Participants will consume two ounces per day (57 g) of pistachios as an evening snack (i.e., after dinner and before sleep).

Advice to consume a snack that contains 1-2 exchanges (15-30 g of carbohydrate) as an evening snack - this is consistent with the current standard of care for people with impaired fasting glucose.

Type 2 Diabetes

Cardiovascular Diseases

Pistachio

Usual care

Pennsylvania State University

Pistachios Blood Sugar Control, Heart and Gut Health

The Effect of Pistachios on Risk Factors for Cardiometabolic Disease in Individuals With Pre-diabetes: a Randomized, Cross-over Study

fasting blood glucose assessed by blood draw and expressed in mg/dL

HbA1c assessed by blood draw and expressed in micro IU/mL

fasting serum insulin levels assessed by blood draw and expressed in micro IU/mL

Blood pressure measured assessed using a SphymoCor Ecel (Atcor Medical).

A measure of arterial stiffness assessed using a SphymoCor Ecel (Atcor Medical). A higher percentage value is indicative of greater arterial stiffness.

Assessed using fasting blood draw and standardized HOMA-IR calculation. Fasting plasma glucose multiplied by fasting plasma insulin divided by 405.

Assessed using calibrated scale in Clinical Research Center

Assessed using the Healthy Eating Index 2015

microbiome composition assessed using fecal collection kit

Penny

Distinguished Professor of Nutrition

Penn State University

Participants will consume a test meal containing white bread (dose: 50g available carbohydrate) at three study visits.

Participants will consume a test meal containing one variety of dried fruit (dose: 50g available carbohydrate) per visit for four visits. Varieties include raisins, sultanas, dates, and apricots.

Participants will consume a test meal containing white bread (dose: 50g available carbohydrate) and one variety of dried fruit (dose: 7g fructose) per visit for four visits. Varieties of dried fruit include: raisins, sultanas, dates, and apricots.

Participants will consume a test meal containing white bread (dose: 25g available carbohydrate) and one variety of dried fruit (dose: 25g available carbohydrate) per visit for four visits. Varieties of dried fruit include: raisins, sultanas, dates, and apricots.

PreDiabetes

Diabetes Mellitus

Dysglycemia

A randomized multiple-crossover acute-feeding trial design. Each participant will act as their own control receiving the treatments in random order, each separated by a 1 day washout period.

White Bread (Control)

Dried Fruit - Glycemic Index

Catalytic Fructose Dose Effect

High GI Displacement Effect

GI Labs

Dried Fruit and Postprandial Glycemia Trial

Dried Fruit as a Means for Lowering the Glycemic Response to High Glycemic Index-carbohydrate Foods

John Sievenpiper

Associate Professor, Staff Physician, Scientist

University of Toronto

International Nut and Dried Fruit Council (INC)

The National Dried Fruit Trade Association (NDFTA)

Glycemia Consulting Inc.

Body Weight

Obesity

Overweight

Adiposity

Obesity, Abdominal

An intervention in which tree nuts and/or peanuts are included in the diet

Dietary tree nuts & peanuts

The Toronto 3D (Diet, Digestive tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital

Meta-analyses of Nuts and Risk of Obesity

Nuts in Relation to Markers of Adiposity, Overweight, and Obesity: A Series of Systematic Reviews and Meta-analyses of Randomized Controlled Trials and Prospective Cohort Studies

Associate Professor

The Physicians' Services Incorporated Foundation

Diabetes

Prediabetes

Dyslipidemia

Hypertension

Metabolic Syndrome

Almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios and walnuts in whole, meal, or flour form

Tree nuts

The Toronto 3D (Diet, Digestive tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Micheal's Hospital

Meta-analyses of the Effect of Tree Nuts on Glycemic Control and Features of the Metabolic Syndrome

Effect of Tree Nuts on Glycemic Control and Features of the Metabolic Syndrome: A Systematic Review and Meta-analysis of Controlled Dietary Trials to Provide Evidence-based Guidance for Nutrition Guidelines Development

Glycated blood proteins (HbA1c, total glycated hemoglobin, fructosamine, glycated albumin), fasting glucose, fasting insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR)

Harmonized metabolic syndrome diagnostic measures (waist circumference, TG, HDL-C, blood pressure, fasting glucose)

pistacia/carbohydrate

Pistachios Blood Sugar Control, Heart and Gut Health

Dried Fruit and Postprandial Glycemia Trial

Meta-analyses of Nuts and Risk of Obesity

Meta-analyses of the Effect of Tree Nuts on Glycemic Control and Features of the Metabolic Syndrome

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