Almonds vs complex carbohydrates in a weight reduction program

Abstract

OBJECTIVE:To evaluate the effect of an almond-enriched (high monounsaturated fat, MUFA) or complex carbohydrate-enriched (high carbohydrate) formula-based low-calorie diet (LCD) on anthropometric, body composition and metabolic parameters in a weight reduction program. DESIGN: A randomized, prospective 24-week trial in a free-living population evaluating two distinct macronutrient interventions on obesity and metabolic syndrome-related parameters during weight reduction. SUBJECTS: In total, 65 overweight and obese adults (age: 27-79 y, body mass index (BMI): 27-55 kg/m 2 ). INTERVENTION: A formula-based LCD enriched with 84 g/day of almonds (almond-LCD; 39% total fat, 25% MUFA and 32% carbohydrate as percent of dietary energy) or self-selected complex carbohydrates (CHO-LCD; 18% total fat, 5% MUFA and 53% carbohydrate as percent of dietary energy) featuring equivalent calories and protein. MAIN OUTCOME MEASUREMENTS: Various anthropometric, body composition and metabolic parameters at baseline, during and after 24 weeks of dietary intervention. RESULTS: LCD supplementation with almonds, in contrast to complex carbohydrates, was associated with greater reductions in weight/BMI (À18 vs À11%), waist circumference (WC) (À14 vs À9%), fat mass (FM) (À30 vs À20%), total body water (À8 vs À1%) and systolic blood pressure (À11 vs 0%), P ¼ 0.0001-0.05. A 62% greater reduction in weight/BMI, 50% greater reduction in WC and 56% greater reduction in FM were observed in the almond-LCD as compared to the CHO-LCD intervention. Ketone levels increased only in the almond-LCD group (+260 vs 0%, Po0.02). High-density lipoprotein cholesterol (HDL-C) increased in the CHO-LCD group and decreased in the almond-LCD group (+15 vs À6%, P ¼ 0.05). Glucose, insulin, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and LDL-C to HDL-C ratio decreased significantly to a similar extent in both dietary interventions. Homeostasis model analysis of insulin resistance (HOMA-IR) decreased in both study groups over time (almond-LCD: À66% and CHO-LCD: À35%, Po0.0001). Among subjects with type 1 diabetes, diabetes medication reductions were sustained or further reduced in a greater proportion of almond-LCD as compared to CHO-LCD subjects (96 vs 50%, respectively). CONCLUSION: Our findings suggest that an almond-enriched LCD improves a preponderance of the abnormalities associated with the metabolic syndrome. Both dietary interventions were effective in decreasing body weight beyond the weight loss observed during long-term pharmacological interventions; however, the almond-LCD group experienced a sustained and greater weight reduction for the duration of the 24-week intervention. Almond supplementation of a formula-based LCD is a novel alternative to self-selected complex carbohydrates and has a potential role in reducing the public health implications of obesity.

An almond-enriched diet increases plasma α-tocopherol and improves vascular function but does not affect oxidative stress markers or lipid levels

“…Despite an additional 300kcal to the dietary energy intake, no significant intake in calories was reported in the food diaries for any group nor was there any significant change in BMI in the intervention groups suggesting energy compensation by subjects; this compensation effect has been reported in previous studies with almond snacks [38]. It has been reported previously that nut intake increases satiety, which may explain the reduction in calories consumed from non-almond foods [39].…”

Weight Loss and Maintenance in Adult Populations: What Works?

“…7 The ability of a physician to adapt downward on the number and dosing of medications used to treat type 2 diabetes can be profound when carbohydrate intake is minimal in the context of a hypocaloric diet. 6 Over the past several decades, we have noted that many patients have stated that they believe that a weight-loss diet that is higher in one or more of the macronutrients may work best for them for weight management (eg, low-fat, high-carbohydrate diet; high-protein, low-carbohydrate diet), which may reflect their unique level of success or failure with prior dieting experiences. Sacks et al randomly assigned 811 overweight adults to one of four diets (targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20%, 15%, and 65%; 20%, 25%, and 55%; 40%, 15%, and 45%; and 40%, 25%, and 35%) for two years and found that diets with varying amounts of carbohydrate, protein, and fat are equally successful in promoting clinically significant weight loss and maintenance over two years, thus refuting prior studies showing that a high-protein, low-carbohydrate diet can facilitate greater weight loss over a six-month initial period.…”

“…Thus, interventions including a variety of methods with follow-up visits that are tailored to meet the client's desires and health goals are more likely to promote successful weight loss and maintenance. In light of our experience with using nuts in overweight and obese patients seeking weight loss, 6,20 a review of the current evidence to date and discussion of the potential mechanisms by which nuts may influence body weight are featured in the following section.…”

“…6 This approach simulates the low-glycemic diet that has been shown to have the greatest impact for an obese patient with type 2 diabetes and for premenopausal women. 7 The ability of a physician to adapt downward on the number and dosing of medications used to treat type 2 diabetes can be profound when carbohydrate intake is minimal in the context of a hypocaloric diet.…”

“…High caloric restriction can yield dramatic effects on the number and dosing of medications that are used to manage hypertension and/or type 2 diabetes. 6 Medically supervised weight-loss programs must have experienced health professionals available to adapt hypertensive and diabetes medications downward to prevent episodes of hypotension and hypoglycemia, respectively. Non-prescription medications, including herbal supplements, should also be addressed because they may contain an active chemical component of other medications and cause a possible cross-reaction of medications.…”