Nuts as a Replacement for Carbohydrates in the Diabetic Diet
Article Figures & Tables
Figures
- Figure 1
Mean HbA1c measurements in participants with type 2 diabetes consuming full-nut dose, half-nut dose, or muffins.
Tables
- Table 1
Baseline characteristics of study participants
Number (%) of participants P Nuts Half dose Muffins n 40 38 39 Age (years)* 63 (9) 62 (8) 61 (10) 0.61† Sex Male 26 (65) 26 (68) 26 (67) 0.97‡ Female 14 (35) 12 (32) 13 (33) Race/ethnicity European 23 (58) 25 (66) 18 (46) 0.83‡ Indian 10 (25) 8 (21) 13 (33) Far Eastern 4 (10) 3 (8) 3 (8) African 3 (8) 2 (5) 3 (8) Hispanic 0 (0) 0 (0) 1 (3) Native American 0 (0) 0 (0) 1 (3) Weight (kg)* 80 (15) 86 (16) 83 (15) 0.20† BMI (kg/m2)* 29 (5) 30 (5) 29 (4) 0.37† Current smokers 2 (5) 4 (11) 3 (8) 0.57‡ HbA1c (%) <7.0 20 (50) 20 (53) 22 (56) 0.84‡ ≥7.0 20 (50) 18 (47) 17 (44) Duration of diabetes (years)* 7 (6) 8 (6) 8 (6) 0.57† Medication use Hypoglycemic medications 40 (100) 38 (100) 39 (100) 1.00‡ Thiazolidinedione 12 (30) 11 (29) 11 (28) 1.00‡ Biguanide 35 (88) 36 (95) 35 (90) 0.62‡ Sulfonylurea 14 (35) 13 (34) 17 (44) 0.64‡ Meglitinides (nonsulfonylurea) 2 (5) 3 (8) 2 (5) 0.79‡ α-Glucosidase inhibitors 0 (0) 0 (0) 0 (0) 1.00 Dipeptidyl peptidase-4 inhibitor 0 (0) 0 (0) 1 (3) 0.66‡ Cholesterol-lowering medications 23 (58)a 31 (82)b 30 (77)ab 0.046‡ Blood pressure medications 23 (58) 29 (76) 28 (72) 0.12‡ Data are n (%) or *mean (SD).
↵†P value is for overall F test for between-groups differences using the generalized linear model ANOVA.
↵‡P values for Fisher exact test where appropriate were calculated separately for distribution of each medication, since participants were from multiple nationalities or on multiple medications. A difference in superscript letters signifies a significant difference in percentage changes using the Q statistic.
- Table 2
Mean study measurements and significance of treatment differences in the intention-to-treat analysis
Baseline* End point* Treatment difference† Full-nut dose Half-nut dose Muffins Full-nut dose Half-nut dose Muffins Full-nut dose vs. muffins (P) Full- vs. half-nut dose (P) Half-nut dose vs. muffins (P) n 40 38 39 40 38 39 Glucose (mmol/L) 7.3 (6.9–7.7) 7.4 (6.9–7.8) 7.1 (6.7–7.5) 7.2 (6.7–7.6) 7.4 (6.7–8.1) 7.2 (6.7–7.7) 0.079 0.304 0.681 HbA1c (%) 7.1 (6.9–7.3) 7.1 (6.9–7.3) 7.1 (7.0–7.3) 6.9 (6.7–7.1) 7.0 (6.8–7.3) 7.1 (6.9–7.2) 0.001 0.004 0.863 Lipids (mmol/L) Total cholesterol 4.4 (4.1–4.8) 4.0 (3.8–4.2) 4.2 (3.9–4.5) 4.2 (3.9–4.6) 4.0 (3.8–4.3) 4.3 (3.9–4.6) <0.001 0.042 0.203 LDL cholesterol 2.5 (2.1–2.8) 2.2 (2.0–2.4) 2.3 (2.0–2.5) 2.3 (1.9–2.6) 2.1 (1.9–2.4) 2.3 (2.1–2.6) <0.001 0.123 0.048 HDL cholesterol 1.2 (1.1–1.2) 1.1 (1.0–1.2) 1.2 (1.1–1.3) 1.2 (1.1–1.3) 1.2 (1.1–1.3) 1.2 (1.1–1.3) 0.405 0.364 0.995 Triglycerides 1.8 (1.5–2.0) 1.6 (1.3–1.8) 1.6 (1.4–1.9) 1.7 (1.3–2.0) 1.6 (1.3–1.9) 1.6 (1.4–1.8) 0.158 0.064 0.970 Total cholesterol:HDL cholesterol ratio 3.9 (3.6–4.3) 3.8 (3.3–4.2) 3.8 (3.4–4.2) 3.6 (3.3–3.9) 3.7 (3.2–4.1) 3.7 (3.3–4.1) 0.006 0.163 0.047 LDL cholesterol:HDL cholesterol ratio 2.2 (1.9–2.5) 2.1 (1.8–2.4) 2.1 (1.8–2.4) 1.9 (1.7–2.2) 1.9 (1.7–2.2) 2.0 (1.7–2.3) 0.002 0.163 0.013 ApoA1 1.5 (1.4–1.5) 1.5 (1.4–1.5) 1.5 (1.4–1.5) 1.5 (1.4–1.5) 1.5 (1.4–1.6) 1.5 (1.4–1.6) 0.26 0.249 0.976 ApoB 0.85 (0.76–0.93) 0.76 (0.70–0.82) 0.79 (0.72–0.85) 0.80 (0.72–0.88) 0.75 (0.69–0.81) 0.80 (0.73–0.87) <0.001 0.147 0.012 ApoB:apoA1 0.58 (0.52–0.63) 0.54 (0.48–0.60) 0.55 (0.49–0.62) 0.54 (0.49–0.59) 0.52 (0.46–0.58) 0.55 (0.49–0.61) 0.004 0.537 0.001 Serum CRP (nmol/L) 1.6 (1.1–2.1) 1.8 (0.9–2.7) 1.9 (1.1–2.6) 2.2 (1.2–3.2) 1.5 (1.1–2.0) 2.0 (1.2–2.8) 0.682 0.186 0.042 Blood pressure (mmHg) Systolic 121 (118–125) 123 (119–128) 125 (121–129) 119 (116–123) 124 (120–128) 124 (120–128) 0.084 0.005 0.274 Diastolic 70 (67–73) 71 (69–74) 71 (68–75) 69 (66–72) 72 (70–74) 72 (68–75) 0.024 0.021 0.888 Data are means (95% CI). n = 117.
↵*Baseline is an average of weeks −1 and 0 and end point is an average of weeks 8, 10, and 12, except for body weight (week 0).
↵†Mean treatment differences (95% CI) were determined and P values were estimated by CONTRAST using average baseline and the difference from week 8, 10, and 12. Significance by Bonferroni, P < 0.0175.
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