Absolutely! Regularly eating nuts can help manage existing diabetes and diabetes-related complications.

Research shows that nut consumption may lower glycosylated haemoglobin (HbA1c, or the ‘average’ of blood glucose levels over a three-month period) and fasting blood glucose levels (1,2).

Several major studies have found nuts benefit markers of glycaemic control (2-4). For instance:

  • A 2014 systematic review and meta-analyses (which pulled together the findings of 26 randomised controlled trials) showed tree nuts significantly lowered fasting glucose (by a mean difference of -0.08mmol/L), compared with control (3).
  • Another study, which tracked participants for an average (median) of 6.2 years, found lower fasting glucose levels among the nut consumers with the highest intake of nuts, compared with the lowest intake (4).
  • A 2019 systematic review, of 40 randomised controlled trials, assessed the effect of nuts on glycaemic control. It found nut intake significantly reduced fasting insulin, and HOMA-IR (a marker of insulin sensitivity) (5).

Did you know? Type 2 diabetes affects an estimated one in 10 adults (10.5%) worldwide (6). In Australia, almost 1.3 million people are living with type 2 diabetes (7). And according to Diabetes Australia, it’s the biggest challenge confronting Australia’s health system.

How do nuts help manage diabetes?

Diet and lifestyle changes underpin diabetes management.

Current international diabetes guidelines recommend healthy dietary patterns, such as the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) diet, and healthy plant-based diets, for managing type 2 diabetes (8). Nuts are an integral part of each of these healthy dietary patterns. 

Scientists have suggested several possible mechanisms by which nuts may help to manage diabetes (1).

  • GI lowering effect – Nuts contain low amounts of carbohydrate, so do not contribute to higher blood glucose levels after a meal (9). Instead, they have a glycaemic index (GI) lowering effect, which is thought to be due to their protein and fat content (10). In other words, they reduce the overall ‘glycaemic load’ of a meal, thereby helping to manage post-prandial (after eating) blood glucose levels.
  • Healthy fatty acids – Nuts have a high ratio of healthy mono- and poly-unsaturated fats, to saturated fats. Research suggests substitution of carbohydrates or saturated fats with unsaturated fats may improve markers of glycaemic control, including HbA1C and HOMA-IR (10,11).
  • Dietary fibre – Nuts are a source of dietary fibre, which helps manage diabetes by slowing down the absorption of nutrients in the gut – resulting in a lower rise in blood glucose levels after eating (12).
  • Vitamins and minerals – Nuts, depending on the type, contain relatively high amounts of magnesium, vitamin E, and selenium, among other nutrients, which may help to manage diabetes-related complications. For instance, magnesium has been linked with helping to improve fasting blood glucose levels (13).
  • Bioactive compounds – Nuts are made up of a matrix of valuable bioactive compounds, including polyphenols. While research is still emerging in this area, polyphenols – which are thought to act as prebiotics in the gut – may have a role in improving HbA1C and insulin resistance (1).

Nuts also help to manage other health issues, such as cardiovascular disease, that can affect people with type 2 diabetes.  

Did you know? Despite their high energy (kilojoule) density, consistent research shows nut consumption is not linked with weight gain, or an increased risk of overweight/obesity (14).

The bottom line:

The scientific evidence to date suggests nut consumption may help in managing type 2 diabetes, as part of a healthy diet. More research is needed into all the potential diabetes-related health benefits of eating nuts. In the meantime, all Australians should be aiming for a 30g handful of nuts each day, whether managing diabetes or not. And with only 2% of Australians meeting this target, many of us have a long way to go!

References

  1. Nishi, SK., et al. Nuts in the prevention and management of Type 2 diabetes. Nutrients, 2023. 15: 878. https://doi.org/10.3390/nu15040878
  2. Viguiliouk, E., 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. 9(7): p. e103376.
  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. 4:4660.
  4. Hosseinpour-Niazi, S., et al. Prospective study of nut consumption and incidence of metabolic syndrome: Tehran Lipid and Glucose Study. Nutrients, 2017. 9:1056.
  5. Tindall, AM., et al. The effect of nuts on markers of glycemic control: A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr, 2019. 109:297–314.
  6. International Diabetes Federation. Diabetes Is “a Pandemic of Unprecedented Magnitude” Now Affecting One in 10 Adults Worldwide. Diabetes Res. Clin. Pr. 2021. 181: 109133.
  7. Diabetes Australia. Diabetes in Australia. Available at: https://www.diabetesaustralia.com.au/about-diabetes/diabetes-in-australia/ Accessed 25 October 2023.
  8. Lifestyle Management: Standards of Medical Care in Diabetes. Diabetes Care, 2019. 42:S46–S60.
  9. Kendall, CWC., et al. Metabolic syndrome and diabetes. Br J Nutr, 2010. 104:465-73.
  10. Josse, AR., Almonds and postprandial glycemia – A dose-response study. Metabolism, 2007. 56:400-04.
  11. Kim, Y.; Keogh, JB.; Clifton, PM. Benefits of nut consumption on insulin resistance and cardiovascular risk factors: Multiple potential mechanisms of actions. Nutrients, 2017. 9:1271.
  12. Dikeman, CL.; Fahey, GC. Viscosity as related to dietary fiber: A Review. Crit Rev Food Sci Nutr, 2006. 46:649-63.
  13. Elderawi, WA., et al. The effects of oral magnesium supplementation on glycemic response among Type 2 diabetes patients. Nutrients, 2019. 11:44.
  14. Nishi, SK., et al. Are fatty nuts a weighty concern? A systematic review and meta-analysis and dose–response meta-regression of prospective cohorts and randomized controlled trials. Obesity Reviews. 2021; e13330. https://doi.org/10.1111/obr.13330
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