*4.5. Body Mass Index (BMI) (Kg/m2)*

Chen et al. [31] did not find any significant effect of the almond-based diet with respect to body weight and BMI. In contrast, Cohen et al. [32] found that chronic almond ingestion resulted in a 4% reduction in BMI compared with control (*p* = 0.047). Six studies contributed to the results of the analysis for BMI (almond gp, *n* = 105; control gp, *n* = 105).

The meta-analysis showed that the BMI was significantly lower (*p* < 0.05) in the almond group compared with the control group (Figure 5), with a mean difference of −0.36 (95% CI: −0.52, −0.19). The results of the sensitivity analysis showed consistency in terms of the significant difference between the almond group and the control group, except when the Hou et al. [6] study was removed.


**Figure 3.** The effect of almonds on (**a**) glycated haemoglobin (Hba1c, %), (**b**) Hba1c (%)—subgroup analysis; (**c**) fasting blood glucose (mmol/L); (**d**) 2 h postprandial blood glucose (mmol/L).

(**b**)

**Figure 4.** The effect of almonds on (**a**) C-reactive protein (mg/L) and (**b**) tumour necrosis factor–α (pg/mL).

**Figure 5.** The effect of almonds on body mass index (Kg/m2).

#### *4.6. Homeostatic Model Assessment of Insulin Resistance (HOMA–IR)*

According to Chen et al. [31], the almond-based diet did not show a significant effect with respect to HOMA-IR compared with control.

Three studies contributed data for HOMA-IR meta-analysis (almond gp, *n* = 63; control gp, *n* = 63) and the difference between the almond and control groups was not significant (*p* > 0.05) (Figure 6). The mean difference was −0.41 (95% CI: −1.32, 0.50). The sensitivity analysis did not change the results between the almond group and the control group (*p* > 0.05) in respect of HOMA–IR.


**Figure 6.** The effect of almond on HOMAR–IR.
