Nuts and Dried Fruits: An Update of Their Beneficial Effects on Type 2 Diabetes

Occurrence, genetic characterization, and antibiotic susceptibility of Cronobacter spp. isolated from low water activity functional foods in Brazil

Cronobacter spp. are bacterial pathogens isolated from a wide variety of foods. This study aims at evaluating the occurrence of Cronobacter spp. in low water activity functional food samples, detect the presence of virulence genes, and determine the antibiotic susceptibility of strains. From 105 samples, 38 (36.2%) were contaminated with Cronobacter spp. The species identified by polymerase chain reaction (PCR) and sequencing analyses (rpoB and fusA genes, respectively) were C. sakazakii (60.3%), C. dublinensis (25.4%), C. turincensis (9.5%), and C. malonaticus (4.8%). Nineteen fusA alleles were identified, including four new alleles. The virulence genes were identified by PCR and all isolates were positive for ompX and sodA genes, 60.3% to cpa gene, and 58.7% to hly gene. Using the disk diffusion method, antibiotic susceptibility to twelve antibiotics was assessed twice, separated by a 19-month period. In the first test, the isolates showed diverse antibiotic susceptibility profiles, with nineteen isolates (30.2%) being multi-drug resistant (resistant to three or more antibiotic classes), in the second, the isolates were susceptible to all antibiotics. Cronobacter spp. in functional foods demonstrates the need for continued investigation of this pathogen in foods, and further research is needed to clarify the loss of resistance of Cronobacter strains.

Nuts and seeds - a scoping review for Nordic Nutrition Recommendations 2023

Background

Nuts and seeds have been part of diets in most of the world for millenniums, and they have also been consumed in the Nordic and Baltic countries for centuries. Consumption of nuts and seeds is linked with various health outcomes. Therefore, when updating the Nordic Nutrition Recommendations (NNR), summarizing the best evidence on key health outcomes from the consumption of nuts and seeds is essential.

Objectives

This study aims to evaluate the updated evidence on the consumption of nuts and seeds and health outcomes regarded relevant for the Nordic and Baltic countries, as well as their dose-response relationship presented in updated systematic reviews and meta-analyses.

Method

The scoping review is built on a de novo systematic review and an umbrella review published in 2022 on the consumption of nuts and seeds and its various health outcomes, including cardiovascular disease and diabetes.

Results

Intake of nuts and seeds is associated with a lower risk of cardiovascular diseases, with evidence assessed as probable. This conclusion is mirrored by evidence from trials on biomarkers for chronic diseases. An intake of a serving of nuts of 28-30 g/day compared to not eating nuts is estimated to translate into approximately 20% relative reduction in the risks of cardiovascular disease and premature deaths. For cancers, consumption of a serving of nuts is inversely associated with cancer mortality. However, for type 2 diabetes, there are mixed and inconclusive results. Additionally, there are inverse associations between nut consumption and respiratory and infectious disease mortality. Allergies for nuts are seen among 1-2% of the population.

Conclusion

Overall, the current evidence supports dietary recommendations to increase nut consumption to a serving of nuts and seeds per day for people without allergies to these foods.

Causal relationship of cereal intake and type with cardiovascular disease: a Mendelian randomization study

Background

Observational studies have suggested that cereal consumption is associated with a reduced risk of cardiovascular disease (CVD). However, the potential causal relationship is not clear. We aimed to investigate the association of cereal intake and cereal type with CVD risk.

Methods

Two-step Mendelian randomization (MR) analysis was performed to confirm the causal association of cereal intake and cereal type with the risk of several common CVDs. Furthermore, two-step MR analysis was used to explore the mediating effect of cardiovascular metabolic factors, and multivariable MR analysis was used to assess the impact of socioeconomic status, such as education and income, on the causal association.

Results

The MR analysis indicated that genetically predicted cereal intake is associated with reduced risk of large artery stroke (LAS) (odd ratio (OR): 0.421; 95% confidence interval (CI) [0.193, 0.918]; p = 0.030), and muesli as the primary cereal intake is associated with reduced risk of coronary heart disease (CHD) (OR: 0.100; 95% CI [0.023, 0.437]; p = 0.002), myocardial infarction (MI) (OR: 0.101; 95% CI [0.020, 0.509]; p = 0.005), heart failure (OR: 0.210; 95% CI [0.064, 0.684]; p = 0.010), ischemic stroke (IS) (OR: 0.130; 95% CI [0.029, 0.591]; p = 0.008), LAS (OR: 0.017; 95% CI [0.0004, 0.737]; p = 0.034), and small-vessel stroke (OR: 0.021; 95% CI [0.001, 0.708]; p = 0.005). In contrast, genetically predicted biscuits as the primary cereal intake increased the risk of CHD (OR: 6.557; 95% CI [1.197, 36.031]; p = 0.031), and other cereals, such as cornflakes, as the primary cereal intake increased the risk of CHD (OR: 3.803; 95% CI [1.194, 12.111]; p = 0.024), MI (OR: 4.240; 95% CI [1.185, 15.174]; p = 0.026), stroke (OR: 3.154; 95% CI [1.070, 9.298]; p = 0.037), and IS (OR: 3.736; 95% CI [1.185, 11.782]; p = 0.024). Multivariable MR analysis underscored the significant role of education and income in the causal association, and two-step MR analysis indicated that body mass index, lipids, and blood glucose exerted important mediating effects in the causal association.

Conclusion

The findings of our study underscore the causal beneficial influence of muesli as the primary cereal intake on CVDs. A reasonable consumption of muesli may provide primary prevention of CVDs.

Novel Lines of Research on the Environmental and Human Health Impacts of Nut Consumption

Nuts have formed part of human diets throughout the ages. In recent decades, research has shown they are key foods in dietary patterns associated with lower chronic disease risk. The current state of climate change, however, has introduced an imperative to review the impact of dietary patterns on the environment with a shift to plant-based diets. Nuts emerge as a significant source of protein in plant-based diets and are a minimally processed and sustainable food. Research in this area is evolving to drive better production methods in varying climate conditions. Nevertheless, nut consumption remains an important contributor to human health. The mechanisms of action can be explained in terms of the nutrients they deliver. Studies of nut consumption have linked components such as monounsaturated fatty acids, plant omega-3 fatty acids, antioxidants, and plant sterols to improved lipoprotein profiles, lower blood pressure, and reduced cardiovascular disease risk. Preliminary research also indicates possible beneficial effects of nut consumption on reproductive health. In any case, the ultimate effects of foods on health are the results of multiple interactive factors, so where nuts fit within dietary patterns is a significant consideration for research translation. This has implications for research methodologies, including categorization within food groups and inclusion in Healthy Dietary Indices. The aim of this narrative review is to outline new focal points for investigation that examine the environmental and some novel human health impacts of nut consumption and discuss future directions for research.

