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Nuts & Diabetes


What type of sugar is in nuts?

To the sugar free fanatics, eating any form of sugar is banned but this can mean little is left in the diet to eat since many naturally healthy foods contain sugars. Takes nuts for instance - not really thought of as "sugary" foods - yet they naturally contain sugars in the form of sucrose (which is the form of sugar in sugar cane). Since nuts are seeds, these sugars provide some energy for when the seed germinates. This is when energy is needed to produce a root and shoot for a new nut tree to grow. Nut varieties naturally contain a tiny 2-6g of sugars per 100g or around 1-2g of sugar per 30g handful. Of course, there are party nuts which also contain added sugars e.g. honey coated, chocolate coated and vienna almonds. Leave these nuts for special occasions and enjoy a healthy handful of raw, roasted unsalted nuts everyday.

Published Jan 2017

Are pistachio nuts good for people with diabetes?

Yes, pistachios are good for people with type 2 diabetes. Research has found that when pistachios are eaten with carbohydrate foods, they help slow the rise in blood glucose following a meal. This improves blood glucose control and helps keep you feeling fuller for longer. Less snacking means less energy is eaten, and a greater chance of weight loss which will also improve diabetes control. It seems pistachios affect genetic material involved in insulin sensitivity too and they help stop arteries from becoming too stiff which can lead to high blood pressure.

So many reasons to eat a healthy handful of nuts such as pistachios each day.

References:
1) Sauder KA, McCrea CE, Ulbrecht JS, Kris-Etherton PM, West SG. Effects of pistachios on the lipid/lipoprotein profile, glycemic control, inflammation, and endothelial function in type 2 diabetes: A randomized trial. Metabolism. 2015 Nov;64(11):1521-9.
2) Hernández-Alonso P et al. Chronic pistachio intake modulates circulating microRNAs related to glucose metabolism and insulin resistance in prediabetic subjects. Eur J Nutr. 2016 Jul 6. [Epub ahead of print]
3) Bulló M, Juanola-Falgarona M, Hernández-Alonso P, Salas-Salvadó J. Nutrition attributes and health effects of pistachio nuts. Br J Nutr. 2015 Apr;113 Suppl 2:S79-93.
4) Kasliwal RR, Bansal M, Mehrotra R, Yeptho KP, Trehan N. Effect of pistachio nut consumption on endothelial function and arterial stiffness. Nutrition. 2015 May;31(5):678-85.

Published Jan 2017

Do nuts have a glycemic index (GI) rating?

Only cashews and chestnuts have been tested for GI because these are the only nuts that contain enough carbohdyrate to be GI tested. The GI of cashews is 25 and for chestnut meal, the GI is 54. GI is a ranking between 0 and 100 with anything less than 55 considered 'low GI'. Low GI foods are digested and absorbed more slowly, causing a slow rise in blood glucose which means better type 2 diabetes control and better appetite control.

GI is dependent on the size of the food particles - the smaller the particles, the faster the digestion rate and the higher the GI. Chestnut meal or ground chestnuts would have a higher GI than whole chestnuts for instance.

While all the other nuts do not have a GI ranking themselves, they can cause a lower GI effect when eaten with other carbohdyrate foods. This is because nuts are complex structures which takes time to digest, slowing the whole passage of food through the intestine and slowing the rise of blood glucose after a meal.

Nuts are a great afternoon-tea snack, helping to control appetite, keeping you feeling fuller for longer until dinner. Adding nuts to meals will also help increase fullness.

Published Jan 2017

Can people with diabetes (diabetics) eat nuts?

Yes, people with diabetes can eat nuts and there are many reasons why they should eat nuts regularly.

People with Type 2 diabetes have an increased risk of heart disease and are also likely to be overweight compared to those without diabetes. Daily nut consumption can help reduce the risk of developing heart disease while also helping to control blood glucose, blood cholesterol and blood pressure.

Nuts are generally a low carbohydrate snack and those nuts that contain carbohydrates (cashews and chestnuts) contain low glycemic index carbs. A handful of nuts make a perfect afternoon-tea snack and adding nuts to meals with carbs will help lower the rise in blood glucose after a meal.

