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Kendall C.W.C.,Clinical Nutrition and Risk Factor Modification Center | Kendall C.W.C.,University of Toronto | Kendall C.W.C.,University of Saskatchewan | Josse A.R.,McMaster University | And 5 more authors.
European Journal of Clinical Nutrition | Year: 2011

Background/Objectives: Dietary strategies that reduce post-prandial glycemia are important in the prevention and treatment of diabetes and coronary heart disease (CHD). This may be achieved by addition of high-quality protein and fat contained in pistachio nuts, to carbohydrate-containing foods or meals. Subjects/Methods: A total of 10 healthy volunteers (3 males, 7 females); aged 48.3±6.4 years; Body mass index (BMI) 28.0±4.8 kg/m 2 participated in two studies. Study 1 assessed the dose-response effect of 28, 56 and 84 g pistachios consumed alone or co-ingested with white bread (50 g available carbohydrate); Study 2 assessed the effective dose (56 g) of pistachios on post-prandial glycemia consumed with different commonly consumed carbohydrate foods (50 g available carbohydrate). Relative glycemic responses (RGRs) of study meals compared with white bread, were assessed over the 2 h post-prandial period. Results: The RGRs of pistachios consumed alone expressed as a percentage of white bread (100%) were: 28 g (5.71±.8%); 56 g (3.8±1.8%); 84 g (9.3±3.2%), P<0.001. Adding pistachios to white bread resulted in a dose-dependent reduction in the RGR of the composite meal; 28 g (89.1±6.0, P=0.100); 56 g (67.3±9.8, P=0.009); 84 g (51.5±7.5, P<0.001). Addition of 56 g pistachios to carbohydrate foods significantly reduced the RGR: parboiled rice (72.5±6.0) versus rice and pistachios (58.7±5.1) (P=0.031); pasta (94.8±11.4) versus pasta and pistachios (56.4±5.0) (P=0.025); whereas for mashed potatoes (109.0±6.6) versus potatoes and pistachios, (87.4±8.0) (P=0.063) the results approached significance. Conclusions: Pistachios consumed alone had a minimal effect on post-prandial glycemia and when taken with a carbohydrate meal attenuated the RGR. The beneficial effects of pistachios on post-prandial glycemia could, therefore, be part of the mechanism by which nuts reduce the risk of diabetes and CHD. © 2011 Macmillan Publishers Limited All rights reserved. Source

Kendall C.W.C.,University of Toronto | Kendall C.W.C.,Clinical Nutrition and Risk Factor Modification Center | Kendall C.W.C.,University of Saskatchewan | Josse A.R.,McMaster University | And 4 more authors.
British Journal of Nutrition | Year: 2010

The ability of nuts to improve the blood lipid profile and reduce the risk of CHD is now well established. The interest that health effects of nuts have gained recently has brought the possible benefits of consuming nuts, such as improvement in the conditions of the metabolic syndrome, and their potential to prevent and control diabetes into focus. Results from cohort studies have associated nut consumption with a reduced risk of developing diabetes and CVD. However, few randomised controlled trials have assessed the effect of nuts on diabetes control, and those that have been undertaken have shown improvements in blood lipids but not in the glycaemic control. Diabetes agencies are increasingly recognising the importance of controlling postprandial glycaemia fluctuations. Acute feeding studies indicate that nuts have minimal effects on rising postprandial blood glucose levels when eaten alone, and diminish the postprandial glycaemic response when consumed with high-glycaemic index carbohydrate foods in both normoglycaemic and type 2 diabetic individuals. Nuts have a healthy nutritional profile, high in MUFA and PUFA, are a good source of vegetable protein and are rich in fibre, vitamins and minerals. Incorporation of nuts in the diet may therefore improve the overall nutritional quality of the diet. While more research is required to establish the ability of nuts to improve glycaemic control in the long run, early data indicate that the inclusion of nuts in the diets of individuals with diabetes and the metabolic syndrome is warranted, in view of their potential to reduce CHD risk. Copyright © The Authors 2010. Source

Kendall C.W.C.,University of Toronto | Kendall C.W.C.,Clinical Nutrition and Risk Factor Modification Center | Kendall C.W.C.,University of Saskatchewan | Esfahani A.,University of Toronto | And 3 more authors.
Food Hydrocolloids | Year: 2010

The dietary pattern of humans has shifted towards a diet in which refined grains, meat, added fats and sugar are common and vegetable protein and fibre intake is low. This change in diet and the shift to a sedentary lifestyle is largely responsible for the increased prevalence of obesity and chronic diseases including type 2 diabetes, heart disease and cancer. Over the past forty years, traditional dietary approaches have been investigated as a remedy to these chronic diseases. In addition to high fibre diets, other dietary tools such as the dietary glycaemic index have been developed, which also link carbohydrate metabolism to chronic diseases. The current body of scientific literature supports the notion that high fibre diets are important in prevention and management of the aforementioned chronic diseases. However, these benefits may be amplified when dietary fibre intake is in the context of a low GI diet. © 2009 Elsevier Ltd. All rights reserved. Source

Anand S.S.,McMaster University | Anand S.S.,Hamilton Health Sciences | Hawkes C.,City University London | De Souza R.J.,McMaster University | And 16 more authors.
Journal of the American College of Cardiology | Year: 2015

Major scholars in the field, on the basis of a 3-day consensus, created an in-depth review of current knowledge on the role of diet in cardiovascular disease (CVD), the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries and age/race/ethnicity/socioeconomic groups suggesting the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps is highlighted. Large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however, major gaps exist both in dietary pattern research and ways to change diets and food systems. On the basis of the current evidence, the traditional Mediterranean-type diet, including plant foods and emphasis on plant protein sources provides a well-tested healthy dietary pattern to reduce CVD. © 2015 American College of Cardiology Foundation. Source

Jenkins A.L.,Clinical Nutrition and Risk Factor Modification Center
European Journal of Clinical Nutrition | Year: 2016

Background/Objectives:There has been recent interest in barley as a therapeutic food owing to its high content of beta-glucan (β-glucan), a viscous soluble fiber recognized for its cholesterol-lowering properties. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the cholesterol-lowering potential of barley β-glucan on low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (apoB) for cardiovascular disease (CVD) risk reduction.Methods:MEDLINE, Embase, CINAHL and the Cochrane CENTRAL were searched. We included RCTs of ⩾3-week duration assessing the effect of diets enriched with barley β-glucan compared with controlled diets on LDL-C, non-HDL-C or apoB. Two independent reviewers extracted relevant data and assessed study quality and risk of bias. Data were pooled using the generic inverse-variance method with random effects models and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed by the Cochran Q-statistic and quantified by the I2 statistic.Results:Fourteen trials (N=615) were included in the final analysis. A median dose of 6.5 and 6.9 g/day of barley β-glucan for a median duration of 4 weeks significantly reduced LDL-C (MD=−0.25 mmol/l (95% CI: −0.30, −0.20)) and non-HDL-C (MD=−0.31 mmol/l (95% CI: −0.39, −0.23)), respectively, with no significant changes to apoB levels, compared with control diets. There was evidence of considerable unexplained heterogeneity in the analysis of non-HDL-C (I2=98%).Conclusions:Pooled analyses show that barley β-glucan has a lowering effect on LDL-C and non-HDL-C. Inclusion of barley-containing foods may be a strategy for achieving targets in CVD risk reduction.European Journal of Clinical Nutrition advance online publication, 8 June 2016; doi:10.1038/ejcn.2016.89. © 2016 Macmillan Publishers Limited Source

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