Nuts in the Prevention and Management of Type 2 Diabetes

Diabetes is a continuously growing global concern affecting >10% of adults, which may be mitigated by modifiable lifestyle factors. Consumption of nuts and their inclusion in dietary patterns has been associated with a range of beneficial health outcomes. Diabetes guidelines recommend dietary patterns that incorporate nuts; however, specific recommendations related to nuts have been limited. This review considers the epidemiological and clinical evidence to date for the role of nut consumption as a dietary strategy for the prevention and management of type 2 diabetes (T2D) and related complications. Findings suggest nut consumption may have a potential role in the prevention and management of T2D, with mechanistic studies assessing nuts and individual nut-related nutritional constituents supporting this possibility. However, limited definitive evidence is available to date, and future studies are needed to elucidate better the impact of nuts on the prevention and management of T2D.

Microbiological Profile, Prevalence, and Characterization of Salmonella enterica in Peanuts, Pecans, Raisins, Sun-Dried Tomatoes, and Chocolate Sprinkles Sold in Bulk in Markets in Querétaro, Mexico

ABSTRACT

In Mexico, the prevalence of Salmonella enterica in low-water-activity foods and its link to outbreaks are unknown. The aim of this study was to determine the microbiological profile and the prevalence of S. enterica in several low-water-activity foods, including peanuts, pecans, raisins, sun-dried tomatoes, and chocolate sprinkles, purchased in retail establishments in Querétaro, Mexico. Seventy samples of each food item sold in bulk were purchased. Aerobic plate count, molds, yeasts, total coliforms, Escherichia coli, and Staphylococcus aureus were quantified in 10-g samples. The prevalence of S. enterica in 25-g samples was determined. From positive samples, S. enterica isolates (60) were characterized based on their antimicrobial susceptibility to 14 antibiotics, the presence-absence of 13 virulence genes, and serotype. The concentration of aerobic plate count, molds, yeasts, total coliforms, and E. coli ranged from 3.1 to 5.2 log CFU g-1, from 2.0 to 2.4 log CFU g-1, from 2.0 to 3.0 log CFU g-1, from 0.6 to 1.1 log most probable number (MPN) g-1, and from 0.5 to 0.9 log MPN g-1, respectively. S. aureus was not detected in any sample (<10 CFU g-1). The prevalence of S. enterica in chocolate sprinkles, raisins, peanuts, pecans, and sun-dried tomatoes was 26, 29, 31, 40, and 52%, respectively. Most isolates (68.3%) were resistant to at least one antibiotic. Chromosome-associated virulence genes were found in all isolates, and only one strain had sopE, and 98.3% of the isolates were grouped in the same virulotype. Among the isolates, the most frequent serotype was Tennessee (51 of 60). According to the characteristics evaluated, we grouped the isolates into 24 clusters. The elevated prevalence of S. enterica highlights the role of low-water-activity food items sold in bulk at markets as potential vehicles for pathogen transmission. Regardless of the low variability among S. enterica isolates, their characterization could be helpful to elucidate which strains are circulating in these foods for improving epidemiological surveillance.

HIGHLIGHTS

Modulation of gut microbiota by bioactive compounds for prevention and management of type 2 diabetes

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin resistance. Gut microbiota (GM) are specific groups of microbes colonized in the gastrointestinal (GI) tract. They profoundly influence health, disease protection, and associated with metabolic activities, and play a vital role in the production of functional metabolites from dietary substances. Dysbiosis of GM has been linked to the onset of T2DM and can be altered to attain eubiosis by intervention with various nutritional bioactive compounds such as polyphenols, prebiotics, and probiotics. This review presents an overview of the evidence and underlying mechanisms by which bioactive compounds modulate the GM for the prevention and management of T2DM.

Nuts and Metabolic Syndrome: Reducing the Burden of Metabolic Syndrome in Menopause

Menopause imposes a dramatic fall in estrogens, which is followed by an increase in the proportion of fat. The rising androgen/estrogen ratio along the menopause transition favors the accumulation of central fat, which contributes to insulin resistance and a series of concatenated effects, leading to a higher incidence of metabolic syndrome. The modulatory effect of diet on the metabolic syndrome phenotype has been shown for the Mediterranean diet, and nuts are key determinants of these health benefits. This review of the impact of nuts on the risk factors of the metabolic syndrome cluster examined studies—prioritizing meta-analyses and systemic reviews—to summarize the potential benefits of nut ingestion on the risk of metabolic syndrome associated with menopause. Nuts have a general composition profile that includes macronutrients, with a high proportion of unsaturated fat, bioactive compounds, and fiber. The mechanisms set in motion by nuts have shown different levels of efficacy against the disturbances associated with metabolic syndrome, but a beneficial impact on lipids and carbohydrate metabolism, and a potential, but minimal reduction in blood pressure and fat accumulation have been found.

Polyunsaturated fatty acid intake and incidence of type 2 diabetes in adults: a dose response meta-analysis of cohort studies

BACKGROUND

To evaluate the association and dose-response relationship between polyunsaturated fatty acid (PUFA) intake and incidence of type 2 diabetes (T2D) in adults.

METHODS

PubMed, Embase, Cochrane Library, and Web of Science databases were searched for cohort studies that examined the association between PUFA and T2D incidence published up to September 6, 2021. Relative risk (RR) or hazard ratio (HR) was used as the effect indicator, each effect size was expressed by 95% confidence interval (CI). The presence of heterogeneity of effect size between studies was assessed by the Q-test and I² statistics. If I² ≥ 50%, the random-effects model was applied, otherwise the fixed effects model was used. Sensitivity analysis was performed for all models. Potential publication bias was assessed. We conducted linear and nonlinear dose-response meta-analyses, calculated summary relative risk (SRR).

RESULTS

Twenty-five articles were selected including 54,000 patients in this study. Our estimates observed no linear associations between total PUFA and the incidence of T2D. However, the summary dose-response curve of T2D risk increased in a nonlinear pattern with the consumption of omega-3 PUFA (P_nonlinearity < 0.001) and docosahexaenoic acid (DHA) (P_nonlinearity = 0.040). Our subgroup analysis showed that total PUFA intake was associated with increased incidence of T2D in Europe (RR: 1.040, 95% CI 1.009 to 1.072), and Australia (RR: 1.188, 95% CI 1.113 to 1.269). However, total PUFA intake was associated with decreased T2D incidence in Asia (RR: 0.897, 95% CI 0.860 to 0.936). Subgroup analysis based on PUFA types showed that DHA intake was associated with decreased T2D incidence (RR: 1.164, 95% CI 1.048 to 1.294) while linoleic acid (LA) decreased T2D incidence (RR: 0.956, 95% CI 0.930 to 0.983). Regarding the sex subgroup, women's intake of total PUFA would increase the risk of T2D (RR: 1.049, 95% CI 1.019 to 1.079) while total PUFA intake decreased the risk of T2D in men (RR: 0.955, 95% CI 0.913 to 0.999).

CONCLUSION

For specific PUFA, dose-response curves show nonlinear significant associations between PUFA intakes and T2D. It may be necessary to pay attention to the effects of PUFA and type of intake on T2D. Trial registration Not applicable.

The effect of Spirulina sauce, as a functional food, on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease patients: A randomized double-blinded clinical trial

OBJECTIVE

This study sought to investigate the effect of Spirulina on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease (NAFLD) patients.

