Effects of Consuming Almonds on Insulin Sensitivity and Other Cardiometabolic Health Markers in Adults With Prediabetes

Figures & data

Figure 1. Flow diagram of subjects assessed for eligibility, excluded, randomized, and analyzed for the study. BMI = body mass index; CHO = carbohydrates; HTN = hypertension; PI, principal investigator.

Table 1. Demographic and Anthropometric Baseline Characteristics of Subjects Who Completed the Study.^a

Characteristic	Per Protocol Sample (N = 33)
	n (%)
Sex
Male	17 (51.5)
Female	16 (48.5)
Race
White/Caucasian	15 (45.5)
Black/African American	13 (39.4)
Other	5 (15.2)
Ethnicity
Not Hispanic/Latino	28 (84.9)
Hispanic/Latino	4 (12.1)
Not reported	1 (3.0)
Current smoker	3 (9.1)
Consumes alcohol	24 (72.7)
	Mean (SEM) or Median (IQL)^b
Age (y)	48.3 (2.2)
Height (cm)	170 (1.9)
Weight (kg)	88.6 (3.0)
Waist circumference (cm)	101 (1.9)
Body mass index (kg/m^2)	30.5 (0.7)
Physical activity (MET hours/week)	260 (241, 297)

Note. ^aIQL = interquartile limits; MET = metabolic equivalent; SEM = standard error of the mean.

b Values are means (SEM) except for physical activity, which is median (IQL).

Table 2. Energy, Macronutrient, and Select Nutrient Intakes at Baseline and During Almond and Carbohydrate Treatment Periods of Subjects Who Completed the Study (N = 33).^a–c

	Mean (SEM) or Median (IQL)
Parameter	Baseline	Almond	CHO	p value^d
Energy (kcal/d)	2052 (140)	2244 (106)	2270 (114)	0.688
CHO (% energy)	48.3 (1.4)	37.3 (1.5)*	52.8 (1.3)*	<0.001
Sugar (% energy)	17.4 (1.5)	12.8 (1.1)*	19.0 (1.0)	<0.001
Protein (% energy)	16.9 (0.8)	18.5 (0.6)	16.3 (0.7)	0.002
Total fat (% energy)	34.9 (1.1)	46.5 (1.2)*	32.1 (1.0)	<0.001
SFA (% of energy)	11.3 (0.5)	11.3 (0.5)	10.5 (0.5)	0.159
UFA (% of energy)	23.6 (0.8)	35.3 (0.9)*	21.7 (0.7)	<0.001
Dietary fiber (g/d)	18.1 (12.4, 22.0)	24.5 (22.8, 28.1)*	19.0 (15.3, 21.9)	0.006
Cholesterol (mg/d)	322 (218, 443)	281 (211, 423)	320 (224, 464)	0.876
Sodium (mg/d)	3136 (2499, 3988)	2766 (2099, 3264)	3236 (2472, 4749)	0.999
Calcium (mg/d)	673 (436, 959)	802 (671, 954)	812 (600, 989)	0.337
Magnesium (mg/d)	158 (126, 200)	366 (332, 421)*	154 (95.5, 200)	<0.001

Note. ^aCHO = carbohydrate; IQL = interquartile limits; SEM = standard error of the mean; SFA = saturated fatty acids; UFA = unsaturated fatty acids.

b Values are means (SEM) except for dietary fiber, cholesterol, sodium, calcium and magnesium, which are medians (IQL).

c An asterisk (*) denotes that the percent change from baseline was statistically significant, p < 0.05.

d p values are for the comparison of treatment conditions in the percent change from baseline.

