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Results:

The walnut group consumed significantly more PUFA than the control (P= 0.035), an outcome attributed to walnut consumption (contributing 67% dietary PUFA at 12 months). Most of the effects were seen in the first 3 months. Despite being on weight maintenance diets, both groups sustained a 1–2 kg weight loss, with no difference between groups (P= 0.680). Both groups showed improvements in all clinical parameters with significant time effects (P< 0.004), bar triacylglycerol levels, but these were just above normal to begin with. The walnut group produced significantly greater reductions in fasting insulin levels (P= 0.046), an effect seen largely in the first 3 months.

Conclusions:

Dietary fat can be manipulated with whole foods such as walnuts, producing reductions in fasting insulin levels. Long-term effects are also apparent but subject to fluctuations in dietary intake if not of the disease process.