METHODS

This randomized, double-blind clinical trial was performed on 46 NAFLD patients. Subjects were allocated to consume either Spirulina sauce or placebo, each 20 g/day for 8 weeks. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, and serum lipids, glucose, insulin, malondialdehyde, and antioxidant capacity were assessed pre- and postintervention.

RESULTS

Fatty liver grade was significantly different between the two groups. A significant change for ALT (alanine aminotransferase) and AST (aspartate aminotransferase) was seen between the two groups (p = .03 and .02, respectively), while ALP (alkaline phosphatase) serum levels were not significantly different within or between groups. Pertaining to glycemic profile, all variables, except HOMA-IR, were not significantly different within or between groups. Finally, statistically significant changes were seen in both MDA (malondialdehyde) and TAC (total antioxidant capacity) among the groups (p = .04 and <.001, respectively).

CONCLUSIONS

Spirulina may improve fatty liver grade by modifying liver enzymes, oxidative stress, and some lipid profiles; however, there was effect of Spirulina on anthropometric characteristics and blood pressure.

Effect of two postharvest technologies on the micronutrient profile of cashew kernels from Mozambique

The economics involved in processing cashew nuts (Anacardium occidentale) might alter micronutrient profiles and concentrations. We analyzed and evaluated carotenoids, tocopherols, tocotrienols, minerals, fatty acids, and amino acids in (1) cashew kernels with testa recovered from nuts dried with and without the apple, and (2) testa-free industrial grade baby butts, splits, and white whole kernels using HPLC, ICP-OES, and GC-MS techniques. The results indicated that drying cashews with the respective apple slightly decreased the concentration of some carotenoids and total fatty and amino acids, but increased the concentration of iron, magnesium, and total tocotrienols compared with the conventionally (sun-) dried kernels. We also found high concentrations of carotenoids in the testa-containing kernels. Among the industrially processed kernel, baby butt grade was associated with lower content of β-carotene, total tocopherols, and tocotrienols, but with significantly higher concentrations in minerals, fatty acids, and amino acids than in white wholes and split grades. Conventional sun drying of cashew nuts revealed results similar to drying with apples regarding micronutrient concentrations. The high micronutrient content of industrial grade BB is reflected in widespread human consumption and better market value.

Nutrition and physical activity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022

Background

This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on Nutrition and Physical Activity provides clinicians an overview of nutrition and physical activity principles applicable to the care of patients with increased body fat, especially those with adverse fat mass and adiposopathic metabolic consequences.

Methods

The scientific information and clinical guidance is based upon referenced evidence and derived from the clinical perspectives of the authors.

Results

This OMA CPS on Nutrition and Physical Activity provides basic clinical information regarding carbohydrates, proteins, fats (including trans fats, saturated fats, polyunsaturated fats, and monounsaturated fats), general principles of healthful nutrition, nutritional factors associated with improved health outcomes, and food labels. Included are the clinical implications of isocaloric substitution of refined carbohydrates with saturated fats and vice-versa, as well as definitions of low-calorie, very low-calorie, carbohydrate-restricted, and fat-restricted dietary intakes. Specific dietary plans discussed include carbohydrate-restricted diets, fat-restricted diets, very low-calorie diets, the Mediterranean diet, Therapeutic Lifestyle diet, Dietary Approaches to Stop Hypertension (DASH), ketogenic (modified Atkins) diet, Ornish diet, Paleo diet, vegetarian or vegan diet (whole food/plant-based), intermittent fasting/time restricted feeding, and commercial diet programs. This clinical practice statement also examines the health benefits of physical activity and provides practical pre-exercise medical evaluation guidance as well as suggestions regarding types and recommended amounts of dynamic (aerobic) training, resistance (anaerobic) training, leisure time physical activity, and non-exercise activity thermogenesis (NEAT). Additional guidance is provided regarding muscle physiology, exercise prescription, metabolic equivalent tasks (METS), and methods to track physical activity progress.

Conclusion

This Obesity Medicine Association Clinical Practice Statement on Nutrition and Physical Activity provides clinicians an overview of nutrition and physical activity. Implementation of appropriate nutrition and physical activity in patients with pre-obesity and/or obesity may improve the health of patients, especially those with adverse fat mass and adiposopathic metabolic consequences.

Therapeutic Effect of Sunflower Seeds and Flax Seeds on Diabetes

Diabetes mellitus (DM) is a metabolic syndrome that is spreading like an epidemic throughout the world without any differentiation of races and ethnic groups and has become the cause of death worldwide. It is characterized by high levels of glucose in the blood and has different types classified on the basis of varying pathophysiology. Type 1 diabetes or insulin-dependent diabetes is characterized by insulin insufficiency due to autoimmune dysfunction. Type 2 diabetes or non-insulin-dependent diabetes results from the combination of resistance to insulin action or/and inadequate insulin secretion. Gestational diabetes (GDM) is defined as hyperglycemia due to insulin resistance during pregnancy. Other types include the monogenic type of DM such as neonatal diabetes mellitus (NDM), maturity-onset diabetes of young (MODY), and diabetes in metabolic syndrome. Diabetes is diagnosed by criteria given by American Diabetes Association (ADA) for different tests like fasting plasma glucose test and hemoglobin A1c test. It is characterized by polydipsia, polyphagia, hyperglycemia, and glucosuria. Diabetes mellitus is managed through medications but many studies have proven that consumption of particular foods leads to decreased glucose levels in diabetic patients. Seeds like sunflower and flax seeds have a role in the reduction of glucose levels and can be used to treat type 2 diabetes. The bioactive components in these seeds like chlorogenic acid in sunflower seeds and secoisolariciresinol diglucosoid are involved in the treatment of insulin resistance or insulin production. In different studies, different amounts of these seed extracts were consumed by rats and humans and it resulted in better glycemic control, which provides information that these seeds have anti-diabetic properties.

Association of plant-based diet and type 2 diabetes mellitus in Chinese rural adults: The Henan Rural Cohort Study

AIMS/INTRODUCTION

Studies have found that a plant-based diet was associated with a lower risk of type 2 diabetes, but evidence is scarce on such associations in China. The aim of this study was to investigate whether a plant-based diet is related to a lower risk of type 2 diabetes among Chinese adults.

MATERIALS AND METHODS

A total of 37,985 participants were enrolled from the Henan Rural Cohort Study. An overall plant-based diet index (PDI) was created by assigning positive and reverse scores to 12 commonly consumed food groups. Multivariate logistic regression models and restricted cubic spline analysis were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI).

RESULTS

After multivariable adjustment, the risk of type 2 diabetes was inversely associated with the PDI (extreme-quartile OR = 0.88, 95% CI: 0.79-0.98; P = 0.027), the risk associated with a 1 standard deviation (SD) increase in PDI was 4% lower (95% CI, 0.93-1.00; P trend  = 0.043) for type 2 diabetes. Moreover, the odds of type 2 diabetes was decreased with an increment of PDI after fitting restricted cubic splines (P trend  < 0.01).

CONCLUSIONS

Among Chinese populations, diets higher in plant foods and lower in animal foods were associated with a reduced risk of type 2 diabetes.

