The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Abstract
:1. Introduction
1.1. Description of the Intervention
1.2. How This Intervention Might Work
1.3. Why It Is Important to Do This Review
1.4. Aim
2. Methods
2.1. Types of Studies
2.2. Types of Participants
2.3. Types of Interventions
2.4. The Inclusion Criteria
2.5. The Exclusion Criteria
2.6. Types of Outcome Measures
- Gut microbiota;
- Blood glucose parameters: glycated haemoglobin (HbA1c, %);
- Inflammatory markers: tumour necrosis factor α (TNF-α); high-sensitivity C-reactive protein (hsCRP);
- Body mass index (BMI) (Kg/m2).
- Secondary outcome measures of interest:
- Fasting blood glucose (FBG, mmol/L);
- Postprandial blood glucose (2 h PBG, mmol/L);
- Homeostatic model assessment of insulin resistance (HOMA–IR);
- Glucagon-like peptide-1 (GLP-1);
- Fasting insulin.
2.7. Search Methods for Identification of Studies
3. Data Collection and Analysis
3.1. Selection of Studies
3.2. Data Extraction and Management
3.3. Assessment of Risk of Bias in Included Studies
3.4. Data Analysis
4. Results
4.1. Evaluation of the Risk of Bias of Included Studies
4.2. Gut Microbiota
4.3. Glycaemic Control
4.4. Inflammatory Markers
4.5. Body Mass Index (BMI) (Kg/m2)
4.6. Homeostatic Model Assessment of Insulin Resistance (HOMA–IR)
4.7. Glucagon-Like Peptide-1 (GLP-1)
4.8. Fasting Insulin
5. Discussion
Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient/Population | Intervention | Comparator | Outcome (Primary) | Study Designs | Combining Search Terms |
---|---|---|---|---|---|
Patients with diabetes | Almonds | Control | Glycometabolism | Randomised controlled trial | |
Patients with diabetes OR type 2 diabetes OR Diabetes OR Diabetes complications OR diabetes mellitus, type 2 OR diabetes mellitus | Almond OR Tree, Almond OR Almond Tree OR Sweet Almond OR Almond Trees OR Tree Nuts OR Almond, Sweet | 1. Randomised controlled trial OR controlled clinical trial OR randomized OR placebo OR drug therapy OR randomly OR trial OR groups 2. “Animals” NOT “Humans” 3. 1 NOT 2 | Column 1 AND Column 2 AND Column 3 |
Citation/Country of Study | Type of Study | Sample Details and Duration of Study | Mean Age (Years) | Aim | Interventions | Results |
---|---|---|---|---|---|---|
Bodnaruc et al. [30] Canada | A randomised cross-over study | 7 men with type 2 diabetes. Data were collected during two experimental sessions separated by a ≥7day washout period. | 63.9 ± 2.5 | To evaluate the effects of almonds on postprandial glucose response. | Participants completed 2 experimental visits and control (white bread, butter, cheese) and test (white bread, almonds) diets were ingested. | The test meal was associated with lower postprandial glycemia and insulinemia. |
Chen et al. [31] Taiwan | A randomised cross-over controlled study | 40 patients with type 2 diabetes. 12-weeks duration. | 54.9 ± 10.5 | To examine the effect of almonds on glycaemia | Approximately 60 g/day almonds added to a National Cholesterol Education Programme Step II diet (NCEP II) compared to NCEP II diet alone as control | Both almond-based and control diets did not significantly affect body weight and BMI or change HbA1c, fasting serum glucose, insulin, or HOMA-IR values. |
Cohen et al. [32] USA | A randomised parallel study | 13 participants diagnosed with type 2 diabetes Almond-based diets (n = 6) Control (n = 7) 12-weeks duration. | Almond group: 66 ± 3.3 Control group: 66 ± 3.3 | To examine the impact of chronic almond ingestion on glycaemic control in patients with type 2 diabetes. | Participants were randomised to almond group (1 oz of almonds, 5 days/week) or cheese group (2 cheese sticks, 5 days/week) | HbA1c was the only blood marker that changed significantly between the treatment groups (p = 0.045). Chronic almond ingestion resulted in a 4% reduction in BMI compared with control (p = 0.047). |
Hou et al. [6] China | A randomised controlled study | Almond group (n = 14) Peanut group (n = 11) 12-weeks duration. | Almond group: 70.86 ± 8.21 Peanut group: 68 ± 5.80 | To compare the effects of peanuts and almonds incorporated into a low-carbohydrate diet on cardiometabolic and inflammatory parameters in patients with type 2 diabetes | Peanuts or almonds were incorporated into a low-carbohydrate diet and both groups were compared after a 3-month intervention. | Almonds and peanuts have similar effect on improving fasting and postprandial blood glucose among patients with type 2 diabetes when incorporated into a low-carbohydrate diet. |