References:
1) Li TY, Brennan AM, Wedick NM, Mantzoros C, Rifai N, Hu FB. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes.J Nutr. 2009 Jul;139(7):1333-8.
2) Viguiliouk E, Kendall CW, Blanco Mejia S, et al. Effect of tree nuts on glycemic control in diabetes: a systematic review and meta-analysis of randomized controlled dietary trials. PLoS One. 2014 Jul 30;9(7):e103376.
3) Kendall CW, Josse AR, Esfahani A, Jenkins DJ. Nuts, metabolic syndrome and diabetes. Br J Nutr. 2010 Aug;104(4):465-73.

Published Jan 2017

Do nuts help insulin resistance?

Yes, nuts help with insulin resistance. But what is insulin resistance?

Insulin is a hormone produced by the pancreas in response to eating carbohydrate foods. Once carbohydrate rich foods are digested and absorbed into the blood stream as glucose - the simplest carbohydrate, insulin is responsible for moving the glucose into the cells where the energy factories make energy for the body. Insulin resistance is where the body's cells resist the action of insulin and the pancreas needs to produce even greater levels of insulin to see that same result. Insulin has a sneaky side effect - it can also slow the breakdown of body fat so belly fat accumulates. This can worsen insulin resistance and the cycle starts again. Inflammation plays a role in insulin resistance too.

If left untreated, insulin resistance can lead to type 2 diabetes, polycystic ovarian syndrome and obesity.

Nuts can help insulin resistance in several ways:
1) Reduce the rise in blood glucose - if blood glucose levels remain in the normal range, the pancreas doesn't need to produce abnormal levels of insulin. Nuts help slow the digestion of carbohydrate rich foods, lowering the rise in blood glucose following a meal
2) Reduce inflammation - nuts contain phytochemicals with antioxidant and anti-inflammatory properties
3) Reduce weight gain and help with weight management - less belly fat means insulin works more effectively.

Eating a healthy handful of nuts each day is a great place to start to improve insulin resistance.

References:
1) Casas-Agustench, Bulló M, Salas-Salvadó J. Nuts, inflammation and insulin resistance.Asia Pac J Clin Nutr. 2010;19(1):124-30.

Published Jan 2017

Do nuts contain sugar?

Yes raw, natural nuts contain natural sugars and depending on the nut variety, contain between 2.1 and 5.9g sugars per 100g. Pistachios contain the most sugar (5.9g/100g) and Brazil nuts the least (2.1g/100g). The type of sugar found naturally in nuts is sucrose - the same type that is in sugar cane and crystallised as white, brown or raw sugar. There's so much hype about sugars at present but there's no need to be concerned about the natural sugar content of nuts. If we avoided all foods that contain sugars, there'd be little left to eat as many plant foods contain some level of natural sugars.

Despite their natural sugar content, nuts help to reduce the glycemic index of a meal, reducing the rise in blood glucose following a meal containing carbohydrate foods(1-4). The protein, healthy fats and fibre content of nuts helps to slow their digestion.

Some nuts are coated in sugar (Vienna almonds), honey (honey coated) or chocolate coated. These products will be higher in added sugars and are best left as party nuts on special occasions.

References:
1) Kendall CW et al The glycemic effect of nut-enriched meals in healthy and diabetic subjects.Nutr Metab Cardiovasc Dis. 2011 Jun;21 Suppl 1:S34-9.
2) Parham M et al. Effects of pistachio nut supplementation on blood glucose in patients with type 2 diabetes: a randomized crossover trial. Rev Diabet Stud. 2014 Summer;11(2):190-6.
3) Blanco Mejia S et al. Effect of tree nuts on metabolic syndrome criteria: a systematic review and meta-analysis of randomised controlled trials.BMJ Open. 2014 Jul 29;4(7):e004660.
4) Kendall CW et al. The impact of pistachio intake alone or in combination with high-carbohydrate foods on post-prandial glycemia. Eur J Clin Nutr. 2011 Jun;65(6):696-702.

Last updated July 2016

Should pregnant and lactating women eat nuts?