Pineapple (Ananas comosus L.) By-Products Valorization: Novel Bio Ingredients for Functional Foods

Pineapple is consumed on a large scale around the world due to its appreciated sensorial characteristics. The industry of minimally processed pineapple produces enormous quantities of by-products (30–50%) which are generally undervalued. The end-of-life of pineapple by-products (PBP) can be replaced by reuse and renewal flows in an integrated process to promote economic growth by reducing consumption of natural resources and diminishing food waste. In our study, pineapple shell (PS) and pineapple core (PC), vacuum-packed separately, were subjected to moderate hydrostatic pressure (225 MPa, 8.5 min) (MHP) as abiotic stress to increase bromelain activity and antioxidant capacity. Pressurized and raw PBP were lyophilized to produce a stable powder. The dehydrated samples were characterized by the following methodologies: chemical and physical characterization, total phenolic compounds (TPC), antioxidant capacity, bromelain activity, microbiology, and mycotoxins. Results demonstrated that PBP are naturally rich in carbohydrates (66–88%), insoluble (16–28%) and soluble (2–4%) fiber, and minerals (4–5%). MHP was demonstrated to be beneficial in improving TPC (2–4%), antioxidant activity (2–6%), and bromelain activity (6–32%) without affecting the nutritional value. Furthermore, microbial and mycotoxical analysis demonstrated that powdered PC is a safe by-product. PS application is possible but requires previous decontamination to reduce the microbiological load.

A higher-protein nut-based snack product suppresses glycaemia and decreases glycaemic response to co-ingested carbohydrate in an overweight prediabetic Asian Chinese cohort: the Tū Ora postprandial RCT

Nut-based products may aid low-glycaemic dietary strategies that are important for diabetes prevention in populations at increased risk of dysglycaemia, such as Asian Chinese. This randomised cross-over trial assessed the postprandial glycaemic response (0-120 min) of a higher-protein nut-based (HP-NB) snack formulation, in bar format (1009 kJ, Nutrient Profiling Score, NPS, -2), when compared with an iso-energetic higher-carbohydrate (CHO) cereal-based bar (HC-CB, 985 kJ, NPS +3). It also assessed the ability to suppress glucose response to a typical CHO-rich food (white bread, WB), when co-ingested. Ten overweight prediabetic Chinese adults (mean, sd: age 47⋅9, 15⋅7 years; BMI 25⋅5, 1⋅6 kg/m2), with total body fat plus ectopic pancreas and liver fat quantified using dual-energy X-ray absorptiometry and magnetic resonance imaging and spectroscopy, received the five meal treatments in random order: HP-NB, HC-CB, HP-NB + WB (50 g available CHO), HC-CB + WB and WB only. Compared with HC-CB, HP-NB induced a significantly lower 30-120 min glucose response (P < 0⋅05), with an approximately 10-fold lower incremental area under the glucose curve (iAUC0-120; P < 0⋅001). HP-NB also attenuated glucose response by approximately 25 % when co-ingested with WB (P < 0⋅05). Half of the cohort had elevated pancreas and/or liver fat, with 13-21 % greater suppression of iAUC0-120 glucose in the low v. high organ fat subgroups across all five treatments. A nut-based snack product may be a healthier alternative to an energy equivalent cereal-based product with evidence of both a lower postprandial glycaemic response and modulation of CHO-induced hyperglycaemia even in high-risk, overweight, pre-diabetic adults.

Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies

BACKGROUND

Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results, making desirable the performance of an updated meta-analysis.

OBJECTIVES

We aimed to systematically review and meta-analyze all the published studies investigating the relations of total nuts and different types of nuts-i.e., walnuts, peanuts, peanut butter, and total tree nuts-with the prevalence and incidence of T2D.

METHODS

A systematic search was conducted in the PubMed and Cochrane databases through 12 August, 2020. The inverse variance method with fixed-effect models was used to pool data across studies, expressed as risk ratios (RRs) or ORs and 95% CIs for prospective cohort and cross-sectional studies, respectively. The Cochran Q test and I2 statistics were used to test and quantify heterogeneity, respectively. Dose-response meta-analysis was also conducted.

RESULTS

Eight studies (5 prospective and 3 cross-sectional) were included in the quantitative synthesis. Meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and T2D. Meta-analyses of prospective cohort studies showed an inverse association between peanut butter consumption and T2D incidence (RR: 0.87; 95% CI: 0.77, 0.98; I2 = 50.6%; Pheterogeneity = 0.16), whereas no association was observed between peanuts or tree nuts and T2D. There was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies. The certainty of the evidence using NutriGrade was very low for all the exposures.

CONCLUSIONS

Current results do not demonstrate an association of total nut, peanut, or tree nut consumption with T2D. Peanut butter consumption may be inversely associated with this disease.This review protocol was registered at www.crd.york.ac.uk/prospero/ as CRD42020149756.

Is sugar extracted from plants less healthy than sugar consumed within plant tissues? The sugar anomaly

There are dilemmas in the minds of consumers with respect to sugar consumption - they would like to consume sugars for sweetness, but in a healthy (and perhaps guilt free!) way. In a sense, consumers believe that if sugar does not appear as an ingredient on the product label, but is intrinsic in the food (and will appear as a nutrient), it is 'good'. As an ingredient, however, it is viewed as a 'bad chemical' associated with tooth decay and obesity. The reality is that unless processing induced modifications have occurred, the sugar molecule within a plant tissue is the same molecule structure as present in purified sugar. The same calorific value. However, there is an argument that humans eat too refined food and that if sugars were eaten in their natural context (e.g. within a fruit), their presence and concentration would be in harmony (where different nutrients complement and balance the sugar concentration) with the human body. This reflects the process of eating, satiety, presence of other nutrients (including water) and the associated impact of the indigestible components of plant foods on the transit/nutrient bioavailability control and thus benefits through the gut. The authors explore these issues in this article and seek to provide a scientific basis to different sides of the argument - sugar is good or bad depending on how (in which format and how much/how concentrated) it is consumed. More importantly perhaps, how should sugar consumption - an important nutrient - be managed to optimize the benefits but reduce the disadvantages? © 2020 Society of Chemical Industry.

The effect of kefir-spirulina on glycemic status and antioxidant activity in hyperglycemia rats

Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia. It is caused by impaired insulin secretion or by insulin receptor insensitivity. DM and its complications are often related to increases in the level of oxidative stress. Spirulina is a nutrient-dense food that contains an abundance of antioxidant compounds. In combination with kefir, it may serve as both a nutrient-rich diet and an antioxidant agent that can prevent complications of diabetes. This study aims to investigate the nutritional content of kefir-spirulina and its effect on glycemic status and antioxidant activity in streptozotocin-nicotinamide (STZ-NA) induced diabetic rats. A total of 30 male Sprague Dawley rats were divided into five groups: normal control (K1), diabetic control (K2), pioglitazone treatment (K3), kefir combined with 1% spirulina treatment (P1), and kefir combined with 2% spirulina treatment (P2). All rats were induced by STZ-NA, except for the normal control. Before and after the 28 days of intervention, blood samples were taken and analyzed for fasting plasma glucose, postprandial glucose, and SOD activity. The nutritional content, ethanol content, and total antioxidant capacity of kefir-spirulina were also analyzed. The diabetic rats that were fed with kefir-spirulina (P1 and P2) had a significant decrease in both fasting and postprandial plasma glucose (p <0.001) compared to the diabetic control rats. The decrease of plasma glucose in K2 is comparable to the control rats treated with the diabetic drug pioglitazone (K3). The activity of SOD in diabetic rats fed in P1 and P2 were higher (p <0.001) than in untreated diabetic rats (K2). The IC50 of kefir-spirulina was 42 – 43 ppm. It was concluded that kefir combined with spirulina has high nutrition and antioxidant capacity, which is proven to be capable of controlling glycemic status and enhancing antioxidant status in a diabetic rat model.

Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome

Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient's compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities.

Carica papaya Linn. fruit extract inhibited the activities of aldose reductase and sorbitol dehydrogenase: possible mechanism for amelioration of diabetic complications

Background

Diabetes mellitus is a metabolic disorder which is associated with debilitating complications including eye disease, kidney disorder, and diabetic foot disease. One of the mechanisms implicated in the pathogenesis of diabetic complications is the polyol pathway. This study evaluated the inhibitory effect of aqueous extract of four tropical fruits, namely apple (Malus domestica Borkh.), banana (Musa paradisiaca Linn.), pawpaw (Carica papaya Linn.), and watermelon (Citrullus lanatus (Thunb.) Matsum & Nakai), on the activities of polyol pathway enzymes (aldose reductase and sorbitol dehydrogenase).

Results

All the fruits, with the exception of banana, displayed stronger inhibition of sorbitol dehydrogenase than aldose reductase which culminated in low IC50 for the inhibition of sorbitol dehydrogenase. Of the fruit extracts tested, pawpaw inhibited both aldose reductase and sorbitol dehydrogenase most effectively with IC50 of 150.78 μg/mL and 46.30 μg/mL, respectively. Lineweaver-Burk plot also revealed that the pawpaw extract inhibited aldose reductase competitively while sorbitol dehydrogenase was inhibited in a mixed non-competitive manner.

Conclusion

Aqueous extract of pawpaw fruit effectively inhibited polyol pathway enzymes, and this may be attributed to rich nutritional and phytochemical composition of the fruit. Consequently, the consumption of pawpaw fruit may contribute to the amelioration of diabetic complications.

Co-ingested vinegar-soaked or preloaded dried apple mitigated acute postprandial glycemia of rice meal in healthy subjects under equicarbohydrate conditions

This study investigated 2 possible approaches to dietary control of acute postprandial responses to a rice-based meal under equicarbohydrate conditions: (1) a dried apple (DA) preload and (2) co-ingestion of vinegar-soaked DA. We hypothesized that both approaches would counteract hyperglycemia with no negative effect on satiety, possibly explained by an inhibitory effect on digestive enzyme activity and/or the effect of the sugar component of the DA. Fifteen healthy female subjects consumed (1) rice, (2) co-ingestion of DA and rice (DA + R), (3) DA preload and rice (PDA + R), (4) rice with sugar solution (same sugar profile as in DA) preloaded (PSS + R), or (5) co-ingestion of rice with vinegar-soaked DA (VDA + R) in a randomized crossover trial. Acute postprandial glycemic response tests and subjective satiety tests were conducted for each test meal. Compared with rice reference, the PA + R and PSS + R achieved 31.4% and 36.3% reduction of the incremental area under the curve_0-120, 24.3% and 27.0% decreases in the average glucose peak, along with 21.6% and 27.0% decreases in glycemic excursion in 240 minutes, whereas the VDA + R resulted 42.4%, 27.0%, and 29.7% reductions in the incremental area under the curve_0-120, peak, and glycemic excursion, respectively. The DA-containing meals had no effect or a favorable effect on satiety. The in vitro assay found larger resistant starch and smaller rapid digestible starch fractions in DA + R and VDA + R meals compared to those of the rice reference (P < .001). The result of this study supported the research hypothesis, and the DA-containing meals could be considered as a potential dietary approach for glycemic management.

Heat-Stable Hazelnut Profilin: Molecular Dynamics Simulations and Immunoinformatics Analysis

Heat treatment can modify the allergenic potential, reducing allergenicity in specific proteins. Profilins are one of the important hazelnut allergens; these proteins are considered panallergens due to their high capacity for cross-reactivity with other allergens. In the present work, we evaluated the thermostability of hazelnut profilin, combining molecular dynamics simulation and immunoinformatic techniques. This approach helped us to have reliable results in immunogenicity studies. We modeled Cor a 2 profilin and applied annealing simulation, equilibrium, and production simulation at constant temperatures ranging from 300 to 500 K using Gromacs software. Despite the hazelnut profilins being able to withstand temperatures of up to 400 K, this does not seem to reduce its allergenicity. We have found that profilin subjected to temperatures of 450 and 500 K could generate cross-reactivity with other food allergens. In conclusion, we note a remarkable thermostability of Cor a 2 at 400 K which avoids its structural unfolding.

Effects of nut and seed consumption on markers of glucose metabolism in adults with prediabetes: a systematic review of randomised controlled trials

The primary aim was to investigate the effects of nut and seed consumption on markers of glucose metabolism in adults with prediabetes. Studies with a randomised controlled trial (RCT) design, comparing the effects of a diet containing nuts or seeds against a diet without nuts or seeds in adults with prediabetes, were considered eligible. Primary outcome measures included fasting plasma glucose (FPG), 2-h plasma glucose during oral glucose tolerance test and glycated Hb (HbA1c) concentrations. Studies were identified by searching PubMed and Scopus electronic databases and by checking full texts and reference lists of relevant records. Risk of bias was assessed using the Cochrane Collaboration's tool. We included five RCT involving 371 adults with prediabetes or at risk of diabetes; three RCT investigated the effects of whole nut consumption and two the effects of ground flaxseed consumption. Consumption of 57 g/d pistachios or mean intake of 60 g/d almonds for 4 months improved FPG and fasting plasma insulin (FPI) concentrations, insulin resistance, cellular glucose uptake in lymphocytes and β-cell function. Consumption of 56 g/d walnuts for 6 months was not found to affect FPG or HbA1c concentrations. Consumption of 13 g/d flaxseed for 3 months improved FPG and FPI concentrations and insulin resistance. In a second study, however, flaxseed consumption was not found to affect markers of glucose metabolism. The risk of bias was generally low, thus the reported results could be reliable. Further investigation of nut and seed consumption effects in the field of prediabetes is warranted.

Cost-effective voltammetric determination of boron in dried fruits and nuts using modified electrodes

Cost effective, simple and accurate two voltammetric methods for determination of boron in hazelnut, peanut, almond, raisin, prune and date samples were described. Metal nanoparticles-carbon nanotube modified glassy carbon electrode (MNP/CNT/GCE, M = Au or Cu) and poly xylenol orange modified pencil graphite electrode (p-XO/PGE) were used as working electrodes. The oxidation of alizarin red s (ARS) in the boron-ARS complex at MNP/CNT/GCE and the oxidation of tiron in the B-tiron complex at p-XO/PGE were monitored as response. The limit of determination values (based on visual evaluation) for CuNP/CNT/GCE, AuNP/CNT/GCE and p-XO/PGE were calculated as 100 µg/L, 125 µg/L and 80 µg/L, respectively. The results were compared with the results obtained by inductively coupled plasma mass spectrometric method and no significant difference between the results was observed. The accuracy experiments of the methods and uncertainty calculations were also performed using a certified reference material (UME CRM 1202 Elements in Hazelnut).

