Accumulating evidence links nut consumption with an improved risk of metabolic syndrome (MetS); however, long-term trials are lacking. We examined the effects of a daily dose of walnuts for two years on MetS in a large elderly cohort. A total of 698 healthy elderly participants were randomly assigned to either a walnut supplemented or a control diet. The participants in the walnut group were provided with packaged walnuts (1, 1.5, or 2 oz. or ~15% of energy) and asked to incorporate them into their daily habitual diet. The participants in the control group were asked to continue with their habitual diet and abstain from eating walnuts and other tree nuts. Intake of n-3 fatty acid supplements was not permitted in either group. Fasting blood chemistries, blood pressure, and anthropometric measurements were obtained at baseline and at the end of intervention. A total of 625 participants (67% women, mean age 69.1 y) completed this two-year study (90% retention rate). Triglycerides decreased in both walnut (−0.94 mg/dl) and control (−0.96 mg/dl) groups, with no significant between-group differences. There was a non-significant decrease in systolic and diastolic blood pressure in the walnut group (−1.30 and −0.71 mm Hg, respectively) and no change in the control group. Fasting blood glucose decreased by ~1 point in both the walnut and control groups. There were no significant between-group differences in the development or reversion of MetS. In conclusion, supplementing the diet of older adults with a daily dose of walnuts had no effect on MetS status or any of its components, although the walnut group tended to have lower blood pressure.

OWe assessed the effect of a culturally sensitive educational program on lifestyle changes among Hispanics with type‐2 diabetes mellitus (DM2).MThirty‐four participants (25 females and 9 males) joined a three‐month education intervention program. Participants completed a Family Habits Frequency Questionnaire at baseline and after three months. Participants were Spanish speaking Hispanics with DM2 aged 37–69 years.RParticipants showed significant improvement toward acquiring healthier behaviors. For instance, participants read food labels significantly more often after the 3 months compared with baseline (P=0.0002). Also, there was a significant increase of physical activity among mothers such as doing 30 minutes of physical activity (P=0.04) and increasing in walk (P=0.01). The mean change of HbA1c (P=<0.001), fasting plasma glucose (P=0.003), and cholesterol/HDL ratio (P=<0.001) decreased significantly and HDL level (P=<0.001) increased significantly after the educational program.CThe culturally sensitive educational program among Hispanics with DM2 showed significant positive changes in participants’ lifestyle and behaviors.Grant Funding Source: CMS 03–00335 Health Services Research and NIH award 5P20MD001632

In 2010, about one out of 20 households utilized food pantry assistance one or more times. With over 40,000 pantries in the US, this presents an opportunity to address the high prevalence of household food insecurity while simultaneously promoting healthful eating and exercise habits in low‐income communities. The objective of this project is to implement nutrition and physical activity education in the Helping Hands Pantry, a center that provides groceries to over 7,000 people each week. As individual clients waited to receive food, healthy food samples were distributed by nutrition students to draw clients’ attention to the nutrition education display in the waiting room. University nutrition students provided adults with nutrition information, meal planning, and exercising tips and children were given nutrition‐related coloring sheets. Through conducting oral assessments, authors found that many children lacked proper knowledge in nutrition and many adults seemed to know about nutrition, but discounted the importance of exercise. Authors found that targeting educational interventions at food pantries to individual clients is a promising strategy. To promote sustainability and effectiveness, pantry volunteers can be trained to implement the nutrition education interventions described above on a frequent basis.

