Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Walnuts on Endothelial Function in Overweight Adults With at Least One Factor of Metabolic Syndrome: A Randomized, Controlled, Cross-Over Trial
Brief Summary: The purpose of this study is to examine the effects of walnut consumption on endothelial function and lipid markers in overweight patients with at least one factor of metabolic syndrome as compared to the control group.


Options:
A: Inclusion Criteria:

* BMI less than 35 kg/m2.
* Fasting plasma glucose levels between 100 and 125 mg/dl or
* Oral glucose tolerance test of 140 to 199 mg/dl.

Exclusion Criteria:

* Diabetes mellitus.
* Alcohol, tobacco, or drug abuse.
* Significant liver, kidney, thyroid, or other endocrine diseases.
* Frequent consumption of nuts or known history of allergy to them.
* Use of plant sterol, oral antidiabetic drugs, supplemental use of phyllium, fish oil supplements and multivitamins, vitamin E or other antioxidant supplements.
* Bad dentures, implying difficulty to chew pistachios.
* Being pregnant or wishing to become a pregnant 6 months before or during the study, lactating 6wk before or during the study.
* Following vegetarian or weight loss diets.
* Other medical or social conditions that difficult the compliance to the intervention.
B: Inclusion Criteria:

* Presence of a medical diagnosis of diabetes for at least 6 months
* HbA1c \< 9%
* Age greater than 18 years
* Resident of Loma Linda, California area

Exclusion Criteria:

* Allergy to peanuts
* Smokers
* History of irritable bowel disease or diverticulitis
* Statin therapy (unless stable statin dose for 3 months)
C: Inclusion Criteria:

* Male and female age 25-75 years
* Non-smoker
* Overweight (BMI ≥ 25) with central adiposity as indicated by waist circumference (102 cm. in men / 88 cm. in women)
* Meet one risk factor of the metabolic syndrome.

  * blood pressure \> 130/85 or taking antihypertensive medication

    * fasting plasma glucose (FPG) \>100 mg/dL (6.1 mmol/L)
    * fasting serum triglycerides level (TG) \> 150 mg/dL (1.69 mmol/L)
    * fasting high-density lipoprotein (HDL) cholesterol \< 40 mg/dL (1.04 mmol/L)in men, and \< 50 mg/dL (1.29 mmol/L) in women.

Exclusion Criteria:

* Anticipated inability to complete or comply with study protocol
* Use of lipid-lowering or antihypertensive medications or aspirin unless stable on medication for at least 3 months and willing to refrain from taking medication for 12 hours prior to EF scanning
* Preexisting cardiovascular disease (including symptomatic coronary artery disease (CAD), myocardial infarction, angina pectoris, anginal equivalent, peripheral vascular disease, congestive heart failure, carotid stenosis)
* Severe hypertension (systolic blood pressure \>180mmHg or diastolic blood pressure \>105mmHg), even if well-controlled by medication.
* Diagnosed diabetes mellitus
* Regular use of multivitamins, Vitamin C, Vitamin E, fish oil, flax seed oil, omega-3 fatty acids, CoQ10, fiber supplements, garlic pills, arginine, red yeast rice, and any kind of antioxidant and unwillingness to discontinue supplementation for at least 4 weeks prior to study initiation and for study duration
* Allergic to walnuts or any other nuts
* Diagnosed eating disorder
* On any specific diet, weight control diet, vegan diet
* Any rheumatologic disease requiring regular use of NSAIDs or alternative medications
* Regular use of fiber supplements
* Regular use of vasoactive medication (including glucocorticoids, antineoplastic agents, psychoactive agents, or bronchodilators), and anticoagulant drugs (including Coumadin, plavix )
* Diagnosed sleep apnea
* Substance abuse (chronic alcoholism, other chemical dependency)
* Any unstable medical condition that would limit the ability of a subject to participate fully in the trial (e.g., cancer, AIDS, tuberculosis, psychotic disorder)
* Current or impending pregnancy
D: Inclusion Criteria:

* Type 2 diabetes
* Resident in Dunedin
* Aged \<70 years at the time of invitation to participate
* Most recent HbA1c level within the last 12 months ≥ 7%
* Currently prescribed oral tablets or insulin or both for glycaemic control AND three of the following: \*Any pre-existing cardiovascular disease defined as a past history of myocardial infarction, angina, peripheral vascular disease, cerebrovascular accident, transient ischaemic attack; \*Currently prescribed antihypertensive medication; \*Currently prescribed lipid modifying medication; \*Body mass index ≥25

Exclusion criteria:

* Terminal illness

Answer: C