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The Prediabetes Nutritionist

almonds before meals

Eating Almonds Before Main Meals May Prevent After-Meal Blood Sugar Spikes, Reverse Prediabetes

Eating a small handful of almonds before main meals may prevent after-meal blood sugar spikes, encourage weight loss and reverse prediabetes in Asian Indians, according to findings from a small randomised controlled trial.

“These findings are of practical and clinical significance keeping in mind the dysmetabolic [altered metabolic] state of Asian Indians and their greater tendency to convert to diabetes from the prediabetes stage,” the researchers wrote.

The study, “Premeal almond load decreases postprandial glycaemia, adiposity and reversed prediabetes to normoglycaemia: A randomised controlled trial,” was published in Clinical Nutrition ESPEN.

The pancreas controls blood sugar levels tightly by carefully regulating the release of two hormones – insulin and glucagon. After an overnight fast (10-14 hours without food), the pancreas produces glucagon, which stimulates the liver to release glucose to maintain blood sugar levels. However, after meals, the pancreas stops making glucagon and produces insulin to remove excess glucose in the bloodstream.

In healthy people, blood sugar levels after an overnight fast range between 4-5.5 mmol/l and are less than 7.8 mmol/l two hours after meals. People with prediabetes do not respond correctly to insulin (insulin resistance), so their fasting and after-meal blood sugar are higher than normal; fasting blood sugars are typically 5.6-6.9 mmol/L (100-125 mg/dL) and 7.8-11.0 mmol/L (140-199 mg/dL) two hours after a 75g glucose load or oral glucose tolerance test (OGTT).

Carbohydrates raise blood sugar levels the most, and after-meal blood sugar levels greatly determine a person’s risk of weight gain, heart disease, diabetes and its complications. Past studies show that frequent blood sugar spikes after meals can double the risk of heart disease.

Scientists have developed medications, such as Acarbose and nateglinide, to prevent after-meal blood sugar spikes in people with type 2 diabetes. Although effective, these medications cause stomach aches, bloating and indigestion in up to 20-30% of users.

Research suggests that eating foods rich in fibre, protein and healthy fats before carbohydrate-rich foods can slow digestion and prevent after-meal blood sugar spikes. Since nuts are rich in healthy fats, protein and fibre, a team of researchers investigated if eating a small handful of almonds before main meals could prevent post-meal blood sugar spikes in Asian Indians who typically eat carbohydrate-rich diets and have a higher risk of type 2 diabetes.

They enrolled 60 adults [28 males, 38 females] and split them into a control and treatment group. Both groups ate a healthy diet containing a similar proportion of carbohydrates, proteins and fats, but the treatment group ate 20g of raw almonds 30 minutes before breakfast, lunch and dinner. The researchers monitored the participant’s diets throughout the study to ensure they adhered closely to the guidelines and advised them to walk briskly for 45 minutes daily.

They measured the participant’s weight, waist circumference, skinfold thickness, BMI, total cholesterol, low-density lipoprotein (LDL) ‘bad’ cholesterol, insulin resistance and HbA1c at the start and end of the study. They also gave the participants glucose monitors to measure their blood glucose in the fasting state and two hours after lunch and dinner throughout the study.

Compared to controls, the treatment group significantly reduced their weight (-3.1 kg), waist circumference (-3.0 cm), skinfold thickness (-5.2 mm), BMI (-1.2), fasting blood glucose (-6.1 mg/dL), HbA1c (-0.4%) and total cholesterol (-14.0mg/dL) and LDL-cholesterol (-11.8 mg/dL). There was no difference in insulin resistance between both groups.

Almonds before main meal

Ten participants in the treatment group reduced their fasting blood glucose to normal levels compared to four in the control group. In addition, 23 participants in the treatment group achieved normal two-hour OGTT tests compared to seven in the control group, and nine in the treatment group achieved normal HbA1c compared to one in the control group. Overall, seven participants in the treatment group achieved normal fasting and two-hour OGTT, similar to results seen in patients taking Acarbose.

“Almonds taken as a premeal load led to a reduction in glycaemic as well as body weight, waist circumference, and truncal skinfolds, along with improvement in other metabolic markers such as lipid profile and serum insulin. Furthermore, there is no adverse effect reported in this study, whereas postprandial (after-meal) regulator drugs, specifically Acarbose, have adverse effects,” the researchers wrote.

It is unclear how almonds reduce after-meal blood sugar levels, but research shows that eating a small amount of protein, healthy fats and soluble fibre (all present in almonds) before meals causes the body to produce proteins that slow digestion and stimulate insulin release. Almonds also increase the feeling of fullness.

The researchers noted the study’s limitations, including its small sample size, short duration, and inability to apply the results to people with type 2 diabetes.

Further studies should be done on people with poorly-controlled diabetes who take medication to regulate their blood sugar. Long-term studies are also needed to determine if almonds can reverse prediabetes in people with a healthy weight.  

Try These Tips

  • Protein, healthy fats or fibre can slow digestion and prevent after-meal blood sugar spikes.
  • Eat a small handful of nuts or a piece of chicken, cheese or avocado before meals rich in carbohydrates to slow digestion and prevent blood sugar spikes.
  • Alternatively, eat the proteins on your plate first, followed by vegetables and then carbohydrates, to achieve the same blood sugar-lowering effect.  

DISCLAIMER: Not a substitute for medical advice – All content is for informational purposes only and is not intended to provide medical or nutrition advice or to take the place of medical/nutrition advice or treatment from your doctor or health professional. Since each person’s health conditions are very specific, viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. All content, including text, graphics, images, and information in this post/video, is for general information only and does not replace a consultation with your doctor/health professional.

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