Mediterranean Diet + Nuts = Reversal of Metabolic Syndrome

MPj04031620000[1]An article published December 8, 2008, by presents results of a recent scientific study in Spain that showed reduction in “metabolic syndrome” by the Mediterranean diet supplemented with nuts., Reuters, and others helped spread the news.  The Bloomberg article was written by Nicole Ostrow.

Metabolic syndrome is a constellation of clinical factors that are associated with increased risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke.  [Sometimes metabolic sydrome is called Syndrome X, which I sorta like.  Oh, the mystery!]  One in six Americans have the syndrome.  Diagnosis requires at least three of the following five conditions:

  • High blood pressure (130/85 or higher, or using a high blood pressure medication)
  • Low HDL cholesterol:  under 40 mg/dl in a man, under 50 in a women (or either sex taking a cholesterol-lowering drug)
  • Triglycerides over 150 mg/dl (or taking a cholesterol-lowering drug)
  • Abdominal fat:  waist circumference 40 inches or greater in a man, 35 inches or greater in a woman
  • Fasting blood glucose over 100 mg/dl

The scientific study at hand is part of the PREDIMED study being conducted in Spain.  For this portion of the study, 1,224 participants at high risk for cardiovascular disease were randomized to follow a 1) low-fat diet (considered the control group), 2) Mediterranean diet plus 1 liter virgin olive oil per week, or 3) Mediterranean diet plus 30 gm daily of mixed nuts.

Note that the nuts used in this study were walnuts, almonds, and hazelnuts.  Half of all nuts were walnuts; a quarter of the nuts were almonds and a quarter were hazelnuts.

Participants were 55-80 years old, and 61% had metabolic syndrome at baseline.  Participants could eat all they wanted, and there was no increase in physical activity for any of the groups.  Participants were given instructions at baseline and quarterly.

After one year of intervention, the prevalence of metabolic syndrome  was reduced by 14% in the Mediterranean diet plus nuts group compared to the control, low-fat diet group.  The Mediterranean diet plus extra olive oil group reduced prevalence of metabolic syndrome by 7%, but this did not reach statistical significance (P=0.18).

New cases of metabolic syndrome continued to develop at about the same rate in all three groups.  I.e., incident rates were not significantly different.  So, the lower prevalence of metabolic syndrome after one year reflected reversion or clearing of the syndrome in many people who had it at baseline.  Compared to the control group, people in the nutty group were 70% more likely to resolve their metabolic syndrome.  Individuals in the oily group were 30% more likely than controls to resolve the condition.

[Feel free to consult a dictionary for definitions of “prevalence” and “incidence.”]

The researchers conclude that:

A traditional Mediterranean diet enriched with nuts could be a useful tool in the management of the metabolic syndrome. 

My Comments:

Thirty grams (daily) of nuts is a decent-sized snack of about 180 calories.  Thirty grams of almonds formed a heap in the palm of my hand, not touching my fingers.  This is more than the “two tablespoons” reported by December 9.

If you have metabolic syndrome, you might want to try reversing it with all the usual methods (e.g., lose excess fat weight, exercise more) along with a traditional Mediterranean diet enriched with 30 gm of mixed nuts daily.  As usual, check with your personal healthcare provider first.  Be aware that many of them won’t know about this study.

The puzzling thing to me is:  If the Mediterranean diet plus extra nuts is so effective in reversing metabolic syndrome, why didn’t that study cohort see fewer new cases of metabolic syndrome?

Steve Parker, M.D., author of The Advanced Mediterranean Diet

Additional reference:  Salas-Salvado, Jordi, et al.  Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status: One-Year Results of the PREDIMED Randomized Trial.  Archives of Internal Medicine, 168 (2008): 2,449-2,458.


Filed under Causes of Diabetes, Mediterranean Diet

4 responses to “Mediterranean Diet + Nuts = Reversal of Metabolic Syndrome

  1. Pingback: For The Love of Food | Summer Tomato - Upgrade Your Healthstyle | Healthy Eating Tips

  2. Cindy

    Interesting… this dovetails nicely with the DASH diet studies. The small amount of nuts every day is there to up the levels of magnesium, which when coupled with the appropriate amounts of potassium and calcium help lower blood pressure, one of the indicators of metabolic syndrome.

    One thing leaves me mightily perplexed, though. The study had one group that consumed 1 liter of olive oil per week?? That works out to 9.5 tablespoons (143 mL) per day, or 1143 calories per day from olive oil. That seems pretty over the top…

    • Hi, Cindy. Thanks for your comments. That olive oil allotment caught my attention, too. If memory serves me well, that olive oil was sent home with study participants to be shared among all household members, only one of which was likely to be enrolled in the study. So the oil would be split among 3-6 (?) people.


  3. Cindy

    Thanks for your reply, Steve (& love the boar!). Sharing that amount amongst family would make a whole lot more sense. 🙂