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Pistachios: Ideal nighttime snack for prediabetic patients to administer blood glucose levels

A recent study published in The Journal of Nutrition evaluates the efficacy of pistachios in controlling morning blood glucose levels and improving vascular health in prediabetic patients.



Study: Intake of pistachios as a nighttime snack has similar effects on short and longer-term glycemic control in comparison with education to devour 1-2 carbohydrate exchanges in adults with prediabetes: A 12-week randomized crossover trial. Image Credit: nelea33 / Shutterstock.com

Background

Prediabetes is a health condition characterised by impaired fasting blood glucose levels, elevated glycated hemoglobin A1c (HbA1c) levels, and impaired glucose tolerance. Prediabetes in midlife can significantly increase the 30-year relative risk of incident heart problems. In the USA, the prevalence of prediabetes is 38% amongst adults, about 74% of whom are susceptible to developing type 2 diabetes of their lifetime.

Rigorous lifestyle and behavioral therapies, including food plan regulation, weight reduction programs, and exercise, are current treatments for stopping or delaying the onset of type 2 diabetes amongst adults with prediabetes.

Consuming nighttime snacks after dinner but before bedtime has been found to be effective in stopping hyperglycemia the next morning. Consequently, the American Diabetes Association and Academy of Nutrition and Dietetics recommend carbohydrate-rich foods as nighttime snacks to enhance glycemic control in prediabetic and diabetic patients.

Pistachios are wealthy in dietary fiber and unsaturated fatty acids, that are known to positively impact glucose regulation and cardiovascular health. Several randomized controlled trials have shown that pistachios can improve fasting blood glucose levels and insulin sensitivity.

In the present randomized controlled crossover trial, scientists compare the efficacies of pistachios and carbohydrate-rich foods as nighttime snacks in controlling fasting blood glucose levels, reducing cardiovascular disease-related risk aspects, and improving food plan quality in prediabetic adults.

Study design

The study population included 51 prediabetic adults randomly divided into two groups. Within the intervention group, participants were supplied with 57 grams/day of dry roasted and unsalted pistachios as a nighttime snack for 12 weeks. Within the comparator group, participants were supplied with a carbohydrate-rich food as a nighttime snack for 12 weeks.

The first and secondary parameters, including fasting blood glucose, HbA1c, insulin, insulin resistance, lipids/lipoproteins, vascular health, and food plan quality, were assessed on two consecutive days in the beginning and end of every food plan period.

Necessary observations

A complete of 26 participants were randomized to the intervention group, whereas 25 participants were within the comparator group. Dietary adherence was 90% within the intervention group and 93% within the comparator group. Essentially the most commonly consumed carbohydrate-rich foods within the comparator group were crackers, popcorn, and pretzels. 

No significant differences in glucose metabolism-related and vascular health-related parameters were observed between the study groups. Nevertheless, Healthy Eating Index-2015 (HEI-2015) scores, which were estimated to evaluate food plan quality, were higher within the intervention group as in comparison with those within the comparator group. More specifically, intervention group participants had higher HEI scores for seafood and plant proteins, refined grains, and fatty acid ratio as in comparison with those within the comparator group.

Although no significant difference in total energy was observed between the study groups, the proportion of total energy from mono-unsaturated fatty acids and potassium intake was higher within the intervention group. This group also reported a greater intake of dietary fiber, nuts and seeds, and oil, in addition to a lower intake of refined grains.

Study significance

Pistachios as nighttime snacks can increase food plan quality in prediabetic patients; nevertheless, this food item had an analogous effect as carbohydrate-rich snacks on glycemic control and vascular health. Nevertheless, the study findings indicate that prediabetic patients can devour pistachios as a healthier alternative to carbohydrate-rich nighttime snacks to extend alignment with dietary guidelines for U.S. adults.

Importantly, the trial suffered a big attrition rate and missing data because of trial suspension and participant withdrawal in the course of the coronavirus disease 2019 (COVID-19) pandemic. After the beginning of the pandemic, a particular age inclusion criterion was introduced as a component of the University approval process to re-start the trial, which could restrict the generalizability of the study findings to individuals 65 years of age and older.

Journal reference:

  • Riley, T. M., Kris-Etherton, P. M., Hart, T. L., & Petersen, K. S. (2024). Intake of pistachios as a nighttime snack has similar effects on short and longer-term glycemic control in comparison with education to devour 1-2 carbohydrate exchanges in adults with prediabetes: A 12-week randomized crossover trial. The Journal of Nutrition. doi:10.1016/j.tjnut.2024.01.021.  https://www.sciencedirect.com/science/article/pii/S0022316624000403
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