
Interestingly, in the case of peanut intake, a quicker return of insulin to
basal concentrations was observed when obese men consumed shakes containing
conventional peanuts and high-oleic peanuts. Nut consumption led to a
significant lowering in fasting insulin and HOMA-IR; however, it did not have a
considerable effect on fasting glucose or HbA1c.
Consumption of Nuts and Diabetes
Prevention and Management
Epidemiological studies revealed inconsistencies and
inconclusive findings related to nut intake and the incidence of T2D. To date,
the effect of nut consumption, in a dose-dependent manner, on the incidence of
T2D risk has not been elucidated. Also, most of the studies have combined nuts
with other foods, making the assessment of individual nuts' roles in glycaemic
index difficult.
No clinical trials aimed to assess the efficacy of nut
supplementation to reduce or prevent the incidence of diabetes were found.
However, several studies revealed the beneficial effects of the Mediterranean
diet, which entails a high consumption of tree nuts.
The macronutrients, micronutrients, and other bioactive compounds
present in nuts regulate postprandial glycemic and insulinemic levels. In
addition, they aid in body weight management, have anti-inflammatory and
antioxidant properties, control cellular membrane fluidity, and protect β-cells
against glucose toxicity, microRNAs, and pancreatic insulin secretion.
Future Outlook
In the future, dose-response analyses are required to elucidate the
total amount of nuts consumed for possible diabetes-related health benefits.
Also, the impact of nuts in the prevention and management of TYD must be elucidated
in greater detail. Since very little epidemiological and clinical trial data is
available, more research could be conducted in this area to provide more
insights into developing diabetes dietary guidelines.
Conclusion
Based on the limited evidence currently available, nuts may have
beneficial effects on diabetes management and prevention. A diet that includes
nuts may also lower cardiovascular disease risk and mortality in those with T2D
and improve glycemic control.
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