The power of almonds to improve cardiometabolic health

Almonds have been an important part of Indian culture and traditions for millennia. Recent clinical research indicates that incorporating almonds into one's daily diet can improve diet quality and yield health benefits. The recent dietary guidelines by the Indian Council of Medical Research (ICMR), released in May 2024, endorse regular consumption of nuts as part of a healthy diet. They highlight almonds as a valuable source of plant protein and a nutritious snack rich in healthy fats, fibre, essential vitamins, and minerals.

The majority of the non-communicable disease burden in India is due to unhealthy diets. Improving diet quality through nutritional strategies like incorporating almonds into an overall healthy diet is critical to improve overall well-being and reduce risk of diet-related chronic diseases.

The prevalence of elevated blood sugar levels in India is alarmingly high, with mounting evidence indicating that the Indian population exhibits higher levels of insulin resistance and a stronger genetic predisposition to diabetes than western populations. A study conducted by the ICMR in 2023 revealed that 1.4% of India’s population, or 101 million people, are living with diabetes. Additionally, 15.3% of the population, or another 136 million people, are pre-diabetic.

The Indian population also faces a heightened risk of progressing from pre-diabetes to type 2 diabetes. It has been observed that postprandial hyperglycemia—a condition characterised by a rapid increase in glucose levels after consuming a meal—is common in the Indian population, even among those who do not have diabetes. Research has further shown that diabetes is more prevalent among senior citizens in urban areas. With India’s elderly population set to comprise 20% of the country’s total population by 2050, managing this condition remains a critical public health issue.

The nutrient profile of almonds—including slow-digesting fibre, plant protein, good monounsaturated fat, no sugar and essential nutrients such as magnesium, potassium, and vitamin E— make almonds an ideal snack choice for those aiming to control blood sugar.

Two recent research studies conducted by my research group at the National Diabetes, Obesity, and Cholesterol Foundation (NDOC) in New Delhi demonstrated that consuming a small handful of almonds three times per day before major meals (“premeal load”) significantly improved blood sugar control among Asian Indians with prediabetes and overweight/obesity in both the short term (over three days) and longer term (over three months). Remarkably, the three-month almond intervention reversed prediabetes, or glucose intolerance, to normal blood sugar levels in nearly one-quarter (23.3%) of the participants. These promising findings highlight the potential of almonds as a dietary strategy for preventing and managing diabetes in India.

In addition to having an elevated diabetes risk, Indians also have a 20–50 percent higher mortality rate from coronary artery disease (CAD) than other populations, due to a combination of factors, including genetic predisposition. Research has also shown that daily almond snacking may be effective in improving heart health and reducing risk of cardiovascular disease by reducing low-density lipoprotein (LDL) cholesterol while maintaining high-density lipoprotein (HDL) cholesterol, which is crucial for maintaining good heart health. Multiple clinical studies have also shown that almonds can aid in weight management and can be a helpful addition to calorie-restricted weight loss diets.

Incorporating almonds into daily meals and snacks is a simple yet effective way to enhance nutrition in our diets, a sentiment increasingly shared by a growing portion of the population. Almonds were also recognised as the most preferred healthy snacking option by respondents.

The ICMR guidelines recommend swapping deep-fried snacks with nuts. Aside from being consumed as a standalone snack, almonds can be added to a morning bowl of breakfast oats, mixed into salads for extra crunch and nutrition, or consumed in butter or milk form, which is especially useful as a dairy substitute for vegans. It is important that almonds should be included within the prescribed calorie requirement of any individual and within otherwise healthy diets. Their adaptability in culinary applications—from traditional Indian sweets to savoury dishes—makes almonds an easy and convenient addition to any diet. Embracing almonds as part of a balanced diet can pave the way for a healthier, more resilient population, offering a practical solution for managing and preventing diseases through healthy diets.

This article is authored by Dr Anoop Misra, chairman, National Diabetes Obesity and Cholesterol Foundation.