Randomised trial · Nutrients · 2020Conflicts declared

Almond-based low-carb diet, depression and blood sugar in type 2 diabetes

What it found

In people with type 2 diabetes, a diet that replaced some staple food with almonds improved depression scores and long-term blood sugar more than a low-fat diet over 3 months.

The almond diet also changed gut bacteria and kept a gut hormone higher.

What they found

Studies in people

Depression

The almond diet group had a significant drop in depression score after 3 months, while the low-fat diet group did not. The almond group's score was significantly lower than the low-fat group's at the end.

Blood sugar control

Both groups improved their HbA1c, but the almond diet group had a bigger drop than the low-fat group after 3 months.

Gut bacteria

The almond diet increased certain short-chain fatty acid-producing bacteria (Roseburia, Ruminococcus, Eubacterium) compared to the low-fat diet or to baseline. It also decreased Bacteroidetes and Bacteroides.

GLP-1 hormone

After 3 months, the almond diet group had higher fasting GLP-1 levels than the low-fat diet group, though neither group changed significantly from their own baseline.

Weight and BMI

Weight and BMI improved significantly within the almond diet group over 3 months, but there was no significant difference between the two groups at the end.

What the authors conclude

“A-LCD could exert a beneficial effect on depression and glycometabolism in patients with T2DM.”
Ren M, Zhang H, Qi J, et al, 2020

Also in their conclusions

  • They conclude that an almond-based low-carb diet may be an effective intervention for improving both depression and blood sugar control in patients with type 2 diabetes.
  • They speculate that the improvement in depression may be linked to the diet stimulating growth of short-chain fatty acid-producing bacteria, increasing short-chain fatty acids and GPR43 activation, and maintaining GLP-1 secretion.
  • They advise that future studies should further examine short-chain fatty acids and GPR43 activation.

How it was done

The authors wanted to find a diet that helps both depression and blood sugar in people with type 2 diabetes, since most diets focus only on blood sugar. Almonds had shown promise for both.

They randomly assigned 45 people with type 2 diabetes to either an almond-based low-carb diet (56 g almonds per day replacing 150 g staple food) or a low-fat diet for 3 months. Depression scores, HbA1c, gut bacteria and GLP-1 were measured at the start and after 3 months.

What it can’t tell you

  • The study included people with type 2 diabetes both with and without depression, so the findings may not apply to those with clinical depression.
  • Depression was not monitored continuously, so the earliest time point for improvement is unknown.
  • The study did not measure short-chain fatty acids or GPR43 activation, so the proposed mechanism is speculative.

The paper

Title
An Almond-Based Low Carbohydrate Diet Improves Depression and Glycometabolism in Patients with Type 2 Diabetes through Modulating Gut Microbiota and GLP-1: A Randomized Controlled Trial
Type
Randomised controlled trial
Evidence
Studies in people
Summarised from
Full text
Cite
Ren M, Zhang H, Qi J, et al (2020). An Almond-Based Low Carbohydrate Diet Improves Depression and Glycometabolism in Patients with Type 2 Diabetes through Modulating Gut Microbiota and GLP-1: A Randomized Controlled Trial. Nutrients. doi:10.3390/nu12103036Free full textPubMed 33022991DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error