Inclusion of walnut in the diets of adults at risk for type 2 diabetes and their dietary pattern changes: a randomized, controlled, cross-over trial

Valentine Yanchou Njike, Niloufarsadat Yarandi, Paul Petraro, Rockiy G Ayettey, Judith A Treu, David L Katz, Valentine Yanchou Njike, Niloufarsadat Yarandi, Paul Petraro, Rockiy G Ayettey, Judith A Treu, David L Katz

Abstract

Background: In our recently published study, including walnuts in the diets of adults with prediabetes led to overall improvement in diet quality. This report adds to those study findings by examining the food groups displaced during walnut inclusion in the diets of those adults with prediabetes.

Methods: Randomized, controlled, modified Latin square parallel design with 2 treatment arms. The 112 participants (31 men, 81 women) were randomly assigned to a diet with or without dietary counseling to regulate calorie intake in a 1:1 ratio. Within each treatment arm, participants were further randomized to 1 of 2 sequence permutations to receive a walnut-included diet with 56 g (366 kcal) of walnuts per day and a walnut-excluded diet. Participants in the calorie-regulated arm received advice from a dietitian to preserve an isocaloric condition while including walnuts. We analyzed the 12 components of the 2010 Healthy Eating Index to examine dietary pattern changes of study participants.

Results: Seafood and plant protein foods intake significantly increased with walnut inclusion, compared with their exclusion (2.14±2.06 vs -0.49±2.33; p=0.003). The ingestion of healthful fatty acids also significantly increased with walnut inclusion, compared with their exclusion (1.43±4.53 vs -1.76±4.80; p=0.02). Dairy ingestion increased with walnut inclusion in the calorie-regulated phase, compared with walnut inclusion without calorie regulation (1.06±4.42 vs -2.15±3.64; p=0.02).

Conclusions: Our data suggest that walnut inclusion in the diets of adults at risk for diabetes led to an increase in intake of other healthful foods.

Trial registration number: NCT02330848.

Keywords: A1C; Nutrition; Nuts.

Conflict of interest statement

This study was conducted with funding from the Centers for Disease Control and Prevention and the California Walnut Commission. DLK has been compensated for public speaking by the California Walnut Commission.

