Purpose: We previously demonstrated that including walnuts in the diets of adults at risk for type 2 diabetes mellitus (T2DM) led to improved overall diet quality. This report examines the specific changes in their nutrient intake. Design: This was a randomized, controlled, modified Latin square parallel design trial with 2 treatment arms. Participants were randomized to walnut intake with, or without, dietary advice to regulate caloric intake. Within each treatment arm, they were further randomized to one of 2 sequence permutations (walnut-included/walnut-excluded or walnut-excluded/walnut-included diet), with a 3-month washout between treatment phases. Setting: Community hospital in Lower Naugatuck Valley in Connecticut. Participants: Cohort of 112 participants (31 men and 81 women) at risk for T2DM. Intervention: Participants included 56 g (366 kcal) of walnuts in their daily diets for 6 months. Measures: Nutrient intake was assessed using web-based Automated Self-Administered 24-Hour Dietary Assessment. Analysis: Data were analyzed using generalized linear models. Results: Walnut inclusion led to increased intake of total fat, calcium, magnesium, thiamin, total saturated fatty acids, and monounsaturated and polyunsaturated fatty acids (379.0 ± 90.3 g vs −136.5 ± 92.7 g, P < .01; 230.7 ± 114.2 mg vs −95.2 ± 117.4 mg, P = .05; 111.0 ± 33.9 mg vs −32.3 ± 34.9 mg, P < .01; 0.28 ± 0.2 mg vs −0.47 ± 0.2 mg, P = .02; 8.6 ± 3.4 g vs −1.1 ± 3.5 g, P =.05; 6.3 ± 3.9 g vs −6.3 ± 4.0 g, P = .03; and 25.4 ± 4.0 vs −6.6 ± 4.2 g, P < .01, respectively). Vitamin C intake decreased (−65.3 ± 55.3 mg vs 98.9 ± 56.8 mg, P = .04). Protein intake increased from baseline with the inclusion of walnuts (20.0 ± 8.8 g, P < .05). Walnut inclusion led to an increase in total calories consumed when caloric intake is not regulated. Conclusion: Including walnuts in the diets of these adults led to increased dietary intake of some nutrients associated with lower risk of developing T2DM and other cardiometabolic risk factors.
Inclusion of walnut in the diets of adults at risk for type 2 diabetes and their dietary pattern changes: a randomized, controlled, cross-over trial