Clark shares a 2 pound bag of dried fruit with 7 of his friends. How much dried fruit will each person receive if they divide the snack evenly?
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Abstract
Nuts and dried fruit are essential foods in the Mediterranean diet. Their frequent consumption has been associated with the prevention and/or the management of such metabolic conditions as type 2 diabetes (T2D), metabolic syndrome and cardiovascular diseases. Several previous reviews of epidemiological studies and clinical trials have evaluated the associations of nuts and/or dried fruit with various metabolic disorders. However, no reviews have focused on the mechanisms underlying the role of nuts and/or dried fruit in insulin resistance and T2D. This review aims to report nut and dried-fruit nutritional interventions in animals and humans, and to focus on mechanisms that could play a significant role in the prevention and treatment of insulin resistance and T2D.
Keywords: diabetes, nuts, dried fruits, insulin resistance, mechanisms, clinical trials
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1. Introduction
Nuts and traditional dried fruit (i.e., with no added sugar) are key food categories in the Mediterranean diet and other regional diets [1]. Several prospective studies, clinical trials and research in animals have reported beneficial effects after nut consumption [2]. However, the benefits of dried fruits (DF), mainly raisins, have been less explored [3].
Over time, food consumption has varied. More than 30 years ago, the consumption of nuts and DF was discouraged because of their high fat and sugar content, respectively. However, at the beginning of the 1990s, several randomized clinical trials (RCT) and animal experiments demonstrated their potential beneficial effect on cardiovascular diseases (CVD). Nuts and DF contain various macro and micronutrients together with other important bioactive compounds that may synergically contribute to modulate specific metabolic diseases such as hypercholesterolemia, hypertension and type 2 diabetes (T2D) (reviewed in [3,4]). Even so, the specific role of nuts and DF in the development and progression of insulin resistance (IR) and T2D are still controversial.
In this review, we focus on the role of nuts and DF in the prevention and treatment of T2D. We summarize published in vivo, in vitro, epidemiological and clinical studies, and we review the potential mechanisms that could explain the beneficial role of nut consumption on glucose and insulin metabolism, both of which are altered in T2D and in other glucose-impaired states. Given that the present article is not a systematic review, we may not have identified some studies and publication bias should be acknowledged. However, all authors independently conducted the literature search.
1.1. Nuts and Dried Fruits: The Concept
1.1.1. Nuts
Nuts have been part of the human diet since prehistoric times [5,6]. They are an independent food group and are one of the cornerstones of the Mediterranean diet (MedDiet) [7]. According to the botanical definition, a nut is simply a dried fruit with one seed (rarely two) in which the ovary walls are very hard (stony or woody) at maturity, and the seed is unattached or free within the ovary wall. However, the word “nut” is commonly used to refer to any large, oily kernel in a shell that can be eaten as food. In this review, we use the term “nuts” to refer to almonds, Brazil nuts, cashews, hazelnuts, macadamias, peanuts, pecans, pine nuts, pistachios and walnuts. Although peanuts are actually classified as legumes because of their similar nutrient composition and their proven cardiovascular health benefits, they are commonly regarded as being a nut.