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Premeal almond load decreases postprandial glycaemia, adiposity and reversed prediabetes to normoglycemia: a randomized controlled trial. 

Gulati, S., A. Misra, R. Tiwari, M. Sharma, R.M. Pandey, A.D. Upadhyay, H. Chandra Sati, 2023. Premeal almond load decreases postprandial glycaemia, adiposity and reversed prediabetes to normoglycemia: a randomized controlled trial. Clinical nutrition ESPEN54, 12–22. https://doi.org/10.1016/j.clnesp.2022.12.028

Background: Asian Indians show rapid conversion from prediabetes to type 2 diabetes (T2D). Novel dietary strategies are needed to arrest this progression, by targeting postprandial hyperglycaemia (PPHG). Design: We conducted a free-living randomized controlled open-label parallel arm study to evaluate the effect of a premeal load of almonds (20 g) 30 min before major meals on anthropometric, glycaemic, and metabolic parameters over 3 months. Sixty-six participants with prediabetes in the age range of 18-60 yrs were recruited. The study was registered at clinicaltrials.gov (registration no. NCT04769726). ResultsThirty participants in each arm completed the study. As per ‘intention-to-treat’ analysis, overall additional mean reductions were statistically significant for body weight, BMI, waist circumference (WC), subscapular and suprailiac skinfolds, and improved handgrip strength (Kg) (p < 0·001 for all) in the treatment arm vs. the control arm (after multiple adjustments). In the blood parameters, the additional mean reduction in the treatment arm vs. control arm was statistically significant for fasting and post-75 g oral glucose-load blood glucose, postprandial insulin, HOMA-IR, HbA1c, proinsulin, total cholesterol, and very low-density lipoprotein cholesterol (p < 0·001 for all). Most importantly, we observed a reversal to normoglycemic state (fasting blood glucose and 2 h post-OGTT glucose levels) in 23.3% (7 out of 30) of participants in the treatment arm which is comparable to that seen with Acarbose treatment (25%). ConclusionIncorporation of 20 g of almonds, 30 min before each major meal leads to significant improvement in body weight, WC, glycemia (particularly PPHG), and insulin resistance and shows potential for reversal of prediabetes to normal glucose regulation over 3 months.

Keywords: Almonds; Asian Indians; Postprandial glucose regulators; Postprandial hyperglycaemia; Prediabetes.

Particle size distribution and predicted lipid bioaccessibility of almonds and the effect of almond processing: a randomised mastication study in healthy adults.

Creedon, A.C., E.S. Hung, E. Dimidi, T. Grassby, S.E. Berry, K. Whelan, 2023. Particle size distribution and predicted lipid bioaccessibility of almonds and the effect of almond processing: a randomised mastication study in healthy adults. Nutrients. 15(3):489. https://doi.org/10.3390/nu15030489

Almonds are rich in unsaturated lipids, which play a role in some of the reported benefits of almond consumption for human health. Almond lipids are poorly bioaccessible due to almonds’ unique physicochemical properties that influence particle size distribution (PSD) following mastication, allowing much intracellular lipid to escape digestion in the upper gastrointestinal tract. To investigate the impact of commercial processing (grinding almonds into flour), on PSD and predicted lipid bioaccessibility following mastication, a randomised cross-over design mastication study was conducted in healthy adults. The PSDs of masticated whole and ground almonds was assessed using two laboratory methods (mechanical sieving and laser diffraction). PSD from mechanical sieving was used to calculate lipid bioaccessibility using a theoretical mathematical model. Thirty-one healthy adults (18-45 years) completed both mastication sessions. Following mastication, ground almonds had a PSD with significantly fewer larger particles and more smaller particles, compared with whole almonds. Predicted lipid bioaccessibility of masticated ground almonds (10.4%, SD 1.8) was marginally but significantly greater than the predicted lipid bioaccessibility of masticated whole almonds (9.3%, SD 2.0; p = 0.017). Commercial grinding of almonds significantly influences the PSD of almonds following mastication, which results in a modest but significant increase in predicted lipid bioaccessibility.

Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial.