Some women have been advised to avoid eating nuts during pregnancy and whilst breastfeeding to reduce the risk of their baby developing allergies - there is no evidence to suggest this is the case. In fact, it is now thought that this may have the opposite effect.

The American Academy of Pediatrics (AAP), the Australasian Society of Clinical Immunology and Allergy (ASCIA), and the 2013 Australian Dietary Guidelines all state there is no evidence to show that what a woman eats while pregnant or breastfeeding affects the chance of the child developing an allergy, or allergy symptoms (1,2,3).

Of course if you have a nut allergy, then you need to avoid those nuts you are allergic to.

References:
1) Greer FR et al. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods and hydrolyzed formulas. Pediatrics. Jan 1, 2008;121(1):183-191.
2) The Australasian Society of Clinical Immunology and Allergy (ASCIA). Allergy Prevention in children https://www.allergy.org.au/health-professionals/papers/allergy-prevention-in-children.
3) National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council. www.eatforhealth.gov.au.

Last Update October 2016

Are nuts good for blood glucose (blood sugar) levels?

The GI-lowering effect of nuts (see 'Do nuts have a GI') means that nuts slow the rise of blood glucose after a carbohydrate-containing meal (1-3). High blood glucose after eating is common in people with pre-diabetes and Type 2 diabetes, and can contribute to diabetes related complications (4).

While most nuts don't have their own GI ranking, as they don't contain enough carbohydrate to be tested - cashews and chestnuts do and they are low GI.

References:
1) Jenkins DJ et al. Almonds decrease postprandial glycemia, insulinemia and oxidative damage in healthy individuals. J Nutr. 2006;136(12):2987-92.
2) Parham M et al. Effects of pistachio nut supplementation on blood glucose in patients with type 2 diabetes: a randomised crossover trial. Rev Diabet Stud. 2014 Summer;11(2):190-6.
3) Kendall CW et al. The glydemic effect of nut-enriched meals in healthy and diabetic subjects. Nutr Metab Cardiovasc Dis. 2011 Jun;21 Suppl 1:S34-9.
4) Aryangat AV et al. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk. Vasc Health Risk Manag. 2010;24;6:145-5.

Last Update September 2016

Do nuts have a Glycemic Index (GI)?

The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels. For foods to be measured for their GI, they need to contain a certain amount of carbohydrate. With the exception of chestnuts and cashews, nuts don't contain much carbohydrate and so do not have a GI. Chestnuts have a GI of 54 (low), and cashews have a GI of 25 (low).

However, nuts have a GI-lowering effect – they reduce the overall GI of a meal. That is, when nuts are mixed with foods rich in carbohydrates, they slow the digestion of the meal resulting in a slower rise in blood glucose (1-3). A low-GI diet has been shown to reduce the risk of type-2 diabetes and help in its management (4).

References:
1) Jenkins DJ et al. Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136(12):2987-92.
2) Josse AR et al. Almonds and postprandial glycemia—a dose-response study. Metabolism 2007;56(3):400-4.
3) Kendall C et al. Effect of pistachios on postprandial glucose and insulin levels and gut satiety hormone responses. FASEB J 2009; 23(1-Meeting Abstracts):563.2.
4) Thomas D et al. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database Syst Rev 2009(1):CD006296.

Last update September 2016

Should people with diabetes eat nuts & what are the benefits?

Of course people with diabetes should eat nuts. As a plant food they have a wide variety of nutritional benefits. Nuts have a GI lowering effect, meaning that they can reduce the rise in blood glucose after a meal (1-3). Nuts also help to manage other health issues that often affect people with diabetes, for example, being overweight, heart disease and high blood pressure. Nuts are also a source of important nutrients - healthy fats, fibre, plant sterols, vitamins and minerals – and can help meet recommended daily intakes. Check out our Nuts and diabetes factsheet for the full story.

References:
1) Jenkins DJ et al. Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136(12):2987-92.
2) Josse AR et al. Almonds and postprandial glycemia—a dose-response study. Metabolism 2007;56(3):400-4.
3) Kendall C et al. Effect of pistachios on postprandial glucose and insulin levels and gut satiety hormone responses. FASEB J 2009; 23(1-Meeting Abstracts):563.2.

Last update September 2016

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