Friday, July 7, 2017

Dried Fruit And Nuts For Type 2 Diabetes

Figure 1
Role of nutrients from nuts and dried fruits in glucose and insulin metabolism, and cellular and molecular mechanisms related to T2D/IR. CHO, carbohydrate; CMF, cellular membrane fluidity; GI, glycaemic index; IR, insulin resistance; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; T2D, type 2 diabetes. http://www.mdpi.com/2072-6643/9/7/673/htm (Figure from the open access paper)

Of course, diabetics need to follow the instructions of their physicians; however, we present this article for readers' interest.  It suggests that eating nuts and dried fruit (DF) can be beneficial for diabetics; some of the possible mechanisms are outlined in the figure (above) from the paper.  The fiber and relatively low glycemic index, healthy fats, minerals, and various bioactive compounds alter gene expression, microRNAs (RNA that control gene expression), and microbiota and so helpfully "modulate glucose and insulin metabolism." From the conclusion:


Undoubtedly, the specific composition of nuts and dried fruits means that they can be used to efficiently counteract metabolic diseases such as type 2 diabetes. Their unique profile of macronutrients, micronutrients and other bioactive compounds may explain the beneficial effects observed in clinical and epidemiological studies. However, the exact mechanisms by which they modulate glucose and insulin metabolism and influence T2D have yet to be fully discovered. They contain fiber, fat, minerals and other bioactive molecules that modulate several gene mechanisms at the cellular and molecular level. This may explain some of their beneficial effects. However, further basic and translational research is needed in order to extend their positive health benefits and to find novel mechanisms and targets to explain their contribution to the management of type 2 diabetes.

What about the sugars in the dried fruit?  The authors claim:


Carbohydrate Content—Glycaemic Index of Nuts and Dried Fruits
It should be noted that nuts are relatively low in CHO (approximately 15% of the total energy) whereas DFs have a high amount of CHO (60–80%). Nuts have a low glycaemic index and therefore increase the blood glucose level less and require less insulin secretion, thus favoring the control of T2D. However, because DFs are high in carbohydrates and fiber, their specific GI has been the object of considerable study. The GI of raisins was first evaluated in three heterogeneous groups of subjects (aerobically trained, sedentary or pre-diabetic) and was described between 49 and 69, therefore corresponding to the low-to-moderate GI foods [110]. However, later studies have reported that raisins are in the low GI category in healthy subjects (a GI of 49.4 and an insulinemic index of 47.1) [15]. This suggests a favorable postprandial glucose and insulin response [112], that could be explained by the high proportion of fructose that DFs contain.
Overall, the inclusion of both nuts and DFs in a balanced diet may reduce the overall glycaemic index of the diet, with benefits to glycaemic and insulinemic control in both healthy and T2D subjects.

Fructose of course can cause problems but when combined with the high fiber in the dried fruits that is obviated.

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