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Clinical Care/Education/Nutrition

Including Walnuts in a Low-Fat/Modified-Fat Diet Improves HDL Cholesterol-to-Total Cholesterol Ratios in Patients With Type 2 Diabetes

  1. Linda C. Tapsell, PHD1,
  2. Lynda J. Gillen, B NUTR DIET (HONS)2,
  3. Craig S. Patch, MBA2,
  4. Marijka Batterham, PHD2,
  5. Alice Owen, PHD2,
  6. Marian Baré, MND2 and
  7. Meredith Kennedy, MSC3
  1. 1National Centre of Excellence in Functional Foods, University of Wollongong, New South Wales, Australia
  2. 2Smart Foods Centre, University of Wollongong, Wollongong, New South Wales, Australia
  3. 3Illawarra Diabetes Service, Wollongong, New South Wales, Australia
  1. Address correspondence and reprint requests to Professor Linda Tapsell, National Centre of Excellence in Functional Foods, Northfields Avenue, University of Wollongong, NSW 2522, Australia. E-mail: ltapsell{at}uow.edu.au
Diabetes Care 2004 Dec; 27(12): 2777-2783. https://doi.org/10.2337/diacare.27.12.2777
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Abstract

OBJECTIVE—The aim of this study was to examine the effect of a moderate-fat diet inclusive of walnuts on blood lipid profiles in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS—This was a parallel randomized controlled trial comparing three dietary advice groups each with 30% energy as fat: low fat, modified low fat, and modified low fat inclusive of 30 g of walnuts per day. Fifty-eight men and women, mean age 59.3 ± 8.1 years, started the trial. Dietary advice was given at baseline with monthly follow-up and fortnightly phone calls for support. Body weight, percent body fat, blood lipids, HbA1c, total antioxidant capacity, and erythrocyte fatty acid levels were measured at 0, 3, and 6 months. Data were assessed by repeated-measures ANOVA with an intention-to-treat model.

RESULTS—The walnut group achieved a significantly greater increase in HDL cholesterol–to–total cholesterol ratio (P = 0.049) and HDL (P = 0.046) than the two other treatment groups. A 10% reduction in LDL cholesterol was also achieved in the walnut group, reflecting a significant effect by group (P = 0.032) and time (P = 0.036). There were no significant differences between groups for changes in body weight, percent body fat, total antioxidant capacity, or HbA1c levels. The higher dietary polyunsaturated fat–to–saturated fat ratio and intakes of ω-3 fatty acids in the walnut group were confirmed by erythrocyte biomarkers of dietary intake.

CONCLUSIONS—Structured “whole of diet” advice that included 30 g of walnuts/day delivering substantial amounts of polyunsaturated fatty acid improved the lipid profile of patients with type 2 diabetes.

  • ALA, α-linolenic acid
  • DHA, docosahexaenoic adic
  • EPA, eicosapentaenoic acid
  • MUFA, monounsaturated fat
  • P:S ratio, polyunsaturated fat–to–saturated fat ratio
  • PUFA, polyunsaturated fatty acid
  • SFA, saturated fatty acid

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted August 26, 2004.
    • Received July 9, 2004.
  • DIABETES CARE
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Diabetes Care: 27 (12)

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December 2004, 27(12)
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Including Walnuts in a Low-Fat/Modified-Fat Diet Improves HDL Cholesterol-to-Total Cholesterol Ratios in Patients With Type 2 Diabetes
Linda C. Tapsell, Lynda J. Gillen, Craig S. Patch, Marijka Batterham, Alice Owen, Marian Baré, Meredith Kennedy
Diabetes Care Dec 2004, 27 (12) 2777-2783; DOI: 10.2337/diacare.27.12.2777

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Including Walnuts in a Low-Fat/Modified-Fat Diet Improves HDL Cholesterol-to-Total Cholesterol Ratios in Patients With Type 2 Diabetes
Linda C. Tapsell, Lynda J. Gillen, Craig S. Patch, Marijka Batterham, Alice Owen, Marian Baré, Meredith Kennedy
Diabetes Care Dec 2004, 27 (12) 2777-2783; DOI: 10.2337/diacare.27.12.2777
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