Table 3. Short Intravenous Glucose Tolerance Test and Other Glucose Metabolism Parameters at Baseline and Change or Percentage Change From Baseline Following Almond and Carbohydrate Conditions in Subjects Who Completed the Study (N = 33).^a–d

	Mean (SEM) or Median (IQL)
Parameter	Baseline	Almond, Δ or %Δ	CHO, Δ or %Δ	p value^e
Si x 10^–4 (mU/L^–1)	12.5 (7.7, 26.3)	–15.4 (–31.6, 30.6)	–10.1 (–19.6, 18.9)	0.999
AIRg (mU/L)	26.5 (14.0, 43.8)	12.6 (–11.3, 74.6)	0.0 (–16.1, 37.2)	0.999
DI x 10^–4	342 (159, 665)	11.7 (–34.1, 64.1)	–1.6 (–20.9, 30.7)	0.815
Kg (%)	1.4 (0.1)	10.6 (8.7)	2.2 (5.4)	0.238
Fasting glucose (mg/dL)	101 (91.4, 106)	3.9 (–1.0, 9.8)*	3.2 (–3.4, 8.0)	0.113
Fasting insulin (mU/L)	7.1 (3.8, 9.6)	11.6 (–1.9, 57.9)*	13.2 (–5.9, 45.1)*	0.117
HOMA2-%B	70.2 (58.2, 89.7)	0.9 (–11.7, 17.8)	1.9 (–10.1, 11.1)	0.783
HOMA2-%S	104 (74.5, 194)	–12.0 (–40.8, 1.0)*	–10.0 (–40.9, 4.5)	0.441

Note. ^aΔ = change; %Δ = percentage change; AIRg = acute insulin response to glucose; CHO = carbohydrate; DI = disposition index; HOMA2%B = homeostasis model assessment 2-beta-cell function; HOMA2%S = homeostasis model assessment 2-insulin sensitivity; IQL = interquartile limits; Kg = fractional disappearance of glucose constant; SEM = standard error of the mean; Si = insulin sensitivity.

b Values are medians (IQL) except Kg, which are means (SEM).

c Values are presented as percentage change from baseline, except HOMA2-%B and HOMA2-%S, which are all presented as change from baseline.

d An asterisk (*) denotes that the change or percentage change from baseline was statistically significant, p < 0.05.

e p values are for the comparison of treatment conditions in the percentage change from baseline.

Table 4. Fasting Lipoprotein Lipids and Apolipoproteins at Baseline and Percentage Changes From Baseline Following Almond and Carbohydrate Conditions in Subjects Who Completed the Study (N = 32–33).^a–c

	Mean (SEM) or Median (IQL)
Parameter	Baseline	Almond, %Δ	CHO, %Δ	p value^d
Total-C (mg/dL)	194 (7.1)	1.7 (1.7)	4.0 (1.9)	0.274
Non-HDL-C (mg/dL)	140 (7.2)	1.5 (2.3)	1.4 (2.1)	0.972
LDL-C (mg/dL)	118 (6.4)	2.2 (2.9)	3.2 (2.3)	0.858
HDL-C (mg/dL)	52.0 (46.0, 62.0)	3.7 (–2.7, 9.5)	6.7 (0.0, 17.8)*	0.066
Total-C:HDL-C	3.8 (0.2)	–2.0 (1.7)	–4.0 (2.1)	0.357
TG (mg/dL)	94.3 (66.5, 141)	1.7 (–14.4, 14.1)	2.3 (–13.5, 19.9)	0.881
Apo B (mg/dL)	83.3 (4.6)	2.3 (2.4)	4.3 (3.2)	0.416
Apo A1 (mg/dL)	129 (117, 148)	4.8 (–3.3, 10.1)*	4.1 (–5.5, 11.5)	0.290

Note. ^aApo = apolipoprotein; % Δ = percentage change; CHO = carbohydrate; HDL-C = high-density lipoprotein cholesterol; IQL = interquartile limits; LDL-C = low-density lipoprotein cholesterol; non-HDL-C = non-high-density lipoprotein cholesterol; SEM = standard error of the mean; total-C = total cholesterol; TG = triglycerides.

b Values are means (SEM) except HDL-C, TG, and Apo A1, which are medians (IQL).

c An asterisk (*) denotes that the percentage change from baseline was statistically significant, p < 0.05.

d p values are for the comparison of treatment conditions in the percentage change from baseline.

