Almonds vs complex carbohydrates in a weight reduction program

• Published in: International Journal of Obesity Vol. 27; no. 11; pp. 1365 - 1372
• Main Authors: Wien, M.A, Sabaté, J.M, Iklé, D.N, Cole, S.E, Kandeel, F.R
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.11.2003; Nature Publishing
• Subjects: Adult; adults; Aged; almonds; Anthropometry; Biological and medical sciences; Blood pressure; Body Composition; Body mass index; body water; Carbohydrates; Cholesterol; Compliance; Diabetes; Diabetes. Impaired glucose tolerance; diastolic blood pressure; Diet, Reducing; Dietary Carbohydrates - therapeutic use; drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Energy; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fatty acids; Female; Food, Formulated; glucose; High density lipoprotein; high density lipoprotein cholesterol; homeostasis; Humans; insulin; Insulin resistance; insulin-dependent diabetes mellitus; Intervention; Lipoproteins; low calorie diet; low density lipoprotein; Male; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - diet therapy; Metabolic Syndrome - physiopathology; Middle Aged; Miscellaneous; nutritional intervention; Obesity; Obesity - diet therapy; Obesity - physiopathology; Other metabolic disorders; Overweight; Prospective Studies; Prunus; Public health; Satiation; systolic blood pressure; triacylglycerols; Triglycerides; waist circumference; Weight control; Weight Loss; United States > US; Endocrinopathy; Type 2 diabetes; Obesity; Nuts; Nutrition disorder; Weight loss; Cardiovascular disease; Metabolic diseases; almonds; Weight; metabolic syndrome; Target tissue resistance; X Syndrome; Carbohydrate; insulin resistance; Nutritional status
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802411

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/m2). 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 (-18 vs -11%), waist circumference (WC) (-14 vs -9%), fat mass (FM) (-30 vs -20%), total body water (-8 vs -1%) and systolic blood pressure (-11 vs 0%), P=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%, P<0.02). High-density lipoprotein cholesterol (HDL-C) increased in the CHO-LCD group and decreased in the almond-LCD group (+15 vs -6%, P=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: -66% and CHO-LCD: -35%, P<0.0001). 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.