Li et al. [33] Taiwan | Randomised cross-over clinical trial | 20 Chinese patients with type 2 diabetes. 12-weeks duration. | 58 ± 2 | To evaluate the effect of almond consumption on glycaemia in Chinese patients with type 2 diabetes | Incorporation of almonds into National Cholesterol Education Programme Step II diet (NCEP II) to replace 20% of total daily calorie intake compared with NCEP II diet alone as control. | Adding almonds into a healthy diet has beneficial effects on adiposity and glycaemic control. |
Liu et al. [34] Taiwan | Randomised cross-over controlled feeding trial | 20 Chinese patients with type 2 diabetes. 12-weeks duration. | 58 ± 2 | To examine the effect of almond consumption on inflammation and oxidative stress in patients with type 2 diabetes | Addition of almonds (approximately 56 g/day) into National Cholesterol Education Programme Step II diet (NCEP II) to replace 20% of total daily calorie intake compared with NCEP II diet alone as control. | Adding almonds into a healthy diet could ameliorate inflammation and oxidative stress in patients with type 2 diabetes. |
Lovejoy et al. [35] USA | Randomized double-blind crossover design | 30 participants with type 2 diabetes. 16-weeks duration. | 53.8 ± 1.9 | To assess the effects of almond-enriched diets on insulin sensitivity in patients with diabetes | The 4 diets were as follows: (1) high-fat, high-almond (HFA; 37% total fat, 10% from almonds); (2) low-fat, high-almond (LFA; 25% total fat, 10% from almonds); (3) high-fat control (HFC; 37% total fat, 10% from the MUFAs from olive or canola oil); and (4) low-fat control (LFC; 25% total fat, 10% from olive or canola oil). The almond-containing diets provided 57–113 g almonds/d depending on the total energy level | Almond-enriched diets did not influence glycaemia in patients with diabetes. |
Ren et al. [14] China | Randomised controlled trial | 45 participants with type 2 diabetes. 12-weeks duration. | LCD group: 73.55 ± 4.99 LFD group: 70.48 ± 5.91 | To determine the effect of almond-based low-carbohydrate diet on glycometabolism, gut microbiota, and GLP-1 in patients with type 2 diabetes. | The intervention group consumed a low-carbohydrate diet, which included 56 g/day almonds that replaced 150 g/day staple food, while the control group adopted a low-fat diet education programme. | Almond-based LCD may be effective in regulating glycometabolism in patients with diabetes by stimulating the growth of SCFA-producing bacteria, increasing SCFA production and promoting GLP-1 secretion. The almond-based LCD significantly increased the SCFA-producing bacteria Roseburia, Ruminococcus, and Eubacterium. |
Sweazea et al. [36] USA | Randomised controlled study | 21 participants with type 2 diabetes. 12-weeks duration. | Almond group: 57.8 ± 5.6 Control group: 54.7 ± 8.9 | To evaluate if almond supplementation without further dietary advice improves glycaemic control compared with control. | The almond group consumed 43 g almonds 5–7 times per week and to maintain their usual diet and activity pattern while the control group maintained their usual diet and activity pattern. | Daily almond consumption in the absence of other dietary or physical activity activities is useful in reducing inflammation in patients with type 2 diabetes. |
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Ojo, O.; Wang, X.-H.; Ojo, O.O.; Adegboye, A.R.A. The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients 2021, 13, 3377. https://doi.org/10.3390/nu13103377
Ojo O, Wang X-H, Ojo OO, Adegboye ARA. The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients. 2021; 13(10):3377. https://doi.org/10.3390/nu13103377
Chicago/Turabian StyleOjo, Omorogieva, Xiao-Hua Wang, Osarhumwese Osaretin Ojo, and Amanda Rodrigues Amorim Adegboye. 2021. "The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials" Nutrients 13, no. 10: 3377. https://doi.org/10.3390/nu13103377