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Studies Support the Use of Nuts in Diabetic Diets

Abstracted by Marcia J. Egles, MD, September 16, 2008 from Possible Benefit of Nuts in Type 2 Diabetes by David J. A. Jenkins, Frank B. Hu, Linda C. Tapsell, Andrea R. Josse and Cyril W. C. Kendall in Journal of Nutrition 138:1752S-1756S, September 2008

For many years diabetics, especially overweight adult diabetics, have been encouraged to limit and even avoid nuts in their diets because nuts are a relatively high calorie food. As the heart health benefits of nuts have become more recognized, the use of nuts in diabetic diets is also gaining attention. A recent study reviewed some of the data supporting the conclusion that the consumption of nuts, including peanuts, may be beneficial in both the prevention and management of Type II diabetes.

The Nurses Health Study is a large data base involving more than 83,000 healthy American female nurses aged 34-59 whose health histories were followed from 1980-1996. Among the results generated from this study was the finding that higher nut consumption is associated with a lower risk of developing diabetes¹.

This association remained true even after adjustment for age, family history of diabetes, caloric consumption, and tobacco use. The relative risk of developing diabetes was reduced 27% in those who ate nuts five or more times a week compared to those who rarely or never ate nuts. Higher intakes of nuts were not associated with higher rates of obesity. Among the nurses who did develop diabetes, those who consumed nuts more than five times per week also showed a lower rate of heart disease compared to those who consumed few nuts².

The cholesterol lowering benefits of dietary nuts in non-diabetics has been reported in several studies^(3,4,5). Similar results were reported in a study done in 58 diabetics⁶. LDL cholesterol (low density lipoprotein cholesterol, commonly known as “bad” cholesterol) was lowered by 10% in those who consumed 30 grams of walnuts per day with a low-fat diet as compared to those who seldom ate nuts.

Gallstone disease, which can be associated with diabetes, also appears to be influenced favorably by nut consumption in both men and women. Data review from the Health Professionals’ Follow-up Study⁷, as well as the Nurses Health Study⁸, showed that, in general, a higher consumption of nuts was associated with a lower risk of gallstone disease. In both men and women, those who ate more than five servings of nuts per week had a 30% risk reduction in gallstone disease, compared to those who seldom ate nuts.

The researchers concluded that nut consumption may help protect against not only heart disease, but also diabetes and other metabolic diseases including gallstones.

REFERENCES:

¹ Jiang R, Manson JE, Stampfer MJ, Liu S, Willett WC, Hu FB. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA. 2002;288:2554–60.

² Hu FB, Stampfer MJ, Manson JE, Rimm EB, Colditz GA, Rosner BA, Speizer FE, Hennekens CH, Willett WC. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ. 1998;317:1341–5.

³ Jenkins DJ, Kendall CW, Marchie A, Parker TL, Connelly PW, Qian W, Haight JS, Faulkner D, Vidgen E, et al. Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation. 2002.

⁴ Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003;290:502–10.

⁵ Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, et al. Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr. 2005;81:380–7.

⁶ Tapsell LC, Gillen LJ, Patch CS, Batterham M, Owen A, Bare M, Kennedy M. Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. Diabetes Care. 2004;27:2777–83.

⁷ Tsai CJ, Leitzmann MF, Hu FB, Willett WC, Giovannucci EL. A prospective cohort study of nut consumption and the risk of gallstone disease in men. Am J Epidemiol. 2004;

⁸ Tsai CJ, Leitzmann MF, Hu FB, Willett WC, Giovannucci EL. Frequent nut consumption and decreased risk of cholecystectomy in women. Am J Clin Nutr. 2004;80:76–81.