Cashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial.

Background There is increasing evidence that nut consumption decreases the risk of cardiovascular disease. However, there are few data on the health effects of cashew nuts among adults with type 2 diabetes (T2DM). Objective The study aimed to investigate the effects of cashew nut supplementation on glycemia, body weight, blood pressure, and lipid profile in Asian Indians with T2DM. Methods In a parallel-arm, randomized controlled trial, 300 adults with T2DM [mean ± SD age: 51 ± 9.3 y; body mass index (BMI; in kg/m2): 26.0 ± 3.4; 55% male] were randomly assigned to receive advice to follow a standard diabetic diet (control) or similar advice plus 30 g cashew nuts/d (intervention) for 12 wk. The macronutrient composition of the prescribed diabetic diet was 60-65% energy from carbohydrates, 15-25% from fat, and the rest from protein. Differences between groups in changes in anthropometric and biochemical variables were analyzed using linear models with robust variance estimation under an assumed independence working correlation. Results Participants in the intervention group had a greater decrease in systolic blood pressure from baseline to 12 wk than did controls (-4.9 ± 13.7 compared with -1.7 ± 11.6 mm Hg; P = 0.04) and a greater increase in plasma HDL cholesterol compared with controls (+1.7 ± 5.6 compared with +0.1 ± 4.6 mg/dL; P = 0.01). There were no differences between the groups with respect to changes in body weight, BMI, blood lipid, and glycemic variables. Plasma oleic acid concentrations and self-reported dietary intake of nuts, oleic acid, and monounsaturated fatty acids suggested excellent compliance with the nut consumption. Conclusion Cashew nut supplementation in Asian Indians with T2DM reduced systolic blood pressure and increased HDL cholesterol concentrations with no deleterious effects on body weight, glycemia, or other lipid variables. This study was registered at the clinical trial registry of India as CTRI/2017/07/009022.

[1]  D. Corella,et al.  Erratum. Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet: Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 2011;34:14–19 , 2018, Diabetes Care.

[2]  J. Salas-Salvadó,et al.  Nutritional composition of raw fresh cashew (Anacardium occidentale L.) kernels from different origin , 2015, Food science & nutrition.

[3]  V. Fulgoni,et al.  Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005–2010 , 2015, Nutrition Journal.

[4]  V. Mohan,et al.  Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES) , 2015, Diabetes Care.

[5]  P. Hernández‐Alonso,et al.  Beneficial Effect of Pistachio Consumption on Glucose Metabolism, Insulin Resistance, Inflammation, and Related Metabolic Risk Markers: A Randomized Clinical Trial , 2014, Diabetes Care.

[6]  A. Agarwal,et al.  Textbook of Human Nutrition , 2014 .

[7]  B. Kingwell,et al.  HDL-targeted therapies: progress, failures and future , 2014, Nature Reviews Drug Discovery.

[8]  V. Mohan,et al.  Prevalence of Dyslipidemia in Urban and Rural India: The ICMR–INDIAB Study , 2014, PloS one.

[9]  Min Zhang,et al.  MicroRNA-27a/b regulates cellular cholesterol efflux, influx and esterification/hydrolysis in THP-1 macrophages. , 2014, Atherosclerosis.

[10]  Lawrence A Leiter,et al.  Effect of Tree Nuts on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Dietary Trials , 2014, PloS one.

[11]  A. Kanaya,et al.  Diabetes and Associated Complications in the South Asian Population , 2014, Current Cardiology Reports.

[12]  R. Pandey,et al.  Effects of pistachio nuts on body composition, metabolic, inflammatory and oxidative stress parameters in Asian Indians with metabolic syndrome: a 24-wk, randomized control trial. , 2014, Nutrition.

[13]  V. Mohan,et al.  Diabetes in South Asians: Is the Phenotype Different? , 2013, Diabetes.

[14]  D. Rojas-Rueda,et al.  Nut intake and adiposity: meta-analysis of clinical trials. , 2013, The American journal of clinical nutrition.

[15]  Mikael Fogelholm,et al.  Faculty of 1000 evaluation for Primary prevention of cardiovascular disease with a Mediterranean diet. , 2013 .

[16]  V. Mohan,et al.  Type of vegetable oils used in cooking and risk of metabolic syndrome among Asian Indians , 2013, International Journal of Food Science and Nutrition.

[17]  V. Vadivel,et al.  Health benefits of nut consumption with special reference to body weight control. , 2012, Nutrition.

[18]  B. Strasser,et al.  Effects of Monounsaturated Fatty Acids on Glycaemic Control in Patients with Abnormal Glucose Metabolism: A Systematic Review and Meta-Analysis , 2011, Annals of Nutrition and Metabolism.

[19]  M. Martínez-González,et al.  Nut consumption, weight gain and obesity: Epidemiological evidence. , 2011, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[20]  V. Mohan,et al.  Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians. , 2011, Diabetes technology & therapeutics.

