Study Suggests Almonds May Help Maintain Insulin Sensitivity In Individuals With Prediabetes

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Sheila Weiss, RD       
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Jenny Heap, MS, RD
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Modesto, CA – With nearly 16 million Americans living today with prediabetes, a condition that is the precursor to type 2 diabetes, and with half of all Americans expected to have either prediabetes or  type 2 diabetes by the year 2020, nutritional approaches to maintaining healthy blood sugar levels are essential.1,2  The findings of a scientific study examining the potential health benefits of almond consumption were published in the June, 2010 Journal of the American College of Nutrition. The study illustrates that including almonds as part of a healthy diet may help maintain insulin sensitivity and  healthy levels of LDL-cholesterol in those with prediabetes.3,4  
The study looked at the effects of consuming an almond-enriched diet on factors linked to the progression of type 2 diabetes and cardiovascular disease in adults with prediabetes. After 16 weeks of consuming either an almond-enriched or nut-free diet, both in accordance with American Diabetes Association (ADA) recommendations, the group that consumed an almond-enriched diet showed statistically significant improvements in measures of insulin sensitivity and clinically significant improvements in LDL-cholesterol levels , both of which are risk factors for heart disease and type 2 diabetes. Three caveats are that although study participants in both groups were instructed to consume the same amount of calories from carbohydrates, there was less self-reported carbohydrate intake among those in the almond group and although the diets were prescribed by registered dietitians, meals were not provided. The study’s diet and activity level data were based on participant report.4
“We have made great strides in chronic disease research from evidence of effective treatment to support of effective prevention” said Dr. Michelle Wien, Assistant Research Professor in Nutrition at Loma Linda University’s School of Public Health and Principal Investigator for this study, which was conducted at the University of Medicine and Dentistry of New Jersey. Wien adds, “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.  It would be beneficial to conduct tightly controlled metabolic feeding studies and postprandial studies that feature controlled amounts of carbohydrate to confirm the findings of this study, which was performed in a free-living population.”

Study at a Glance:
• The People: 65 adults with prediabetes (48 women and 17 men) with an average age of 53.5 +10y were enrolled in the study.4  A total of 54 of these participants completed the study. 11 withdrew (7 from the intervention group, 4 from the control group), mostly due to personal and work schedule conflicts.
• The Diet: The study population was randomly divided into either the intervention or control group. The control group consumed a diet that conformed with the American Diabetes Association (ADA) recommendations, which consists of 15-20% calories from protein, 10% total energy from saturated fat, 60-70% from carbohydrate and monounsaturated fatty acids (MUFA) and cholesterol <300 mg/day for 16 weeks, excluding all nuts. The intervention group consumed the ADA-recommended diet with 20% of the calories from almonds. A caveat is that although study participants in both groups were instructed to consume the same amount of calories from carbohydrates, there was less self-reported carbohydrate intake among those in the almond group and although the diets were prescribed by registered dietitians, the meals were not provided, so that the study’s diet and activity level data were based on participant report.4
• The Results: The intervention group, who were on an almond-enriched diet, showed greater improvements in fasting insulin levels (-1.78µU/ml vs. +1.47µU/ml, p=0.002), homeostasis model analysis for insulin resistance (-0.48 vs. +0.30, p=0.007), homeostasis model analysis for beta-cell function (-13.2 vs. +22.3, p=0.001) and clinically significant reductions in LDL-cholesterol (-12.4 mg/dl vs. -0.4 mg/dl, p=0.052) as compared to the nut-free group.4
• Study Limitations: The single fasting insulin sample and sample size are limitations in this study, as well as possible errors in patient self-reporting of dietary intakes and differences in carbohydrate intakes between the two groups. 4
This study suggests that consuming an ADA-recommended diet consisting of 20% of the total calories from almonds for 16 weeks may help  maintaininsulinsensitivity and healthy LDL-cholesterol levels in individuals with prediabetes.4 Improvements in LDL-cholesterol levels approached statistical significance. Nutrients in almondshave been shown to help maintain healthy LDL-cholesterol levels, insulin sensitivity and i beta-cell function3.

This study contributes to the growing body of evidence that suggests that almond consumption may contribute to heart health3, Almonds offer 3.5 grams of fiber, 13 grams of unsaturated fat and only 1 gram of saturated fat per one-ounce serving.

Consumers all over the world enjoy California Almonds as a natural, wholesome and quality food product, making almonds California’s leading agricultural export in terms of value. The Almond Board of California promotes almonds through its research-based approach to all aspects of marketing, farming and production on behalf of the more than 6,000 California Almond growers and processors, many of whom are multi-generational family operations. Established in 1950 and based in Modesto, California, the Almond Board of California is a non-profit organization that administers a grower-enacted Federal Marketing Order under the supervision of the United States Department of Agriculture. For more information on the Almond Board of California or almonds, visit

Good news about fat. U.S. Dietary Guidelines recommend that the majority of your fat intake be unsaturated. One serving of almonds (28g) has 13g of fat and only 1g of saturated fat.

1 Cowie CC, et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006. Diabetes Care 32 : 287-294, 2009. 
2 United Health Center for Health Reform and Modernization. The United States of Diabetes : Challeneges and Opportunities in the Decade Ahead. November 2010.
3 Scientific evidence suggests, but does not prove, that eating 1.5 ounces per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.
4 Wien M, et al. Almond consumption and cardiovascular risk factors in adults with prediabetes. J Am Coll Nutr. 2010 Jun;29(3):189-97.
5  U.S. Department of Agriculture, Agricultural Research Service, 2010. USDA National Nutrient Database for Standard Reference, Release 23. Nutrient Data Laboratory Page,