Nuts may be a suitable replacement for carbohydrates in the diet of patients with type 2 diabetes, according to a new report.

In a study of 117 patients with type 2 diabetes, researchers found that consuming two ounces of nuts daily in place of carbohydrate-rich foods improves both glycemic control and serum lipids.

The investigators, led by David J. A. Jenkins, MD, of St. Michael’s Hospital in Toronto, randomly assigned subjects to one of three treatments (daily supplements) for three months: mixed nuts (75 g/day; 40 patients), half portions of nuts (38 patients), or muffins (39 patients).

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The nuts consisted of mixed unsalted almonds, pistachios, pecans, hazelnuts, walnuts, peanuts, cashews, and macadamias. The muffin was a healthy whole-wheat product, sweetened with apple concentrate, with no sugar added, the researchers explained. The muffin had similar protein content to the nuts because of the inclusion of egg white and skim milk powder, they noted.

Patients in the full-nut dose group had a significant mean 0.21% decrease in absolute hemoglobin A1c (HbA1c) units from baseline, whereas no significant changes occurred in the other groups, the researchers reported in Diabetes Care (2011;34:1-5). LDL cholesterol decreased significantly in the full-nut dose group compared with those assigned to the muffin group. The LDL cholesterol decrease in the half-nut group was intermediate and not significantly different from the other groups.

“Increased “mixed nut consumption as a source of unsaturated (monounsaturated and polyunsaturated) fat intake to replace dietary starch favorably affected both HbA1c and serum lipids,” the authors observed.

Dr. Jenkins’ group concluded that “mix, unsalted, raw, or dry-roasted nuts have benefits for both blood glucose and blood lipids and may be used to increase vegetable oil and protein intake in the diets of type 2 diabetic patients as part of a strategy to improve diabetes control without weight gain.”