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Effects of walnut consumption on endothelial function in type 2 diabetics: a randomized, controlled, cross-over trial.

Ma, Y., V.Y. Njike, J. Millet, S. Dutta, K. Doughty, J.A. Treu, D.L. Katz, 2010. Effects of walnut consumption on endothelial function in type 2 diabetics: a randomized, controlled, cross-over trial. Diabetes Care. 33(2):227-32.

Objective: To determine the effects of daily walnut consumption on endothelial function, cardiovascular biomarkers, and anthropometric measures in type 2 diabetics. Methods: This study was a randomized, controlled, single-blind, cross-over trial. Twenty-four participants with type 2 diabetes (mean age 58 years; 14 women, 10 men) were randomly assigned to one of the two possible sequence permutations to receive an ad libitum diet enriched with 56 (366 kcal) of walnuts per day and an ad libitum diet without walnuts for 8 weeks. Subjects underwent endothelial function testing (measured as flow-mediated dilatation or FMD) and assessment of cardiovascular biomarkers before and after each 8-week treatment phase. The primary outcome measure was the change in FMD after 8 weeks. Secondary outcome measures included changes in plasma lipids, HbA1c, fasting glucose, insulin sensitivity, and anthropometric measures. Results: Endothelial function significantly improved after consumption of a walnut-enriched ad libitum diet compared to an ad libitum diet without walnuts (2.2 ± 1.7 % vs. 1.2 ± 1.6 %; p=0.04). The walnut-enriched diet increased fasting serum glucose, lowered serum total cholesterol and low-density lipoprotein cholesterol from baseline (10.0 ± 20.5 mg/dL; p=0.04, -9.7 ± 14.5 mg/dL; p<0.01; and -7.7 ± 10 mg/dL; p<0.01 respectively), though these changes were not significant when compared to an ad libitum diet without walnuts. There were no significant changes in anthropometric measures, plasma HbA1c, and insulin sensitivity. Conclusions: A walnut-enriched ad libitum diet improves endothelium-dependent vasodilatation in type 2 diabetics, suggesting a potential reduction in overall cardiac ris