Bioactives and health benefits of nuts and dried fruits

Nuts and dried fruits have been part of the human diet since prehistoric times. They are nutrient-rich foods and constitute an excellent means to deliver health-promoting bioactive compounds. As such, they serve as important healthful snack items, besides being part of many traditional and new recipes of gastronomy worldwide. Frequent consumption of nuts and/or dried fruits is highly recommended to obtain the full benefit of the nutrients, bioactives, and antioxidants that they contain, together with their desirable flavour. The macronutrients, micronutrients, and other health-promoting bioactive compounds contained in nuts and dried fruits may synergistically contribute to modulate the risk of cardiometabolic and other non-communicable diseases through various mechanisms. Experimental research, prospective studies, and human clinical trials have reported beneficial effects of nut consumption on various health outcomes. The benefits of dried fruits, however, have been less explored. This review summarizes recent findings on bioactive constituents, health claims, and health benefits of nuts and dried fruits and also discusses their great potential as healthy foods to benefit a number of diseases afflicting human beings.

Diabetes, Diabetic Complications, and Phosphate Toxicity: A Scoping Review

This article presents a scoping review and synthesis of research findings investigating the toxic cellular accumulation of dysregulated inorganic phosphate-phosphate toxicity-as a pathophysiological determinant of diabetes and diabetic complications. Phosphorus, an essential micronutrient, is closely linked to the cellular metabolism of glucose for energy production, and serum inorganic phosphate is often transported into cells along with glucose during insulin therapy. Mitochondrial dysfunction and apoptosis, endoplasmic reticulum stress, neuronal degeneration, and pancreatic cancer are associated with dysregulated levels of phosphate in diabetes. Ectopic calcification involving deposition of calcium-phosphate crystals is prevalent throughout diabetic complications, including vascular calcification, nephropathy, retinopathy, and bone disorders. A low-glycemic, low-phosphate dietary intervention is proposed for further investigations in the treatment and prevention of diabetes and related diabetic pathologies.

Nuts

Nuts are fruits composed of two parts: an inedible hard shell and an edible seed. Nuts are known as an energy-dense and nutrient-rich food source. In general, nuts are recognized as a good source of fat, fiber, and protein. Nuts are extremely beneficial parts of any diet since their consumption may lower risk for some diseases, such as cardiovascular diseases and cancer. They are acknowledged for their low glycemic index owning to high unsaturated fat and protein content and relatively low carbohydrate content. They have been shown to increase cognitive function as well.

Legume Consumption and Cardiometabolic Health

Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.

Effects of Consuming Almonds on Insulin Sensitivity and Other Cardiometabolic Health Markers in Adults With Prediabetes

Objective: This study was designed to assess the effects of replacing high-carbohydrate (CHO) foods with raw almonds on insulin sensitivity and cardiometabolic health markers in overweight or obese adults with prediabetes.Method: This randomized crossover study consisted of two 6-week dietary intervention periods, separated by a ≥ 4-week washout. Subjects incorporated 1.5 oz of raw almonds twice daily or isocaloric CHO-based foods into their diets, with instructions to maintain body weight. Dietary intakes as well as insulin sensitivity, CHO metabolism indices, lipoprotein lipids and particles, and inflammatory markers were assessed.Results: Thirty-three subjects (17 male, 16 female), mean age 48.3 ± 2.2 years and body mass index 30.5 ± 0.7 kg/m², provided evaluable data. Compared to CHO, almonds resulted in significantly (p < 0.01) higher intakes of protein, fat (unsaturated fatty acids), fiber, and magnesium and significantly (p < 0.001) lower intakes of CHO and sugars. No differences were observed between diet conditions for changes from baseline in the insulin sensitivity index from a short intravenous glucose tolerance test or other indices of glucose homeostasis. No significant differences were observed in biomarkers of cardiovascular risk except that the CHO intervention led to a shift toward a higher concentration of cholesterol in small, dense low-density lipoprotein subfraction 3+4 (LDL3 + 4) particles (p = 0.024 vs almonds).Conclusions: Intake of 3.0 oz/d raw almonds, vs energy-matched CHO foods, improved the dietary nutrient profile, but did not significantly affect insulin sensitivity and most markers of cardiometabolic health in overweight and obese men and women with prediabetes.

Association between nut intake and non-alcoholic fatty liver disease risk: a retrospective case-control study in a sample of Chinese Han adults

OBJECTIVES

Nut consumption has been associated with a lower risk of type 2 diabetes, metabolic syndrome and insulin resistance. However, its effect on the risk of non-alcoholic fatty liver disease (NAFLD) is unknown. Therefore, we investigated the relationship between nut consumption and NAFLD risk.

SETTING AND PARTICIPANTS

We conducted a retrospective case-control study including 534 patients diagnosed with NAFLD and 534 controls matched by sex and age (±5 years) from the Affiliated Nanping First Hospital of Fujian Medical University in China.

MAIN OUTCOME MEASURES

Information on dietary intake was collected using a semiquantitative food frequency questionnaire and nut consumption was calculated. Nut consumption was categorised using quartiles based on the distribution of daily nut intake of the controls. Binary logistic regression models were used to estimate ORs and the 95% CIs for the association between nut consumption and NAFLD risk.

RESULTS

After adjusting for potential confounding variables, nut consumption was not associated with NAFLD risk in the overall sample. When the fully adjusted model was stratified by sex, a significant inverse association was found between high nut consumption and NAFLD only among the men in the highest quartile (OR=0.43; 95% CI 0.26 to 0.71; P_{trend =} 0.01). The inverse association of nut consumption with NAFLD risk in men remained significant after controlling for other known or suspected risk factors for NAFLD.

CONCLUSIONS

Diets with a higher intake of nuts may be associated with a decreased risk of NAFLD, particularly in men.

Impact of drying methods on the changes of fruit microstructure unveiled by X-ray micro-computed tomography

Distinct evolution of fruit microstructure under different drying conditions were identified using a 3D imaging and Eulerian–Lagrangian analysis.

Effect of dried fruit on postprandial glycemia: a randomized acute-feeding trial

Background/Objectives

To investigate the effect of dried fruit in modifying postprandial glycemia, we assessed the ability of 4 dried fruits (dates, apricots, raisins, sultanas) to decrease postprandial glycemia through three mechanisms: a glycemic index (GI) effect, displacement effect, or ‘catalytic’ fructose effect.

Subjects/Methods

We conducted an acute randomized, multiple-crossover trial in an outpatient setting in 10 healthy adults. Participants received 3 white bread control meals and 12 dried fruit test meals in random order. The test meals included each of 4 dried fruits (dates, apricots, raisins, sultanas) alone (GI effect), 4 of the dried fruits displacing half the available carbohydrate in white bread (displacement effect), or 4 of the dried fruits providing a small ‘catalytic’ dose (7.5 g) of fructose added to white bread (‘catalytic’ fructose effect). The protocol followed the ISO method for the determination of GI (ISO 26642:2010). The primary outcome was mean ± SEM GI (glucose scale) for ease of comparison across the three mechanisms.

