Metabolic Syndrome Features and Excess Weight Were Inversely Associated with Nut Consumption after 1-Year Follow-Up in the PREDIMED-Plus Study

Abstract

Background High nut consumption has been previously associated with decreased prevalence of metabolic syndrome (MetS) regardless of race and dietary patterns. Objectives The aim of this study was to assess whether changes in nut consumption over a 1-y follow-up are associated with changes in features of MetS in a middle-aged and older Spanish population at high cardiovascular disease risk. Methods This prospective 1-y follow-up cohort study, conducted in the framework of the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial, included 5800 men and women (55–75 y old) with overweight/obesity [BMI (in kg/m2) ≥27 and <40] and MetS. Nut consumption (almonds, pistachios, walnuts, and other nuts) was assessed using data from a validated FFQ. The primary outcome was the change from baseline to 1 y in features of MetS [waist circumference (WC), glycemia, HDL cholesterol, triglyceride (TG), and systolic and diastolic blood pressure] and excess weight (body weight and BMI) according to tertiles of change in nut consumption. Secondary outcomes included changes in dietary and lifestyle characteristics. A generalized linear model was used to compare 1-y changes in features of MetS, weight, dietary intakes, and lifestyle characteristics across tertiles of change in nut consumption. Results As nut consumption increased, between each tertile there was a significant decrease in WC, TG, systolic blood pressure, weight, and BMI (P < 0.05), and a significant increase in HDL cholesterol (only in women, P = 0.044). The interaction effect between time and group was significant for total energy intake (P < 0.001), adherence to the Mediterranean diet (MedDiet) (P < 0.001), and nut consumption (P < 0.001). Across tertiles of increasing nut consumption there was a significant increase in extra virgin olive oil intake and adherence to the MedDiet; change in energy intake, on the other hand, was inversely related to consumption of nuts. Conclusions Features of MetS and excess weight were inversely associated with nut consumption after a 1-y follow-up in the PREDIMED-Plus study cohort. This trial was registered at isrctn.com as ISRCTN89898870.

The Relationship of Tree Nuts and Peanuts with Adiposity Parameters: A Systematic Review and Network Meta-Analysis

“…However, it is worth noting that only those studies conducted in people with overweight and obesity showed significant percentage reductions in both nut and control groups for BW, WC, and BMI (only nut groups), and that such differences were only significant with longer follow-up periods (>12 weeks). These results agreed with previous evidence in PREDIMED trials in a wide range of subjects that showed that nut consumption had an inverse association with excess weight and metabolic syndrome [ 144 ]. Although we have to interpret this with caution, the clinical message seems to be that nut consumption does not lead to a weight or adiposity increase in healthy/normal weight people or people with overweight/obesity.…”

Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies

“…The high content of antioxidants, polyphenols and fiber found in MD have been previously associated with decreased systemic inflammation and central obesity, which could explain its beneficial effect [ 112 , 113 ]. Moreover, an enhanced with nuts MD was found to be helpful regarding the maintenance of body weight status [ 114 , 115 ].…”

Effective non-pharmacological interventions nurse practitioners can implement for the management of metabolic syndrome in primary care settings for adult patients

“…The remaining 13 articles were critically appraised using Critical Appraisal Skills Programme (CASP) and Joanna Briggs as appropriate and are reported in Appendix A and are present in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This integrative review included studies with various methodologies, including five randomized control trials (Blackford et al, 2016;Chirinos et al, 2016;Ramos et al, 2016;Seward et al, 2019;Ying et al, 2016), one quasi-experimental reversal design (Guadalupe-Grau et al, 2018), one randomized cross over study (Hald et al, 2016), two prospective longitudinal studies (Jeejeebhoy et al, 2017;Julibert et al, 2020), one qualitative content analysis of individual interviews (Joelsson et al, 2020), one causal model test (Lee et al, 2016), one randomized parallel controlled single center design (Ruscica et al, 2018), and one prospective randomized double blind placebo controlled clinical study (Usharani et al, 2019).…”

“…There were a range of dietary interventions found in the articles of this review that were used as a component to the management of MetS. The most common dietary suggestions to offer patients in the management of MetS discussed included, increasing dietary fibre, vegetable, fruit, and healthy fat intake Eight of the thirteen articles addressed some form of dietary intervention to manage metabolic syndrome, however only four studies looked exclusively at a dietary component (Hald et al, 2016;Julibert et al, 2020;Ruscica et al, 2018;and Usharani et al, 2019). Hald et al (2016) examined the effect of increased dietary fibre on body weight and gut microbiome.…”

“…Limitations included a small sample size and a lack of effect on measurable criteria for MetS improvement. Julibert et al (2020) examined the effect of increased consumption of nuts such as almonds, pistachios, walnuts on individuals with MetS within the PREDIMED study, a 6 year multicenter randomized trial involving 6,874 participants following a traditional Mediterranean diet. Julibert et al (2020) was a combined prospective 1 year follow up cohort study that took place in Spain in a community setting with 5800 male and female between the ages of 55-75 years old who were overweight and diagnosed with MetS.…”