BackgroundType 2 diabetes is an important global health issue. Since individuals with type 2 diabetes (T2D) are taught to use food exchanges when measuring their macronutrient intake, food frequency questionnaires (FFQ) using this familiar method is critical in the dietary intake assessment of this group.AimTo evaluate the ability of a FFQ developed for participants of a diabetes intervention trial in estimating nutrient intake against multiple unannounced 24‐hr recalls.MethodsPatients with type 2 diabetes (T2D) (n= 43; 25 females and 18 males), with mean age of 61.6 (SD 13.1) years and a mean BMI of 29.0 (SD 21.0), participated in a randomized, prospective 24‐week parallel‐group clinical intervention trial. Dietary intake was assessed using 6 unannounced 24‐hr recalls (24HDR) composed of 4 weekdays and 2 weekend days, and a self‐administered semi‐quantitative FFQ with 72 hard‐coded items that was developed for the study. Portion sizes in the FFQ were based on the 2014 American Diabetes Association and the Academy of Nutrition and Dietetics, Choose Your Foods food lists. Wilcoxon signed ranks test, correlation analyses with energy adjustment and deattenuation, and cross‐classification were used to evaluate the agreement between the FFQ and multiple 24HDR on intake of 25 nutrients.ResultsCompared to the 24HDR, the FFQ has significantly underestimated most of the nutrients except for total sugar, animal protein, arachiodonic acid, EPA, dietary fiber, calcium, and potassium. Deattenuated energy‐adjusted correlations ranged between 0.62 (calcium) and 0.07 (iron), with weak correlations (r<0.35) for 9 nutrients, moderate correlations (0.35≤r<0.50) for 5 nutrients and strong correlations (r≥0.50) for 10 nutrients. In the cross‐classification analyses, agreement within 1 quartile ranged from 66% (energy and sodium) to 91% (animal and vegetable proteins) while gross misclassifications ranged from 0% (vegetable protein) to 11% (sodium).ConclusionThe FFQ has a tendency to underestimate absolute intake of most nutrients; however, it has good ranking ability. Underreporting tendency in this group of mostly overweight/obese subjects is similar to findings in other studies. The FFQ developed for the intervention trial can be considered a reasonably valid tool in assessing intake of most nutrients.

Background/ObjectiveLong‐term observational studies and short‐term intervention trials have linked nut consumption with improved cardiometabolic risk factors. However, long‐term trials on nut intake and cardiometabolic risk are lacking. We conducted a year‐long trial to examine the effects of a daily dose of walnuts on cardiometabolic risk markers in an elderly population.MethodsA total of 356 participants (Ages 62–79) were randomly assigned to a walnut or control group. Participants in the walnut group were provided with packaged walnuts (1, 1.5, or 2 oz.) and asked to incorporate into their daily habitual diet. The walnut supplement provided an estimated 15% of their daily energy. Participants in the control group were asked to continue with their habitual diet and to refrain from eating walnuts or excessive intake of other nuts. Both groups were asked to maintain their lifestyles. Blood samples were obtained at baseline and one year and assayed for total cholesterol, LDL and HDL cholesterol, and triglycerides. Blood pressure and waist circumference measurements were obtained at baseline and one year. Data was analyzed using logistic regression and t‐test.ResultsA total of 314 participants completed the study. Data from five participants was incomplete, thus the final sample for this analysis was 309 (155 walnut, 154 control, 66% female). Triglycerides decreased significantly in the walnut group compared to control [−8.41 mg/dl (95% CI −15.54, −1.29 & P=0.02). This was accompanied by a non‐significant decrease in total cholesterol [−3.49 mg/dl (95% CI −9.94, 2.96, & P=0.29), LDL‐cholesterol (−2.40 mg/dl | 95% CI −7.73, 2.93 P=0.38), systolic blood pressure (SBP) (−1.25 mm/Hg | 95% CI −4.96, 2.47 P=0.51), and diastolic blood pressure (−1.62 mm/Hg | 95% CI −3.91, 0.67 & P= 0.17). HDL‐cholesterol increased modestly in the walnut group (+0.35 mg/dl | 95% CI −1.08, 1.78 & P= 0.38). Fasting glucose levels also increased in the walnut group although not significantly (FGL) (+1.82 mg/dl | 95% CI −0.67, 4.32 & P= 0.15). There were no significant between‐group differences in waist circumference.ConclusionSupplementing the diet of older adults with a daily dose of walnuts and no other dietary advice can result in improved blood lipids and blood pressure without adverse effects on waist circumference.Support or Funding InformationThe study is funded by the California Walnut Commission.