The body of evidence about nuts and diabetes continues to grow, with new local and international research papers regularly published.

Key studies: systematic reviews and meta-analyses

The effect of nuts on markers of glycaemic control: a systematic review and meta-analysis of randomized controlled trials. (2019).
Results from a recent systematic literature review and meta-analysis have found that nuts significantly decrease HOMA-IR and fasting insulin – suggesting that nuts improve insulin sensitivity.

Association between plant-based dietary patterns and risk of type 2 diabetes: a systematic review and meta-analysis (2019).
Greater adherence to plant-based eating patterns significantly associated with reduced risk of type 2 diabetes. Association strengthened with healthier plant foods including nuts, fruit and veg, wholegrains and legumes.

Meta-analysis of prospective studies on the effects of nut consumption on hypertension and type 2 diabetes mellitus. (2015).
Findings from this meta-analysis indicate that consumption of nuts (>2 servings/week) may be inversely associated with hypertension risk, but not with T2DM risk.

Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis. (2015).
Nut consumption may play a role in reducing cancer risk. Additional studies are needed to more accurately assess the relationship between nut consumption and the prevention of individual types of cancer, given the scarcity of available data. No significant association was found with type 2 diabetes.

Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis. (2014).
Our meta-analysis indicates that nut intake is inversely associated with IHD, overall CVD, and all-cause mortality but not significantly associated with diabetes and stroke. The inverse association between the consumption of nuts and diabetes was attenuated after adjustment for body mass index. These findings support recommendations to include nuts as part of a healthy dietary pattern for the prevention of chronic diseases.

Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. (2014).
This systematic review supports inverse associations between eating nuts and incident IHD and diabetes, and eating legumes and incident IHD.

Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies. (2014).
A higher consumption of nuts was associated with reduced risk of CAD and hypertension but not stroke or T2D. Large randomized controlled trials are warranted to confirm the observed associations.

Other evidence

Effects of daily consumption of cashews on oxidative stress and atherogenic indices in patients with type 2 diabetes: a randomized, controlled-feeding trial. (2019).
A recent RCT concluded daily consumption of cashews significantly reduced insulin and LDL: HDL cholesterol ratio in patients with diabetes.

Mixed nut consumption may improve cardiovascular disease risk factors in overweight and obese adults. (2019).
Supplementation of 42.5g/day of mixed nuts into a usual diet significantly decreased insulin levels, glucose, BMI and body weight, compared to an isocaloric pretzel snack in an 8-week RCT.

The impact of nuts consumption on glucose/insulin homeostasis and inflammation markers mediated by adiposity factors among American adults. (2018).
Participants with a higher nut intake had a more cardioprotective profile of glucose/insulin homeostasis and inflammatory markers. The authors suggest the low GI and anti-inflammatory effects of nuts provides reasons for their inclusion in diets aimed at reducing the risk of type 2 diabetes, impaired glucose metabolism and CVD.

Nuts, inflammation and insulin resistance. (2010).
As chronic inflammation is a key early stage in the atherosclerotic process that predicts future CVD events and is closely related to the pathogenesis of insulin resistance, many recent studies have focused on the potential effect of nut consumption on inflammation and insulin resistance. Through different mechanisms, some components of nuts such as magnesium, fibre, alpha-linolenic acid, L-arginine, antioxidants and MUFA may protect against inflammation and insulin resistance.

The effect of nuts on inflammation. (2008).
The relationship observed between frequent nut consumption and the reduced risk of cardiovascular mortality and type 2 diabetes in some prospective studies could be explained by the fact that nuts are rich in all of these modulator nutrients. In fact, frequent nut consumption has been associated with lower concentrations of some peripheral inflammation markers in cross-sectional studies. Nut consumption has also been shown to decrease the plasma concentration of CRP, IL-6 and some endothelial markers in recent clinical trials.

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