Almond Consumption Decreases Android Fat Mass Percentage in Adults With High Android Subcutaneous Adiposity but Does Not Change HbA1c

Abstract

Objectives: The purpose of this study was to determine if the mixed evidence of almond consumption on HbA1c stems from testing people with different body fat distributions (BFD) associated with different risks of glucose intolerance. Methods: A 6-month RCT in 134 adults was conducted. Participants were randomly assigned to the almond or control treatment based on their BFD. Those in the almond group consumed 0.75 oz of almonds with their breakfast and as their afternoon snack (1.5 oz almonds/day) every day, and were instructed not to consume any other nuts. Those in the control treatment continued their habitual breakfast and afternoon snack routines, but were instructed not to consume any nuts. At 0 and 6 months, body composition was measured and blood samples were collected for analyses of HbA1c, glycemia and lipemia. Appetite and dietary intake data were recorded at 0, 2, 4, and 6 months and a blood sample was obtained for compliance testing. Body weight was measured every two weeks. An intention-to-treat linear mixed model analysis was performed with Bonferroni pairwise comparisons on diet quality, energy intake, HbA1c, and body composition change values. Results: Incorporating almonds into the diet increased total diet quality by 8.3 ± 2.1% over the intervention (P = 0.001). Participants consuming almonds ingested 195 ± 87 kcals/day more than participants in the control group (P = 0.027), but this did not result in differences in body weight (P > 0.3). The almond, high android subcutaneous adiposity (SAT) group had a greater reduction in android fat mass % (P = 0.038), preserved android lean mass % (P = 0.042), and tended to decrease android VAT mass (P = 0.079) compared to those in the control, high SAT group. There were no differences of HbA1c between groups (P > 0.05). Conclusions: Incorporating 1.5-oz of almonds into the diet improves diet quality without promoting positive energy balance and weight gain. Long-term consumption of almonds may also improve android composition in those with high android SAT. However, testing people with different BFD does not account for the mixed evidence on almond consumption and HbA1c.