References

    1. Imamura F, O'Connor L, Ye Z et al. . Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. Br J Sports Med 2016;50:496–504. 10.1136/bjsports-2016-h3576rep
    1. Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014 Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2014.
    1. Knowler WC, Barrett-Connor E, Fowler SE et al. , Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403. 10.1056/NEJMoa012512
    1. .
    1. Knowler WC, Fowler SE, Hamman RF et al. , Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009;374:1677–86. 10.1016/S0140-6736(09)61457-4
    1. Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. Lancet Diabetes Endocrinol 2015;3:866–75. 10.1016/S2213-8587(15)00291-0
    1. Alouki K, Delisle H, Bermúdez-Tamayo C et al. . Lifestyle interventions to prevent type 2 diabetes: a systematic review of economic evaluation studies. J Diabetes Res 2016;2016:2159890 10.1155/2016/2159890
    1. .
    1. de Koning L, Chiuve SE, Fung TT et al. . Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 2011;34:1150–6. 10.2337/dc10-2352
    1. Jacobs S, Harmon BE, Boushey CJ et al. . A priori-defined diet quality indexes and risk of type 2 diabetes: the Multiethnic Cohort. Diabetologia 2015;58:98–112. 10.1007/s00125-014-3404-8
    1. Njike VY, Ayettey R, Petraro P et al. . Walnut ingestion in adults at risk for diabetes: effects on body composition, diet quality, and cardiac risk measures. BMJ Open Diabetes Res Care 2015;3:e000115.
    1. Guenther PM, Kirkpatrick SI, Reedy J et al. . The Healthy Eating Index-2010 is a valid measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr 2014;144:399–407. 10.3945/jn.113.183079
    1. Dominguez LJ, Bes-Rastrollo M, Basterra-Gortari FJ et al. . Association of a dietary score with incident type 2 diabetes: the Dietary-Based Diabetes-Risk Score (DDS). PLoS ONE 2015;10:e0141760 10.1371/journal.pone.0141760
    1. Patel PS, Forouhi NG, Kuijsten A et al. , InterAct Consortium. The prospective association between total and type of fish intake and type 2 diabetes in 8 European countries: EPIC-InterAct Study. Am J Clin Nutr 2012;95:1445–53. 10.3945/ajcn.111.029314
    1. Wu JH, Micha R, Imamura F et al. . Omega-3 fatty acids and incident type 2 diabetes: a systematic review and meta-analysis. Br J Nutr 2012;107(Suppl 2):S214–27. 10.1017/S0007114512001602
    1. Pan A, Sun Q, Bernstein AM et al. . Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of US men and women. JAMA Intern Med 2013;173:1328–35. 10.1001/jamainternmed.2013.6633
    1. de Koning L, Fung TT, Liao X et al. . Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr 2011;93:844–50. 10.3945/ajcn.110.004333
    1. Malik VS, Li Y, Tobias DK et al. . Dietary protein intake and risk of type 2 diabetes in us men and women. Am J Epidemiol 2016;183:715–28.
    1. Viguiliouk E, Stewart SE, Jayalath VH et al. . Effect of replacing animal protein with plant protein on glycemic control in diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2015;7:9804–24. 10.3390/nu7125509
    1. Chen M, Sun Q, Giovannucci E et al. . Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Med 2014;12:215 10.1186/s12916-014-0215-1
    1. Malik VS, Sun Q, van Dam RM et al. . Adolescent dairy product consumption and risk of type 2 diabetes in middle-aged women. Am J Clin Nutr 2011;94:854–61. 10.3945/ajcn.110.009621
    1. Gao D, Ning N, Wang C et al. . Dairy products consumption and risk of type 2 diabetes: systematic review and dose-response meta-analysis. PLoS ONE 2013;8:e73965 10.1371/journal.pone.0073965
    1. Tong X, Dong JY, Wu ZW et al. . Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of cohort studies. Eur J Clin Nutr 2011;65:1027–31. 10.1038/ejcn.2011.62
    1. Sluijs I, Forouhi NG, Beulens JW et al. , InterAct Consortium. The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin Nutr 2012;96:382–90. 10.3945/ajcn.111.021907
    1. Pan A, Malik VS, Schulze MB et al. . Plain-water intake and risk of type 2 diabetes in young and middle-aged women. Am J Clin Nutr 2012;95:1454–60. 10.3945/ajcn.111.032698
    1. Fagherazzi G, Vilier A, Saes Sartorelli D et al. . Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr 2013;97:517–23. 10.3945/ajcn.112.050997
    1. O'Neil CE, Keast DR, Fulgoni VL III et al. . Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health and Nutrition Examination Survey (NHANES) 1999–2004. Asia Pac J Clin Nutr 2010;19:142–50.
    1. Blanco Mejia S, Kendall CW, Viguiliouk E et al. . Effect of tree nuts on metabolic syndrome criteria: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2014;4:e004660.
    1. Ye EQ, Chacko SA, Chou EL et al. . Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr 2012;142:1304–13.
    1. Sahyoun NR, Jacques PF, Zhang XL et al. . Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults. Am J Clin Nutr 2006;83:124–31.
    1. Aune D, Norat T, Romundstad P et al. . Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Eur J Epidemiol 2013;28:845–58.
    1. Sun Q, Spiegelman D, van Dam RM et al. . White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med 2010;170:961–9. 10.1001/archinternmed.2010.109
    1. Guasch-Ferré M, Hruby A, Salas-Salvadó J et al. . Olive oil consumption and risk of type 2 diabetes in US women. Am J Clin Nutr 2015;102:479–86. 10.3945/ajcn.115.112029
    1. Thanopoulou AC, Karamanos BG, Angelico FV et al. . Dietary fat intake as risk factor for the development of diabetes: multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGSD). Diabetes Care 2003;26:302–7. 10.2337/diacare.26.2.302
    1. Due A, Larsen TM, Mu H et al. . Comparison of 3 ad libitum diets for weight-loss maintenance, risk of cardiovascular disease, and diabetes: a 6-mo randomized, controlled trial. Am J Clin Nutr 2008;88:1232–41.
    1. Salmerón J, Hu FB, Manson JE et al. . Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr 2001;73:1019–26.
    1. Risérus U, Willett WC, Hu FB. Dietary fats and prevention of type 2 diabetes. Prog Lipid Res 2009;48:44–51.
    1. Cooper AJ, Forouhi NG, Ye Z et al. , InterAct Consortium. Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. Eur J Clin Nutr 2012;66:1082–92. 10.1038/ejcn.2012.85
    1. Bazzano LA, Li TY, Joshipura KJ et al. . Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 2008;31:1311–17. 10.2337/dc08-0080
    1. Carter P, Gray LJ, Troughton J et al. . Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 2010;341:c4229 10.1136/bmj.c4229
    1. Li M, Fan Y, Zhang X et al. . Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open 2014;4:e005497 10.1136/bmjopen-2014-005497
    1. Wu Y, Zhang D, Jiang X et al. . Fruit and vegetable consumption and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2015;25:140–7. 10.1016/j.numecd.2014.10.004
    1. Horikawa C, Yoshimura Y, Kamada C et al. . Japan Diabetes Complications Study Group Dietary sodium intake and incidence of diabetes complications in Japanese patients with type 2 diabetes: analysis of the Japan Diabetes Complications Study (JDCS). J Clin Endocrinol Metab 2014;99:3635–43. 10.1210/jc.2013-4315
    1. Poggio R, Gutierrez L, Matta MG et al. . Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr 2015;18:695–704. 10.1017/S1368980014000949
    1. Kalogeropoulos AP, Georgiopoulou VV, Murphy RA et al. . Dietary sodium content, mortality, and risk for cardiovascular events in older adults: the Health, Aging, and Body Composition (Health ABC) Study. JAMA Intern Med 2015;175:410–19. 10.1001/jamainternmed.2014.6278
    1. Cohen HW, Hailpern SM, Alderman MH. Sodium intake and mortality follow-up in the Third National Health and Nutrition Examination Survey (NHANES III). J Gen Intern Med 2008;23:1297–302. 10.1007/s11606-008-0645-6

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