Abstract
Epidemiological and clinical studies have indicated that nut consumption could be a healthy dietary strategy to prevent and treat type 2 diabetes (T2DM) and related cardiovascular disease (CVD). The objective of this review is to examine the potential mechanisms of action of nuts addressing effects on glycemic control, weight management, energy balance, appetite, gut microbiota modification, lipid metabolism, oxidative stress, inflammation, endothelial function and blood pressure with a focus on data from both animal and human studies. The favourable effects of nuts could be explained by the unique nutrient composition and bioactive compounds in nuts. Unsaturated fatty acids (monounsaturated fatty acids and polyunsaturated fatty acids) present in nuts may play a role in glucose control and appetite suppression. Fiber and polyphenols in nuts may also have an anti-diabetic effect by altering gut microbiota. Nuts lower serum cholesterol by reduced cholesterol absorption, inhibition of HMG-CoA reductase and increased bile acid production by stimulation of 7-α hydroxylase. Arginine and magnesium improve inflammation, oxidative stress, endothelial function and blood pressure. In conclusion, nuts contain compounds that favourably influence glucose homeostasis, weight control and vascular health. Further investigations are required to identify the most important mechanisms by which nuts decrease the risk of T2DM and CVD.
Highlights
The prevalence of diabetes mellitus will increase worldwide from 382 million individuals in 2013 to 592 million individuals in 2035
This review aims to address the potential mechanisms of nut consumption on the prevention and treatment of Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), focusing on body weight control, glucose control, gut microbiota composition, inflammation, oxidative stress, lipid profiles, endothelial function and hypertension
No significant differences in weight, body mass index (BMI) and waist circumference were observed between two groups at weeks 0, 4, 8, 12, and 16, even though the reductions in these measurements occurred in both groups over the course of the study [36]
Summary
The prevalence of diabetes mellitus will increase worldwide from 382 million individuals in 2013 to 592 million individuals in 2035. T2DM is associated with an increased risk of adverse cardiovascular events [3]. 4-fold higher risk of CVD than individuals without diabetes [5]. Lifestyle modification including diet can decrease the risk of developing T2DM [7]. A large number of epidemiological and clinical studies have shown that consumption of different types of nuts (almonds, walnuts, hazelnuts, pecans, pistachios, macadamia nuts, cashews and Brazil nuts) is associated with a reduced risk of T2DM [8,9,10] and CVD [8,9,10,11,12]. All human interventions available on PubMed that covered these areas were included This is the only systematic review that covers all these areas
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