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Diabetes Metab Res Rev. 2018 Oct;34(7):e3031. doi: 10.1002/dmrr.3031. Epub 2018 Jul 11.

Association between walnut consumption and diabetes risk in NHANES.

Author information

1
Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
2
Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
3
School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA.
4
Department of Psychology, University of Southern California, Los Angeles, CA, USA.

Abstract

BACKGROUND:

Dietary interventions and cohort studies relating tree nut consumption to blood glucose levels suggest a possible effect of walnuts.

OBJECTIVE:

To examine the associations between walnut consumption and diabetes risk using data from the National Health and Nutrition Examination Survey.

METHODS:

National Health and Nutrition Examination Survey data on adults conducting 24-hour dietary recall was pooled across the years 1999 through 2014. Diabetes status or risk was based on self-report, medication use, fasting plasma glucose levels, and haemoglobin A1c (HbA1c ) levels. Individuals were characterized based on reported consumption of walnuts, mixed-nuts, or no nuts.

RESULTS:

After adjustment for covariates, walnut consumers showed lower risk for diabetes compared with non-nut consumers based on self-report (odds ratio of 0.47, 95% confidence interval [CI] 0.31-0.72) as well as fasting blood glucose (relative risk ratio 0.32, CI 0.17-0.58) and HbA1c (relative risk ratio 0.51, CI 0.27-0.99). For each standard deviation of increase in walnut intake, prevalence of diabetes dropped 47%. The gender by walnut interaction suggests that the effect may be more potent among women than men (dose response P = .061).

CONCLUSIONS:

Both among individuals with known diabetes and those diagnosed based on elevated diabetes blood markers, the prevalence of individuals with diabetes was significantly lower among the walnut consumers. A possible gender-specific effect invites further attention.

KEYWORDS:

NHANES; diabetes mellitus; epidemiology; haemoglobin A1c; nut consumption; plasma glucose

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