Gayathri, R., K. Abirami, N. Kalpana, V.S. Manasa, V. Sudha, S. Shobana, R.G. Jeevan, V. Kavitha, K. Parkavi, R.M. Anjana, R. Unnikrishnan, K. Gokulakrishnan, D.A. Beatrice, K. Krishnaswamy, R. Pradeepa, R.D. Mattes, J. Salas-Salvadó, W. Willett, V. Mohan, 2023. Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial. Front. Nutr. 9: 1055923. https://doi.org/10.3389/fnut.2022.1055923

Background: Asian Indians have an increased susceptibility to type 2 diabetes and premature coronary artery disease. Nuts, like almonds, are rich in unsaturated fat and micronutrients with known health benefits. Objectives: This study aimed to assess the efficacy of almonds for reduction of insulin resistance and improving lipid profile in overweight Asian Indian adults. Methods: This parallel-arm, randomized, controlled trial was conducted in Chennai, India on 400 participants aged 25-65 years with a body mass index ≥ 23 kg/m2. The intervention group received 43 g of almonds/day for 12 weeks, while the control group was advised to consume a customary diet but to avoid nuts. Anthropometric, clinical, and dietary data were assessed at periodic intervals. Glucose tolerance, serum insulin, glycated hemoglobin, C-peptide and lipid profile were assessed at baseline and end of the study. Insulin resistance (homeostasis assessment model-HOMA IR) and oral insulin disposition index (DIo) were calculated. Results: A total of 352 participants completed the study. Significant improvement was seen in DIo [mean (95% CI) = + 0.7 mmol/L (0.1, 1.3); p = 0.03], HOMA IR (-0.4 (-0.7, -0.04; p = 0.03) and total cholesterol (-5.4 mg/dl (-10.2, -0.6); p = 0.03) in the intervention group compared to the control group. Incremental area under the curve (IAUC) and mean amplitude of glycemic excursion (MAGE) assessed using continuous glucose monitoring systems were also significantly lower in the intervention group. Dietary 24-h recalls showed a higher significant reduction in carbohydrate and increase in mono unsaturated fatty acid (MUFA) and polyunsaturated fatty acids (PUFA) intake in the intervention group compared to the control group. Conclusion: Daily consumption of almonds increased the intake of MUFA with decrease in carbohydrate calories and decreases insulin resistance, improves insulin sensitivity and lowers serum cholesterol in Asian Indians with overweight/obesity. These effects in the long run could aid in reducing the risk of diabetes and other cardiometabolic disease.

Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise. 

Nieman, D.C., A.M. Omar, C.D. Kay, D.M. Kasote, C.A. Sakaguchi, A. Lkhagva, M.M. Weldemariam, Q. Zhang, 2023. Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise. Front. Nutr. 9:1042719. https://doi.org/10.3389/fnut.2022.1042719

Introduction: This investigation determined if 4-weeks ingestion of nutrient-dense almonds mitigated post-exercise inflammation and muscle soreness and damage. Methods: An acute 90-min of eccentric exercise (90-EE) was used to induce muscle damage in 64 non-obese adults not engaging in regular resistance training (ages 30-65 years, BMI < 30 kg/m2). Using a parallel group design, participants were randomized to almond (AL) (57 g/d) or cereal bar (CB) (calorie matched) treatment groups for a 4-week period prior to the 90-EE (17 exercises). Blood and 24-h urine samples were collected before and after supplementation, with additional blood samples collected immediately post-90-EE, and then daily during 4 additional days of recovery. Changes in plasma oxylipins, urinary gut-derived phenolics, plasma cytokines, muscle damage biomarkers, mood states, and exercise performance were assessed. Results: The 90-EE protocol induced significant muscle damage, delayed onset of muscle soreness (DOMS), inflammation, reduced strength and power performance, and mood disturbance. Interaction effects (2 group × 7 time points) supported that AL vs. CB was associated with reduced post-exercise fatigue and tension (p = 0.051, 0.033, respectively) and higher levels of leg-back strength (p = 0.029). No group differences were found for post-90-EE increases in DOMS and six cytokines. AL was associated with lower levels of serum creatine kinase immediately- and 1-day post-exercise (p = 0.034 and 0.013, respectively). The 90-EE bout increased plasma levels immediately post-exercise for 13 oxylipins. Interaction effects revealed significantly higher levels for AL vs. CB for 12,13-DiHOME (p < 0.001) and lower levels for 9,10-DiHOME (p < 0.001). Urine levels increased in AL vs. CB for seven gut-derived phenolics including 5-(3′,4′-dihydroxyphenyl)-γ-valerolactone that was inversely related to changes in plasma 9,10-DiHOME (r = -0.029, p = 0.021). Discussion: These data support some positive effects of almond intake in improving mood state, retaining strength, decreasing muscle damage, increasing the generation of gut-derived phenolic metabolites, and altering the plasma oxylipin DiHOME response to unaccustomed eccentric exercise in untrained adults. The elevated post-exercise plasma levels of 12,13-DiHOME with almond intake support positive metabolic outcomes for adults engaging in unaccustomed eccentric exercise bouts.

Keywords: (poly)phenols; almonds; cytokines; exercise; inflammation; metabolites; oxylipins.