Results

Ten healthy participants (7 men, 3 women; mean ± SD age and BMI: 39 ± 12 years and 25 ± 2 kg/m²) were recruited and completed the trial. All dried fruit had a GI below that of white bread (GI = 71); however, only dried apricots (GI = 42 ± 5), raisins (GI = 55 ± 5), and sultanas (51 ± 4) showed a significant GI effect (P < 0.05). When displacing half the available carbohydrate in white bread, all dried fruit lowered the GI; however, only dried apricots (GI = 57 ± 5) showed a significant displacement effect (P = 0.025). None of the dried fruits showed a beneficial ‘catalytic’ fructose effect.

Conclusions

In conclusion, dried fruits have a lower GI and reduce the glycemic response of white bread through displacement of half of the available carbohydrate. Longer-term randomized trials are needed to confirm whether dried fruit can contribute to sustainable improvements in glycemic control.

Trial registration

ClinicalTrials.gov identifier, NCT02960373

Nuts and Cardio-Metabolic Disease: A Review of Meta-Analyses

OBJECTIVES

Accumulating epidemiological and intervention evidence suggest that nut consumption is associated with reduced incidence of some cardiometabolic diseases. However, to date no review of meta-analyses of epidemiological and intervention studies has evaluated the effects of nut consumption on cardiometabolic disease. Design/Results: Electronic searches for meta-analyses of epidemiological and intervention studies were undertaken in PubMed®/MEDLINE®. Meta-analyses of prospective studies show that nut consumption appears to be associated with reduced all-cause mortality by 19⁻20% (n = 6), cardiovascular disease (CVD) incidence (19%; n = 3) and mortality (25%; n = 3), coronary heart disease (CHD) incidence (20⁻34%; n = 2) and mortality (27⁻30%; n = 2) and stroke incidence (10⁻11%; n = 7) and mortality (18%; n = 2). No association between nut consumption and the risk of type 2 diabetes mellitus (T2DM) was observed in meta-analyses of prospective studies, whereas a decrease in fasting blood glucose ranging from 0.08 to 0.15 mmol/L was observed in 3 meta-analyses of intervention studies. In the interventions, nut consumption also had favorable effects on total cholesterol (0.021 to 0.28 mmol/L reduction from 8 meta-analyses of interventions) and low-density lipoprotein cholesterol (0.017 to 0.26 mmol/L reduction from 8 meta-analyses of interventions) and endothelial function (0.79 to 1.03% increase in flow-mediated dilation from 4 meta-analyses of interventions). Nut consumption did not significantly affect body weight. Nut consumption had no effect on inflammatory markers in intervention studies. The effect on blood pressure was inconsistent. A higher nut consumption was associated with a lower incidence of hypertension in prospective studies, while nut consumption did not improve blood pressure in intervention studies.

CONCLUSIONS

Nut consumption appeared to be associated with lower all-cause mortality and CVD and CHD mortality. There was no association between nut consumption and the incidence of T2DM although fasting blood glucose is decreased in intervention studies. In intervention studies nuts lower total cholesterol and low-density lipoprotein cholesterol (LDL-C).

Inverse Association between Organic Food Purchase and Diabetes Mellitus in US Adults

BACKGROUND

The organic food market has grown rapidly worldwide in the past 15 years. However, evidence concerning the health effects of organic foods is scarce. We evaluated the cross-sectional association of organic food purchase, as a proxy of organic food consumption, with diabetes in a nationally representative population.

METHODS

We included 8199 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2007⁻2008 and 2009⁻2010. Organic food purchase and frequency were ascertained by questionnaires. Diabetes was defined as a self-reported physician diagnosis or a hemoglobin A1c level ≥6.5% or both. We used logistic regression with sample weights to estimate the odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Individuals who reported purchasing organic foods were less likely to have diabetes compared to those who did not report organic food purchase. After adjustment for age, gender, race/ethnicity, family history of diabetes, socioeconomic status, and dietary and lifestyle factors, the OR of diabetes associated with organic food purchase was 0.80 (95% CI 0.68⁻0.93). The association remained significant after additional adjustment for BMI with OR of 0.80 (0.69⁻0.94).

CONCLUSIONS

In a nationally representative population, frequent organic food purchase was inversely associated with diabetes prevalence in adults in the United States.

A Randomized Controlled Trial to Compare the Effect of Peanuts and Almonds on the Cardio-Metabolic and Inflammatory Parameters in Patients with Type 2 Diabetes Mellitus

A low carbohydrate diet (LCD), with some staple food being replaced with nuts, has been shown to reduce weight, improve blood glucose, and regulate blood lipid in patients with type 2 diabetes mellitus (T2DM). These nuts include tree nuts and ground nuts. Tree nut consumption is associated with improved cardio-vascular and inflammatory parameters. However, the consumption of tree nuts is difficult to promote in patients with diabetes because of their high cost. As the main ground nut, peanuts contain a large number of beneficial nutrients, are widely planted, and are affordable for most patients. However, whether peanuts and tree nuts in combination with LCD have similar benefits in patients with T2DM remains unknown; although almonds are the most consumed and studied tree nut. This study sought to compare the effect of peanuts and almonds, incorporated into a LCD, on cardio-metabolic and inflammatory measures in patients with T2DM. Of the 32 T2DM patients that were recruited, 17 were randomly allocated to the Peanut group (n = 17) and 15 to the Almond group (n = 15) in a parallel design. The patients consumed a LCD with part of the starchy staple food being replaced with peanuts (Peanut group) or almonds (Almond group). The follow-up duration was three months. The indicators for glycemic control, other cardio-metabolic, and inflammatory parameters were collected and compared between the two groups. Twenty-five patients completed the study. There were no significant differences in the self-reported dietary compliance between the two groups. Compared with the baseline, the fasting blood glucose (FBG) and postprandial 2-h blood glucose (PPG) decreased in both the Peanut and Almond groups (p < 0.05). After the intervention, no statistically significant differences were found between the Peanut group and the Almond group with respect to the FBG and PPG levels. A decrease in the glycated hemoglobin A1c (HbA1c) level from the baseline in the Almond group was found (p < 0.05). However, no significant difference was found between the two groups with respect to the HbA1c level at the third month. The peanut and almond consumption did not increase the body mass index (BMI) and had no effect on the blood lipid profile or interleukin-6 (IL-6).In conclusion, incorporated into a LCD, almonds and peanuts have a similar effect on improving fasting and postprandial blood glucose among patients with T2DM. However, more studies are required to fully establish the effect of almond on the improvement of HbA1c.

Fruit and Vegetable Consumption and Their Association With the Indicators of Iron and Inflammation Status Among Adolescent Girls

BACKGROUND

The objective of this study was to identify an association among dietary components, iron, and inflammatory status among adolescent girls.

METHOD

Dietary information for 85 adolescent girls was collected through food frequency questionnaires. Biomarkers of iron and inflammatory status were analyzed.

