An ADA diet consisting of 20% of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinically significant improvements in LDL-C in adults with prediabetes.

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ABSTR ACT: Selecting the optimal composition of macronutrients for a low-calorie meal plan is an important consideration for the initiation and maintenance of weight loss of overweight and obese patients. Physical activity is an effective adjunct plan after some initial weight loss has been achieved. However, the management of medications in patients with comorbidities is imperative for the prevention of complications. Suitable administration of medications that are associated with weight gain or satiety should be considered. The inverse association between the frequency of nut intake and body mass index found in epidemiologic studies may be due to several factors, including dietary compensation and reduced bioavailability of energy from nuts. Some studies have observed that nut consumption is advantageous for the initiation and maintenance of weight loss and yields an improvement in cardiometabolic risk factors. However, additional studies on the effectiveness of using nuts for maintenance of initial weight loss are warranted.

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Background: Persons with prediabetes are at increased risk of developing cardiovascular disease, yet there is scant research on effective meal planning approaches in this population.Aim and Methods: To evaluate the effect of daily almond consumption on blood lipids of adults with prediabetes, we performed a 16‐week trial in 66 free‐living adults (48 women and 18 men; mean±SE age 53±10 years; BMI 30±5 kg/m2) instructed to consume a background meal pattern yielding 35% fat, 50% CHO and 15% protein. Participants were randomized to consume 20% of energy from almonds (almond‐enriched) or a meal pattern without nuts (nut‐free). Fasting total cholesterol (TC), LDL‐cholesterol (LDL‐C), HDL‐cholesterol (HDL‐C) and triglycerides (TG) were measured at baseline and weeks 8 and 16. Mixed model analysis was performed adjusting for baseline values with all time points included in the model.Results: Daily supplementation with almonds was associated with a greater reduction in LDL‐C [−9% vs. −1% (P=0.03)] and LDL‐C:HDL‐C [−13% vs. −1% (P=0.04) over the 16‐week trial. Almond participants had a significant reduction in LDL‐C [−10% (P = 0.01)] and a significant increase in HDL‐C [+5% (P=0.04)] at week 16 compared to baseline levels, resulting in a significant reduction in LDL‐C:HDL‐C (P=0.001).Conclusion: Daily almond consumption within a defined meal pattern is effective in improving blood lipids in adults with prediabetes.