31-OR: Almond Milk Has No Additional Benefits over 2% Milk on Postprandial Glycemia, Lipidemia, and Gastrointestinal Hormones in Patients with Type 2 Diabetes

Almond milk is often used in lieu of dairy milk with the perception of being a healthier substitute, however, its effect on postprandial glycemia compared to 2% milk is not understood. In this study, we compared the 4-hour postprandial effects of almond milk versus carbohydrate- or caloric-matched 2% milk, each served with a similar amount of oatmeal in patients with T2D. In this cross-over, three-way, open-label study, 22 overweight or obese patients with T2D consumed ½ cup (40 g) of oatmeal served with 360 mL almond milk (ALM) or carbohydrate-matched (246 ml) 2% milk (CarbM) or calorie-matched (182 ml) 2% milk, on separate days, in random order. The primary outcome was glucose incremental area under the curve (iAUC 0-240) while changes in other analytes were secondary outcomes. Blood samples for glucose, free fatty acids (FFA) , gastrointestinal (GI) satiety and hunger hormones were drawn at baseline, 15, 30, 60, 90, 120, 180 and 240 minutes. Incremental AUCs were compared between groups using Wilcoxon signed rank test. P-values for analytes other than glucose were adjusted with the false discovery rate (FDR) . P<5% for glucose or FDR<5% were considered significant. There were no differences in iAUC 0-240 for glucose, triglycerides, PYY, active GLP-1 or amylin, leptin, GIP, cholecystokinin, ghrelin or FFA in any pair-wise comparison. However, iAUC 0-240 for insulin and glucagon were significantly higher in CarbM vs. ALM (FDR 0.002 and 0.02 respectively) .

In conclusion, compared to almond milk used with oatmeal, carbohydrate- or caloric-matched 2% milk has similar effects on postprandial glucose, FFA, triglycerides and GI hormones for up to 4 hrs, indicating no additional benefits of almond milk over 2% milk. On the contrary, carbohydrate-matched 2% milk increased insulin and glucagon secretion compared to almond milk. The long-term significance of this increase in insulin release needs to be further elaborated in a long-term study.