Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials

An enhanced risk for cardiovascular disease (CVD) still exists even when T2DM patients have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, our objective was to investigate the effect of almond on cardiometabolic outcomes in patients with T2DM through a systematic review and meta‐analysis of available randomized controlled trials (RCTs). A systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and Google Scholar to identify relevant RCTs up to March 2021. There was no language and time limitation. Weighted mean difference (WMD) was pooled using a random effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Nine RCTs were included in the final analysis. Almond intake resulted in significant reduction in low‐density lipoprotein cholesterol (LDL‐C) (WMD: −5.28 mg/dL; 95% CI, −9.92, −0.64; p = .026) compared with the control group. This lowering effect of LDL‐C was robust in subgroups with almond consumption >50 g/day, and baseline LDL‐C level