[21]  R. Mattes,et al.  Acute and second-meal effects of almond form in impaired glucose tolerant adults: a randomized crossover trial , 2011, Nutrition & metabolism.

[22]  W. Willett,et al.  Effects of the Dietary Approaches to Stop Hypertension (DASH) Eating Plan on Cardiovascular Risks Among Type 2 Diabetic Patients , 2010, Diabetes Care.

[23]  V. Mohan,et al.  Dietary profile of urban adult population in South India in the context of chronic disease epidemiology (CURES – 68) , 2010, Public Health Nutrition.

[24]  B. Koletzko,et al.  High-Throughput Analysis of Total Plasma Fatty Acid Composition with Direct In Situ Transesterification , 2010, PloS one.

[25]  S. Joshi,et al.  Prevalence and pattern of diabetic dyslipidemia in Indian type 2 diabetic patients , 2010 .

[26]  V. Mohan,et al.  Dietary carbohydrates, glycemic load and serum high-density lipoprotein cholesterol concentrations among South Indian adults , 2009, European Journal of Clinical Nutrition.

[27]  R. Hui,et al.  Increase in fasting vascular endothelial function after short-term oral L-arginine is effective when baseline flow-mediated dilation is low: a meta-analysis of randomized controlled trials. , 2009, The American journal of clinical nutrition.

[28]  B. Fielding,et al.  Fatty acid composition of adipose tissue and blood in humans and its use as a biomarker of dietary intake. , 2008, Progress in lipid research.

[29]  P. Kris-Etherton,et al.  Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. , 2008, The Journal of nutrition.

[30]  Arne Astrup,et al.  Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. , 2008, The New England journal of medicine.

[31]  R. Mattes,et al.  Effect of chronic consumption of almonds on body weight in healthy humans , 2007, British Journal of Nutrition.

[32]  J. Mukuddem-Petersen,et al.  Effects of a high walnut and high cashew nut diet on selected markers of the metabolic syndrome: a controlled feeding trial , 2007, British Journal of Nutrition.

[33]  Craig E. Cheifetz,et al.  Pistachio Nut Consumption and Serum Lipid Levels , 2007, Journal of the American College of Nutrition.

[34]  A. Schutte,et al.  Modulation of baroreflex sensitivity by walnuts versus cashew nuts in subjects with metabolic syndrome. , 2006, American journal of hypertension.

[35]  J. Chin-Dusting,et al.  AMINO ACIDS, ARGINASE AND NITRIC OXIDE IN VASCULAR HEALTH , 2006, Clinical and experimental pharmacology & physiology.

[36]  V. Sudha,et al.  Reproducibility and validity of an interviewer-administered semi-quantitative food frequency questionnaire to assess dietary intake of urban adults in southern India , 2006, International journal of food sciences and nutrition.

[37]  B. Rosner,et al.  Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. , 2005, JAMA.

[38]  Alice Owen,et al.  Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. , 2004, Diabetes care.

[39]  V. Mohan,et al.  Risk factors for coronary artery disease in Indians. , 2004, The Journal of the Association of Physicians of India.

[40]  R. Turner,et al.  Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man , 1985, Diabetologia.

[41]  J. Sabaté.  Nut consumption and body weight. , 2003, The American journal of clinical nutrition.

[42]  V. Mohan,et al.  The Chennai Urban Rural Epidemiology Study (CURES)--study design and methodology (urban component) (CURES-I). , 2003, The Journal of the Association of Physicians of India.

[43]  J. Sabaté,et al.  Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feeding trial. , 2003, The American journal of clinical nutrition.

[44]  R. Mensink,et al.  Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. , 2003, The American journal of clinical nutrition.

[45]  J. Rood,et al.  Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. , 2002, The American journal of clinical nutrition.

[46]  J. Haight,et al.  Dose Response of Almonds on Coronary Heart Disease Risk Factors: Blood Lipids, Oxidized Low-Density Lipoproteins, Lipoprotein(a), Homocysteine, and Pulmonary Nitric Oxide: A Randomized, Controlled, Crossover Trial , 2002, Circulation.

[47]  W. Boden.  High-density lipoprotein cholesterol as an independent risk factor in cardiovascular disease: assessing the data from Framingham to the Veterans Affairs High--Density Lipoprotein Intervention Trial. , 2000, The American journal of cardiology.

[48]  P. Kris-Etherton,et al.  High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. , 1999, The American journal of clinical nutrition.

[49]  J. Arends,et al.  Gut permeability, intestinal morphology, and nutritional depletion. , 1998, Nutrition.

[50]  M. Singer,et al.  Nutritional Epidemiology , 2020, Definitions.

[51]  M C Hjortland,et al.  High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. , 1977, The American journal of medicine.

[52]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[53]  J. Folch,et al.  A simple method for the isolation and purification of total lipides from animal tissues. , 1957, The Journal of biological chemistry.