Original Article

European Journal of Clinical Nutrition (2011) 65, 696–702; doi:10.1038/ejcn.2011.12; published online 2 March 2011

The impact of pistachio intake alone or in combination with high-carbohydrate foods on post-prandial glycemia

C W C Kendall1,2,3, A R Josse4, A Esfahani1,2,5 and D J A Jenkins1,2,6

  1. 1Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
  2. 2Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  4. 4Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
  5. 5School of Medicine, New York Medical College, Valhalla, New York, USA
  6. 6Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada

Correspondence: Dr CWC Kendall, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, M5S 3E2. E-mail: cyril.kendall@utoronto.ca

Received 11 August 2010; Revised 13 December 2010; Accepted 13 January 2011; Published online 2 March 2011.





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.



A total of 10 healthy volunteers (3 males, 7 females); aged 48.3±6.4 years; Body mass index (BMI) 28.0±4.8kg/m2 participated in two studies. Study 1 assessed the dose-response effect of 28, 56 and 84g pistachios consumed alone or co-ingested with white bread (50g available carbohydrate); Study 2 assessed the effective dose (56g) of pistachios on post-prandial glycemia consumed with different commonly consumed carbohydrate foods (50g available carbohydrate). Relative glycemic responses (RGRs) of study meals compared with white bread, were assessed over the 2h post-prandial period.



The RGRs of pistachios consumed alone expressed as a percentage of white bread (100%) were: 28g (5.7±1.8%); 56g (3.8±1.8%); 84g (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; 28g (89.1±6.0, P=0.100); 56g (67.3±9.8, P=0.009); 84g (51.5±7.5, P<0.001). Addition of 56g 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.



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.


pistachios; nuts; glycemic index; glycemic load; diabetes

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