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Carbohydrates, glycemic index and diabetes mellitus

Acute effects of pistachio consumption on glucose and insulin, satiety hormones and endothelial function in the metabolic syndrome



Nut consumption has been found to decrease risk of coronary heart disease and diabetes and to promote healthy body weights possibly related to their favorable macronutrient profile. We therefore assessed the effect of pistachios on postprandial glucose and insulin levels, gut hormones related to satiety and endothelial function.


In this randomized crossover study, 20 subjects with metabolic syndrome consumed five study meals over 5–10 weeks. The meals differed in fat type and quantity, but were matched according to available carbohydrates (CHOs). Three meals had 50 g available CHO: white bread (WB50g), white bread, butter and cheese (WB+B+Ch) and white bread and pistachios (WB+P). Two meals had 12 g available CHO: white bread (WB12g) and pistachios (P).


Within each group of available CHO meals, postprandial glucose levels were the highest following the white bread-only meals, and glucose response was significantly attenuated when butter and cheese or pistachios were consumed (P<0.05). Postprandial insulin levels were highest after the WB+B+Ch meal (P<0.05), but did not differ between the white bread-only and pistachio meals. Both endothelial function (reactive hyperemia index) and arterial stiffness (augmentation index) significantly increased after the white bread-only meals compared with the WB+B+Ch meal (all P<0.05). Insulin secretagogue levels were higher when butter and cheese or pistachios were consumed than when white bread only was consumed (P<0.05).


Compared with white bread, pistachio consumption reduced postprandial glycemia, increased glucagon-like-peptide levels and may have insulin-sparing properties. These effects could be beneficial for individuals with diabetes and metabolic syndrome.

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This work was supported by the American Pistachio Growers, Fresno, CA, USA. DJAJ is funded by the Federal Government of Canada as a Canada Research Chair in Nutrition and Metabolism.

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Correspondence to C W C Kendall.

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CWCK has received research grants, travel funding, consultant fees, honoraria or has served on the scientific advisory board for Abbott, Advanced Food Materials Network, Almond Board of California, American Peanut Council, American Pistachio Growers, Barilla, California Strawberry Commission, Canadian Institutes of Health Research, Canola Council of Canada, Danone, General Mills, Hain Celestial, International Tree Nut Council, Kellogg, Loblaw Brands Ltd, Oldways, Orafti, Paramount Farms, Pulse Canada, Saskatchewan Pulse Growers, Solae and Unilever. ALJ is a director of Glycemic Index Laboratories, Toronto, Ontario, Canada. JC and LC are employed by Glycemic Index Laboratories. SGW and KAS have received travel funding and research funding from the American Pistachio Growers. DJAJ reported serving on the Scientific Advisory Board of Unilever, Sanitarium Company, California Strawberry Commission, Loblaw Supermarket, Herbal Life International, Nutritional Fundamental for Health, Pacific Health Laboratories, Metagenics, Bayer Consumer Care, Orafti, Dean Foods, Kellogg’s, Quaker Oats, Procter and Gamble, Coca-Cola, NuVal Griffin Hospital, Abbott, Pulse Canada, Saskatchewan Pulse Growers and Canola Council of Canada; receiving honoraria for scientific advice from the Almond Board of California, International Tree Nut Council Nutrition Research and Education Foundation, Barilla, Unilever Canada, Solae, Oldways, Kellogg’s, Quaker Oats, Procter and Gamble, Coca-Cola, NuVal Griffin Hospital, Abbott, Canola Council of Canada, Dean Foods, California Strawberry Commission, Haine Celestial and Alpro Foundation; being on the speakers panel for the Almond Board of California; receiving research grants from Loblaw Brands Ltd, Unilever, Barilla, Almond Board of California, Solae, Haine Celestial, Sanitarium Company, Orafti, International Tree Nut Council and Peanut Institute; and receiving travel support to meetings from the Almond Board of California, Unilever, Alpro Foundation and International Tree Nut Council. The remaining authors declare no conflict of interest.

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Kendall, C., West, S., Augustin, L. et al. Acute effects of pistachio consumption on glucose and insulin, satiety hormones and endothelial function in the metabolic syndrome. Eur J Clin Nutr 68, 370–375 (2014).

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  • pistachios
  • nuts
  • glycemic index
  • glycemic load
  • metabolic syndrome
  • endothelial function

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