RESULTS

We found that 28.2% of adolescent girls had anemia and 65.9% girls were iron-deficient. Girls who did not consume guava had 3.8-fold (95% confidence interval =1.1-9.4; p = 0.020) increased the risk of having low serum iron levels. Girls who consumed amaranth had significantly (p = 0.024) higher serum hepcidin levels (n = 44; 129.7 ± 81.40 pg/mL vs n = 41; 94.6 ± 55.8 pg/mL) as well as ferritin levels (n = 44; 19.7 ± 16.4 µg/L vs n = 41; 14.0 ± 10.2 µg/L). Overall consumption of fruits and green leafy vegetables among girls significantly affects their iron status.

CONCLUSIONS

Regular consumption of vitamin C-rich fruits and green leafy vegetable intake are imperative for improvement of iron status among adolescent girls.

Nuts and Cardiovascular Disease Prevention

PURPOSE OF REVIEW

We review recent epidemiological and clinical studies investigating the consumption of tree nuts and peanuts and cardiovascular disease (CVD) mortality as well as CVD risk factors.

RECENT FINDINGS

A greater consumption of tree nuts and peanuts is associated with a reduced risk of CVD mortality, as well as lower CVD events. Furthermore, risk factors associated with the development of CVD such as dyslipidemia, impaired vascular function, and hypertension are improved with regular tree nut and peanut consumption through a range of mechanism associated with their nutrient-rich profiles. There is weak inconsistent evidence for an effect of nut consumption on inflammation. There is emerging evidence that consuming tree nuts reduces the incidence of non-alcoholic fatty liver disease (NAFLD) and promotes diversity of gut microbiota, which in turn may improve CVD outcomes. Evidence for CVD prevention is strong for some varieties of tree nuts, particularly walnuts, and length of supplementation and dose are important factors for consideration with recommendations.

Polyphenol-rich foods and risk of gestational diabetes: a systematic review and meta-analysis

Animal studies have demonstrated anti-diabetic properties of several food-derived polyphenols, but data in humans remains unclear. This study aimed to review and meta-analyse evidence concerning the effect of the intake of several polyphenol-rich foods on gestational diabetes (GDM) risk. A systematic literature search was conducted in PubMed, Web of Science and Embase databases for observational studies on the association between dietary intake of foods/diets rich in polyphenols and GDM risk. Inclusion criteria were original research articles with full texts published in peer-reviewed English language journals, which investigated foods within the top 100 richest dietary sources of polyphenols and reported odds ratio/relative risk with their corresponding 95% confidence intervals. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The intake of polyphenol-rich foods and dietary patterns in relation to GDM were pooled with fixed- and random-effects models. In total, 12 (10 cohort, 1 cross-sectional and 1 case-control) studies were included for the final systematic review, comprising 124,959 participants and including 5,786 women with GDM. Five studies found a significant, inverse association between the intake of polyphenol-rich foods or Mediterranean diet and GDM, whereas five studies reported no association and two exhibited a positive association. Meta-analyses further showed that the risk of GDM was about halved amongst women with the highest score of Mediterranean diet compared to those with the lowest score. The results suggest that dietary patterns rich in polyphenols may reduce the risk of GDM despite inconclusive evidence for polyphenol-rich food groups.

Postprandial Glycaemic Responses of Dried Fruit-Containing Meals in Healthy Adults: Results from a Randomised Trial

The aim of this study was to explore the glycaemic response (GR) patterns of four dried fruits (DF) and the mixed meals containing dried fruits, rice and almonds. Dried apples (DApp), dried jujubes (DJ), raisins (Ra) and dried apricots (DApr) were tested in eleven healthy subjects in random order. Test meals included the following 3 groups: (1) dried fruits containing 50 g available carbohydrates; (2) mixed meals consisting of DF and rice (DF + R), each contributing 25 g available carbohydrates; (3) Group (2) supplemented with 30 g almonds (DF + R + A). The postprandial GR and other characteristics in 240 min were investigated. The GI values of 4 DFs were 43 for DApp, 55 for DJ, 56 for both Ra and DApr. The DApp displayed the smallest amplitude of glycaemic excursion within 240 min (MAGE0⁻240). Compared with rice, the DApp + R meal elicited a significantly reduced GR and a smaller MAGE0⁻240 (GI 81 vs. 65). With the addition of almonds, the GIs and MAGE0⁻240 decreased significantly in all DF + A + R combinations except DApp + R + A. The ratio of total fructose/glucose contents of test meals were negatively correlated to GIs. Dried fruits and nuts may have the potential to mitigate the postprandial GR when jointly introduced into glycaemic management diets.

A Pecan-Rich Diet Improves Cardiometabolic Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial

Evidence from observational and intervention studies has shown a high intake of tree nuts is associated with a reduced risk of cardiovascular disease (CVD), mortality from type 2 diabetes (T2DM), and all-cause mortality. However, there is limited data regarding their effects on indicators of cardiometabolic risk other than hypercholesterolemia, and little is known about the demonstrable health benefits of pecans (Carya illinoensis (Wangenh.) K.Koch). We conducted a randomized, controlled feeding trial to compare the effects of a pecan-rich diet with an isocaloric control diet similar in total fat and fiber content, but absent nuts, on biomarkers related to CVD and T2DM risk in healthy middle-aged and older adults who are overweight or obese with central adiposity. After 4 weeks on a pecan-rich diet, changes in serum insulin, insulin resistance (HOMA-IR) and beta cell function (HOMA-β) were significantly greater than after the control diet (p < 0.05). Pecan consumption also lowered the risk of cardiometabolic disease as indicated by a composite score reflecting changes in clinically relevant markers. Thus, compared to the control diet, the pecan intervention had a concurrent and clinically significant effect on several relevant markers of cardiometabolic risk.

Functional Dehydrated Foods for Health Preservation

The market of functional foods has experienced a huge growth in the last decades due to the increased consumers’ awareness in a healthy lifestyle. Dried fruits constitute good snacks, in alternative to salty or sweet ones, and food ingredients due to their taste and nutritional/health benefits. Bioactive molecules are interesting sources to develop functional foods, as they play a major role in improving the health status and minimizing disease risks. The bioactive compounds most widely discussed in literature are presented in this review, for example, polyphenols, phytosterols, and prebiotics. Different technologies to dry bioproducts for producing functional foods or ingredients are presented. New drying techniques for the preservation of bioactive compounds are proposed, focusing more specifically on dielectric drying. A discussion on the techniques that can be used to optimize drying processes is performed. An overview on dehydrated plant based foods with probiotics is provided. The microorganisms used, impregnation procedures, drying methods, and evaluated parameters are presented and discussed. The principal bioactive compounds responsible for nutritional and health benefits of plant derived dried food products—fruits and vegetables, fruits and vegetables by-products, grains, nuts, and algae—are presented. Phytochemical losses occurring during pretreatments and/or drying processes are also discussed.

Anti-aging potential of tree nuts with a focus on the phytochemical composition, molecular mechanisms and thermal stability of major bioactive compounds

Tree nuts, complete functional foods, contain macro- and micronutrients of high biological value.