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CHOOSING HEART-SMART SNACKS WHILE MANAGING DIABETES

Studies indicate that heart-healthy diets including almonds can help improve CVD risk factors associated with type 2 diabetes

5/11/2021

Modesto, CA – World Diabetes Day is November 14 and unfortunately diabetes and prediabetes numbers are increasing. According to the most recent 2019 report from the International Diabetes Federation, more than 463 million adults globally were living with diabetes, and by 2045, that number is expected to increase to 700 million. One in two adults have diabetes and don’t know it. And another 374 million people – more than one in 13 adults – have prediabetes.1

Providing support for people with diabetes is still a high priority. Being in the midst of the COVID-19 pandemic means people with diabetes need to be extra vigilant about their health. According to the Centers for Disease Control (CDC), people with type 1 diabetes, type 2 diabetes or gestational diabetes have increased risk of severe illness from COVID-19.2 Obesity, often a co-morbidity with type 2 diabetes, also elevates the risk of becoming severely ill from COVID-19. 

Research suggests that lifestyle modifications, including improving physical activity, losing excess weight and making important dietary changes not only help manage type 2 diabetes, but for those with elevated risk, can reduce the risk for developing type 2 diabetes and may even provide better long-term effects than medication.3

Several studies funded by the Almond Board of California demonstrate the potential cardiovascular benefits of including almonds in healthy diets among those living with type 2 diabetes:

  • A large study4 among 275 adolescents and young adults in India with prediabetes looked at the effect of almond consumption on factors of metabolic dysfunction including blood glucose, lipids, insulin and selected inflammatory markers.
  • Results showed that those in the almond group, who ate 56 grams (about 2 one-ounce servings) of unroasted almonds every day for three months had the following results:
    • Significantly decreased HbA1c levels compared to the control group (who ate a calorie-equivalent savory snack commonly consumed by this age group in India)
    • Significantly reduced total cholesterol and LDL-cholesterol compared to the control group, while maintaining HDL-cholesterol levels
  • A study of 50 Asian Indians5 with type 2 diabetes and elevated cholesterol levels found that substituting whole, raw almonds – already a familiar food in the Indian culture – for 20% of calories in a well-balanced diet significantly improved measures of heart health that are linked to type 2 diabetes, including:
    • Waist circumference: an indicator of health risk associated with excess fat around the waist
    • Waist-to-height ratio: a measure of body fat distribution
    • Total cholesterol: a measure of the amount of cholesterol in the blood
    • Triglycerides: a form of fat in the blood that can raise risk for heart disease
    • LDL cholesterol: the bad type of cholesterol that is a main source of cholesterol buildup and blockage in the arteries
    • C-reactive protein: a measure of inflammation in the body
    • Hemoglobin A1c: a measure of average blood sugar levels over a two to three month span

Asian Indians have a genetic predisposition to type 2 diabetes, and these findings illustrate the multiple beneficial effects of almonds on cardiovascular risk factors that are associated with type 2 diabetes. 

  • Another study among 33 Chinese participants with type 2 diabetes, who ate a heart-healthy diet, looked at the effect of including 60 grams of almonds a day on maintenance of blood sugar levels and cardiovascular disease factors. While the almond diet offered better overall nutritional quality, neither diet – with or without almonds - improved blood sugar status, nor most cardiovascular risk factors as was expected. However, researchers found that among a subset of participants with baseline HbA1c ≤8, the almond diet lowered fasting serum glucose level (which measures blood sugar levels after fasting) by 6% and HbA1c (which measures average blood sugar levels over a two or three month period) by 3%. These results suggest that including almonds in a healthy diet may help improve long-term blood sugar levels in people with better controlled type 2 diabetes (baseline HbA1c ≤8).

 

Overall, the nutrient profile of almonds – low on the glycemic index and providing a powerful nutrient package including hunger-fighting protein (6 g/28 g), filling dietary fiber (4 g/28 g), good fats and important vitamins and minerals such as vitamin E (7.3 mg/28 g), magnesium (76 mg/28 g) and potassium (210 mg/28 g), combined with their versatility and many forms, makes them a smart snack for those with type 2 diabetes as part of a healthy eating plan.

1 International Diabetes Federation. IDF Diabetes Atlas, 9th edition. 2019. https://www.diabetesatlas.org/en. Accessed July 14, 2021.

2 Centers for Disease Control: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.

3 Haw JS et al. Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. Published online November 6, 2017. doi:10.1001/jamainternmed.2017.6040

4 Madan J, Desai S, Moitra P, Salis S, Agashe S, Battalwar R, Mehta A, Kamble R, Kalita S, Phatak AG, Udipi SA, Vaidya RA and Vaidya AB (2021) Effect of Almond Consumption on Metabolic Risk Factors—Glucose Metabolism, Hyperinsulinemia, Selected Markers of Inflammation: A Randomized Controlled Trial in Adolescents and Young Adults. Front. Nutr. 8:668622. doi: 10.3389/fnut.2021.66862.

5 Gulati S, Misra A, Pandey RM. Effect of almond supplementation on glycemia and cardiovascular risk factors in Asian Indians in North India with type 2 diabetes mellitus: A 24-week study. Journal of Metabolic Syndrome and Related Disorders.2017:15(2):98-105.doi: 10.1089/met.2016.0066.

6 Chen CM et al. Almonds ameliorate glycemic control in Chinese patients with better controlled type 2 diabetes: a randomized, crossover, controlled feeding trial. Nutrition & Metabolism. 2017; 14:51.