Studies consistently show the beneficial effects of eating nuts, but as high-energy foods, their regular consumption may lead to weight gain. We tested if daily consumption of walnuts (approximately 12 % energy intake) for 6 months would modify body weight and body composition in free-living subjects. Ninety participants in a 12-month randomized cross-over trial were instructed to eat an allotted amount of walnuts (28-56 g) during the walnut-supplemented diet and not to eat them during the control diet, with no further instruction. Subjects were unaware that body weight was the main outcome. Dietary compliance was about 95 % and mean daily walnut consumption was 35 g during the walnut-supplemented diet. The walnut-supplemented diet resulted in greater daily energy intake (557 kJ (133 kcal)), which should theoretically have led to a weight gain of 3·1 kg over the 6-month period. For all participants, walnut supplementation increased weight (0·4 (SE 0·1) kg), BMI (0·2 (SE 0·1) kg/m 2 ), fat mass (0·2 (SE 0·1) kg) and lean mass (0·2 (SE 0·1) kg). But, after adjusting for energy differences between the control and walnut-supplemented diets, no significant differences were observed in body weight or body composition parameters, except for BMI (0·1 (SE 0·1) kg/m 2 ). The weight gain from incorporating walnuts into the diet (control ! walnut sequence) was less than the weight loss from withdrawing walnuts from the diet (walnut ! control sequence). Our findings show that regular walnut intake resulted in weight gain much lower than expected and which became non-significant after controlling for differences in energy intake.

Background/Objectives: Walnuts have been shown to reduce serum lipids in short-term well-controlled feeding trials. Little information exists on the effect and sustainability of walnut consumption for longer duration in a free-living situation. Subjects/Methods: A randomized crossover design in which 87 subjects with normal to moderate high plasma total cholesterol were initially assigned to a walnut-supplemented diet or habitual (control) diet for a 6-month period, then switched to the alternate dietary intervention for a second 6-month period. Each subject attended seven clinics 2 months apart. At each clinic, body weight was measured, and in five clinics (months 0, 4, 6, 10 and 12), a blood sample was collected. Results: Our study showed that supplementing a habitual diet with walnuts (12% of total daily energy intake equivalent) improves the plasma lipid profile. This beneficial effect was more significant in subjects with high plasma total cholesterol at baseline. Significant changes in serum concentrations of total cholesterol (P ¼ 0.02) and triglycerides (P ¼ 0.03) were seen and nearly significant changes in low-density lipoprotein cholesterol (LDL-C) (P ¼ 0.06) were found. No significant change was detected in either high-density lipoprotein (HDL) cholesterol LDL to HDL ratio. Conclusions: Including walnuts as part of a habitual diet favorably altered the plasma lipid profile. The lipid-lowering effects of walnuts were more evident among subjects with higher lipid baseline values, precisely those people with greater need of reducing plasma total and LDL-C.

Purpose-The purpose of this study was to evaluate the effects of a culturally sensitive diabetes education program for Hispanics with type 2 diabetes.Methods-This study is a prospective cohort study to test the impact of a comprehensive diabetes education program on blood glucose control on Hispanics with type 2 diabetes. The educational program focused on maintaining glycemic control and general aspects of managing diabetes and complications. The study participants were recruited by flyers placed in Hispanic markets and in ambulatory care clinics. A total of 34 Hispanic male and female subjects with type 2 diabetes participated in the study. The concentrations of glucose, insulin, hemoglobin A1c (HbA1c), total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol were analyzed at baseline and at 3 months.Results-A significant mean change was observed for HbA1c, fasting plasma glucose, cholesterol/ HDL ratio, and HDL after 3 months of education compared with baseline. There were significant reductions in weight, total fat, percent fat, trunk fat, and waist-to-hip ratio compared with baseline. After 3 months, subjects showed a significant positive correlation between changes in body mass index and insulin and weight, total fat, trunk fat, and fat free mass and insulin.Conclusions-A culturally sensitive program conducted in Spanish had a significant impact on important clinical parameters in Hispanic subjects with diabetes in a relatively short time period. The study demonstrates the importance of designing education intervention studies that are sensitive to cultural diversity, particularly in at-risk diabetic subjects.The incidence of diabetes is increasing in the United States. The data indicate that ethnic disparities are present in diabetes-related morbidity and mortality. 1 The 1993 to 2001 Medicare beneficiaries' data show that the prevalence of diabetes was highest in Hispanics and African Americans for all ages. 2 In addition, the prevalence of diabetes is expected to increase by 149% among Hispanics between 2000 and 2050. 3 The frequency of certain diabetic complications such as end-stage renal disease, amputation, and neuropathy is higher in minority populations such as Hispanics and African Americans. Type 2 diabetes is associated with a 2-to 4-fold increase in coronary heart disease. 9 Although the degree of glycemia in diabetic patients is strongly related to the risk of microvascular disease, the correlation between glycemia and macrovascular disease is not clearly established. However, there has been strong evidence suggesting that lipid intervention in diabetic patients is associated with macrovascular risk reduction, specifically heart disease. 10 Some have therefore suggested a multifactor approach that incorporates lipid management. The 2001 American Diabetes Association's clinical practice guidelines promote the importance of glucose control and lipid management in preventing cardiovascular disease. 10 The most common pattern of dyslipide...

PurposeTo determine whether dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) reduces neuropathic pain symptoms in Mexican-Americans with type 2 diabetes.MethodsForty volunteers with type 2 diabetes enrolled in the “En Balance-PLUS” program, which provided weekly nutrition–diabetes education and daily supplementation with 1,000 mg docosahexaenoic acid (DHA)–200 mg eicosapentaenoic acid over 3 months. The study assessed self-reported neuropathic pain symptoms pre/postintervention using the short-form McGill Pain Questionnaire (SF-MPQ), monitored clinical laboratory values at baseline and 3 months, and performed baseline and 3-month metabolomic analysis of plasma samples.ResultsA total of 26 participants self-reported neuropathic pain symptoms at baseline. After 3 months of omega-3 PUFA supplementation, participants reported significant improvement in SF-MPQ scores (sensory, affective, and visual analogue scale; P<0.001, P=0.012, and P<0.001, respectively). Untargeted metabolomic analysis revealed that participants in the moderate–high SF-MPQ group had the highest relative plasma sphingosine levels at baseline compared to the low SF-MPQ group (P=0.0127) and the nonpain group (P=0.0444). Omega-3 PUFA supplementation increased plasma DHA and reduced plasma sphingosine levels in participants reporting neuropathic pain symptoms (P<0.001 and P<0.001, respectively). Increased plasma DHA levels significantly correlated with improved SF-MPQ sensory scores (r=0.425, P=0.030). Improved SF-MPQ scores, however, did not correlate with clinical/laboratory parameters.ConclusionThe data suggest that omega-3 PUFAs dietary supplementation may reduce neuropathic pain symptoms in individuals with type 2 diabetes and correlates with sphingosine levels in the plasma.

No abstract