Moreover, in the Coronary Artery Risk Development in Young Adults (CARDIA) study with 20 years of follow-up, a prudent dietary pattern (including nuts) was associated with a reduced risk of MetS and hypertension, hyperglycemia and dyslipidemia, compared to a Western dietary pattern [29]; these findings are supported by those of a randomized clinical trial in which consuming one serving/day of nuts (15 g walnuts, 7.5 g almonds, or 7.5 g hazelnuts) improved insulin sensitivity among participants with MetS [11]. Here, INS is linked to metabolic syndrome.