If you take 20 grams of almonds about 30 minutes before each of the three major meals of the day, then this collective pre-meal load of 60 gms can actually cut back your post-prandial blood glucose spike by 20 per cent. Yes, an India-specific study has finally proved this corrective nature of the nut. Almonds were chosen as a pre-meal load because of their familiarity among Indians, their concentration of mono-unsaturated fatty acid (MUFA), fibres and proteins.
This study was authored by Dr Seema Gulati, Centre for Nutrition Research, National Diabetes, Obesity, and Cholesterol Foundation (NDOC), and Dr Anoop Misra, Chairman, Fortis CDOC Hospital for Diabetes and Allied Sciences.
“We have published this research in two papers. The first, which studies the immediate effect, has been published in the European Journal of Clinical Nutrition, and the second paper, which assesses the long term effect of pre-meal almond load, has been published in Clinical Nutrition ESPEN. Both are peer-reviewed journals,” says Dr Gulati.
“The study is significant because most Indians are so bothered about their fasting glucose that they rarely bother about watching their post-prandial glucose level, which is usually higher given the composition and carbohydrate-heavy nature of our main meals of the day. What many do not realise is that the post-meal sugar spike is the first indication of the onset of Type 2 diabetes. Uncontrolled, the elevated levels would also reflect in the fasting sugar tests down the line. The beneficial rolldown effect of consuming almonds before meals can not only halt the progression of Type 2 diabetes but also raise the chances of reversing it in early onset cases. In short, it can prevent complications related to diabetes,” says she.
Now use of almonds as a pre-meal snack has led to a significant difference in the two-hour post-meal sugar load by 20 per cent, surprising even the researchers. The team was very thorough with their calculations. “We closely monitored the almond consumption impact on the immediate post-prandial load. We fixed a continuous glucose monitoring system (CGMS) on each subject’s abdomen. Through a thin filament, this measured blood glucose 280 times a day. So, the patient was strapped to his device between one and three days. We could monitor blood glucose levels through the day and after every meal. Even the patients wrote down by how much their post-meal sugar levels spiked or not after eating a certain kind of food,” explains Dr Gulati.
For the long-term study, researchers tracked patients for three months and found results corroborating the shorter study. “Consistent results, serum insulin and glycaemic parameters were safe. The subjects showed reduction in inflammatory markers and lipids along with HbA1c levels and post-prandial glucose. Besides, a lot of our test subjects came to know that they had prediabetes in the first place during the course of the trial. Diabetes is truly a silent killer. So, if there are 90 million diabetics, there are 90 million more who have prediabetes but are not diagnosed at the right time. So, pre-loading meals with nuts seems to be a promising strategy to roll back the disease, particularly among this group. We are already using this in our dietary strategies for patients at our centre because prevention is better than cure,” says Dr Gulati.
“We have been constantly researching diets in our institute, wondering what could be the best pre-meal load. Nuts of all kinds are healthy and well-accepted by Indians; they are very easy to carry to work, do not go bad or rancid and have good fats and proteins, which Indians do not have much of,” adds she.
The same team had earlier also released a study proving how including almonds in the diet could significantly reduce the risk of cardiovascular diseases in Indians with Type 2 diabetes and improve their general health. “India is known as the diabetes capital of the world, with the incidence of Type 2 diabetes currently reaching epidemic proportions,” the researchers had written in the study published in the journal, Metabolic Syndrome and Related Disorders. Once deemed a disease of the affluent, the prevalence of Type 2 diabetes now cuts across all social, demographic and age groups, they had said. They attributed this higher and earlier incidence of Type 2 diabetes in part to the “South Asian phenotype,” a genetic predisposition that makes Indians more susceptible to insulin resistance and Type 2 diabetes. “That was the first free-living study to demonstrate the health benefits of including almonds in the diet among Asian Indians with Type 2 diabetes,” said Dr Gulati, who was lead researcher.
“Almonds are a traditional snack for Indians; however, for the first time we have been able to prove their benefits among diabetics. We now have confidence in prescribing them to all patients as part of their diet plan,” says she.
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