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Dietitians advised the two groups on the Mediterranean diet to use olive oil for cooking; increase fruit, vegetable and fish consumption; eat white meat instead of beef or processed meat; and prepare homemade tomato sauce with garlic, onions and herbs. Drinkers were told to stick with red wine.
After one year, all three groups had fewer people with metabolic syndrome, but the group eating nuts led the improvement, now with 52 percent having those heart risk factors. In the olive oil group, 57 percent had the syndrome. In the low-fat group, there was very little difference after a year in the percentage of people with the syndrome.
The nut-rich diet didn't do much to improve high blood sugar, but the large number of people with Type 2 diabetes -- about 46 percent of participants -- could be the reason, Salas-Salvado said. It's difficult to get diabetics' blood sugar down with lifestyle changes alone, he said.
To verify that study volunteers ate their nuts, researchers gave some of them a blood test for alpha-linolenic acid found in walnuts.
The study was funded by the Spanish Ministry of Health and the government of Valencia, Spain.
Salas-Salvado and another co-author disclosed in the publication that they are unpaid advisers to nut industry groups. Salas-Salvado said all of their research "has been conducted under standard ethical and scientific rules" and that peer-review journal editors determined the study results were not influenced by food industry ties.
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