Table 5. Fasting Lipoprotein Particle and Subfraction Cholesterol Concentrations Assessed by Density Gradient Ultracentrifugation at Baseline and Changes From Baseline Following Almond and Carbohydrate Conditions in Subjects Who Completed the Study (N = 30–32).^a–f

	Mean (SEM) or Median (IQL)
Parameter	Baseline	Almond, Δ or %Δ	CHO, Δ or %Δ	p value^g
LDL Particle (nmol/L)	1417 (78.7)	–25.2 (30.2)	–7.7 (42.3)	0.495
LDL1 + 2-C (mg/dL)	36.4 (19.6, 51.3)	7.9 (–8.6, 34.9)	1.6 (–21.5, 41.2)	0.624
LDL3 + 4-C (mg/dL)	49.3 (3.9)	–0.1 (4.2)	12.1 (5.1)*	0.024
HDL2-C (mg/dL)	11.5 (8.0, 17.0)	6.3 (–8.7, 17.2)	8.0 (–11.4, 25.4)	0.793
HDL3-C (mg/dL)	34.5 (31.5, 40.0)	6.0 (–1.5, 14.1)*	2.4 (–2.6, 14.5)*	0.373

Note. ^aΔ = change; C = cholesterol; CHO = carbohydrate; HDL = high-density lipoprotein; IQL = interquartile limits; LDL = low-density lipoprotein; SEM = standard error of the mean.

b Values are medians (IQL) except LDL_3 + 4-C, which is mean (SEM).

c LDL particle end-of-treatment values are Δ from baseline, whereas all other values are %Δ from baseline.

d N = 32 for all variables with the exception of LDL particle for which N = 30.

e An asterisk (*) denotes that the percentage change from baseline was statistically significant, p < 0.05.

f LDL_1 + 2-C is cholesterol carried by larger, more buoyant particles; LDL_3 + 4-C is cholesterol carried by smaller, denser particles. HDL₂-C is cholesterol carried by larger HDL particles; HDL₃-C is cholesterol carried by smaller HDL particles.

g p values are for the comparison of treatment conditions in the percentage change from baseline.

Table 6. Interleukin-6, Adiponectin, High-Sensitivity C-Reactive Protein, Uric Acid, and Blood Pressures at Baseline and Percentage Changes From Baseline Following Almond and Carbohydrate Treatments in Subjects Who Completed the Study (N = 33).^a,b

	Mean (SEM) or Median (IQL)
Parameter	Baseline	Almond, %Δ	CHO, %Δ	p value^c
IL-6 (pg/mL)	1.3 (0.9, 2.1)	15.0 (–11.0, 31.4)	6.5 (–5.7, 38.9)	0.707
hs-CRP (mg/L)	1.2 (0.5, 4.0)	5.6 (–23.1, 55.0)	1.9 (–25.0, 63.3)	0.925
Adiponectin (ng/mL)	2855 (1301, 5309)	–1.2 (–20.0, 19.2)	3.7 (–7.7, 15.3)	0.631
Uric acid (µmol/L)	5.5 (0.3)	2.7 (2.2)	3.9 (2.9)	0.447
SBP (mm Hg)	125 (2.3)	–1.2 (1.3)	0.4 (1.4)	0.258
DBP (mm Hg)	78.3 (1.7)	–2.0 (1.5)	–1.0 (1.3)	0.509

Note. ^a%Δ = percent change; CHO = carbohydrate; DBP = diastolic blood pressure; hs-CRP = high-sensitivity C-reactive protein; IL-6 = interleukin-6; IQL = interquartile limits; SBP = systolic blood pressure; SEM = standard error of the mean.

b Values are medians (IQL) except uric acid and systolic and diastolic blood pressures, which are means (SEM).

c p values are for the comparison of treatment conditions in the percentage change from baseline.