Abstract
Although nut consumption has been associated with several health benefits, it has not been investigated in individuals with type 1 diabetes. Therefore, our aim was to assess nut consumption and its association with metabolic syndrome in adult individuals with type 1 diabetes taking part in the Finnish Diabetic Nephropathy Study. The nut intake of the 1058 participants was assessed from 3-day food records that were completed twice, and the number of weekly servings, assuming a serving size of 28.4 g, was calculated. Metabolic syndrome was defined as the presence of ≥3 of the cardiovascular risk factors: central obesity, high blood pressure (≥130/85 mmHg or use of antihypertensive medication), high triglyceride concentration (≥1.70 mmol/L or use of lipid-lowering medication), low HDL-cholesterol concentration (<1.00 mmol/L in men and <1.30 mmol/L in women or use of lipid-lowering medication), and hyperglycaemia. Overweight/obesity was defined as a BMI ≥25 kg/m2. HbA1c > 59 mmol/mol (>7.5%) was used as a criterion for suboptimal glycaemic control. Of the 1058 (mean age 46 years, 41.6% men) participants, 689 (54.1%) reported no nut intake. In the remaining sample, the median weekly nut intake was 40.8 g. In the adjusted models, higher nut intake, as the continuous number of weekly servings and the comparison of those with <2 and ≥2 weekly servings, was associated with lower metabolic syndrome score, waist circumference, HbA1c, and BMI. Nut consumption as a continuous variable was negatively associated with the presence of metabolic syndrome, its blood pressure, triglyceride, and HDL-cholesterol components, and suboptimal glycaemic control. Consumption of ≥2 weekly servings was associated with lower odds of suboptimal glycaemic control (by 51.5%), overweight/obesity (by 33.4%), and metabolic syndrome (by 51.8%) and meeting the waist (by 37.3%), blood pressure (by 44.5%), triglyceride (by 37.7%), and HDL-cholesterol (by 36.2%) components of the metabolic syndrome. In conclusion, a weekly nut intake of ≥2 servings was beneficially associated with all the components of the metabolic syndrome in type 1 diabetes. The causality of this association will need to be investigated.
Highlights
Nuts, as part of a healthy diet, have gained increasing attention as they are good sources of unsaturated fatty acids, fiber, vegetable protein, minerals, and bioactive compounds [1]
There is evidence that metabolic syndrome in type 1 diabetes is associated with an increased risk of long-term vascular complications [9]
Lower doses were beneficial as the consumption of at least one weekly serving was associated with lower odds of metabolic syndrome, the blood pressure component, suboptimal glycaemic control, and overweight or obesity
Summary
As part of a healthy diet, have gained increasing attention as they are good sources of unsaturated fatty acids, fiber, vegetable protein, minerals, and bioactive compounds [1]. Given that nuts are low in carbohydrates, they minimally contribute to postprandial glycaemia, which is important to individuals with diabetes. Nut consumption has been associated with a lower risk of coronary arterial disease and related mortality [2,3,4]. Administration issued a qualified health claim in 2003 stating that the daily consumption of 1.5 ounces (42.6 g) of most nuts, as part of a healthy diet, may reduce the risk of heart disease [5]. The components of the metabolic syndrome, including hyperglycaemia, high blood pressure, high triglyceride concentrations, low HDL-cholesterol concentrations, and central obesity [7], are frequently observed in individuals with type 1 diabetes [8]. There is evidence that metabolic syndrome in type 1 diabetes is associated with an increased risk of long-term vascular complications [9]
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