Nutrition Meets Policy: Dr V Mohan Conducts A Clinical Trial That May Change The Handling Of Prediabetes In India

Pistachio trials are just a component on the huge researches in operation at the MDRF, which carries out important epidemiological surveys across India on diabetes, obesity, hypertension, and cardiovascular disorders.

A clinical trial by Dr V Mohan found that daily pistachio consumption improves metabolic health in prediabetic individuals, potentially changing diabetes management in India. One of India's most prominent diabetologists, he also doubles as one of the leading researchers, whose studies including a few landmark ones, were conducted at the Madras Diabetes Research Foundation (MDRF) under the sponsorship of the American Pistachio Growers.

The research, released recently in the Journal of Nutrition, a good reputable journal, unveils the role of pistachios in improving the metabolic health of prediabetic individuals-the very important study with implications that could change the way India manages its ever-growing diabetes load.

A unique study on prediabetes

This was one of the first clinical trials conducted just for pre-diabetic individuals. Earlier studies had almost always been conducted on either healthy populations or on those who had complete diabetes, thus leaving an important gap in intervention at the early stage. Dr Mohan states that this is the moment when intervention matters greatly because pre-diabetics are mostly not yet so-called medically treated, allowing for much cleaner dietary interventions to be tested. Randomized 120 pre-diabetic subjects were selected and 60 of them put into control groups with instructions to avoid nuts altogether. Another 60 went into the intervention group and were eating 30 grams of pistachios each in the morning and then afternoon.

Outcomes measured in the intervention and control groups were blood glucose levels, HbA1c or the three-month's average of blood sugar, lipid profiles, weight, waist circumference, and other metabolism-related parameters. Continuous glucose monitoring was also done to assess changes in blood sugar throughout a day. Surprisingly, without any weight gain regarded as expected with pistachios that have an array of calories, the intervention group noted weight reduction as well as waist circumference reduction, which means a lot from the Indian outlook where abdominal fat is very common. Triglyceride levels reduced while HDL or good cholesterol increased throughout the whole lipid profile. HbA1c dropped marginally by 0.2% which is a big deal for a lot of subjects going through pre-diabetic stages. Improvements were also noted in post-prandial glucose, thereby giving a concrete stand for cardiometabolic effects.

Compliance levels were high with zero side effects

Could the participants really adhere to this idea of eating nuts twice a day? The opposite seemed true as compliance was actually greater than expected. Compliance tracking included returning empty packets, phone calls, or even visits to the homes of subjects. A biochemical marker for pistachio consumption, MHP, was also used to verify adherence; it marked a 62% rise in the intervention group being studied. More than 90 to 95% were actually consuming pistachios on a daily basis. Equally important is that there were no side effects. Despite being very high in fiber and protein, they did not cause any kind of abdominal discomfort, bloating, or flatulence. Dr Mohan feels the good tolerability was noticed for the current dose of 30 grams twice daily.

Attractive potential for rural India

Though it is not really a replacement for medical treatment, pistachios certainly can be taken into consideration in improving dietary patterns in urban and rural India. Dr Mohan explains that the Indian diet is grossly carb-heavy-ranging from rice being considered the major culprit in the South and East to excessive consumption of wheat by the North and West. The downstream consequences are abdominal fat, insulin resistance, and weight gain. Healthy fats and plant proteins like in pistachios can go some way towards halting this downhill spiral. Nuts suppress hunger; therefore, pistachio snackers tend to eat slightly less rice or wheat in their succeeding main meal. Although this was a short-term study, its indication is that in the long run, pistachios could help delay or prevent outright diabetes.

When to eat pistachios

No hard and fast rule, but Dr Mohan claims based on experience that pistachios are best consumed mid-morning and in the evening-traits that occur about an hour before a main meal. This curbs hunger pangs so you don't consume a large lunch or dinner. Rather than reaching out for some unprocessed snacks such as biscuits or samosas, spritzing nuts seem to form a perfect union to fit within one's daily lifestyle.

Advice for families with history of diabetes

Doctor Mohan is quite straightforward: think about the plate differently. Typically, for Indian families, meals comprise refined carbohydrates such as rice and wheat. Instead, vegetables-such as leafy ones, should take half the plate; the other half should be split-between a quarter for proteins such as pistachios, lentils, or Bengal gram, and another quarter for carbs in reasonable quantities. This means, consuming pistachios approximately an hour ahead of the meal, which will help reduce carb intake but keep one from feeling hungry. This is somewhat similar to the Mediterranean diet; it is the very few diets long advocated for heart benefits. Calling it the "Indian Mediterranean Diet," Dr Mohan said. Nuts, once disregarded for their calorie content, now get applauded by nutritionists for many health benefits and should be part of one's daily diet.

MDRF research on whose shoulders currently rests

Pistachio trials are just a component on the huge researches in operation at the MDRF. The foundation carries out important epidemiological surveys across India on diabetes, obesity, hypertension, and cardiovascular disorders. Then there is genomic research with a special focus on one or another rare form of diabetes like neonatal diabetes in newborns because quite a few of these can be treated by simple genetic tests, which would technically fix their lives by whatever means necessary, including avoiding insulin. In terms of nutrition, they are developing ready-to-eat diabetic-friendly snacks. They are also committed to the development of digital health tools encompassing mobile apps, AI-driven programs, and community-based prevention models that will fit together with long-term diabetes care.

International funding and collaborations

The study was funded by the American Pistachio Growers (APG) and hosted by the Madras Diabetes Research Foundation. Dr V. Mohan, Dr Anjana Mohan, Ms. Sudha, and the food and nutrition team at MDRF actually did lead the work. Additionally, this study was done together with Harvard T.H. Chan School of Public Health where world leaders in nutrition science, Professors Shilpa Bhupathiraju, Walter Willett, and Frank Hu played contributing roles. Working very closely with the design and publication of this study, Professor Jordi Salas of Spain ranks as one of the world's top investigators on nuts.

The next step

Building on the very promising early results, the team from MDRF is deep into data analysis and planning for long-term follow up. The same team is aiming to implement long-duration protocols for a six- to twelve-month interval to confirm artisanal prevention of diabetes in pre-diabetics through consumption of pistachios. Another area they would want to look into would be the biological mechanisms of the benefits, more precisely, how pistachios interact with gut microbiota. Whatever turns up, it depends on whether it is the right time for a secured grant to take the research further, but this mark evidence at hand is giant steps in merging nutrition science into India's public health approach to diabetes prevention.

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