INS and metabolic syndrome: In a randomized parallel intervention in subjects with the metabolic syndrome comparing a 12-week healthy diet supplemented with 30 g/day mixed nuts (15 g walnuts, 7.5 g almonds and 7.5 g hazelnuts) with a healthy diet without nuts [118,119,120,121], a healthy diet with added nuts significantly increased walnut ellagitannin-derived urolithins A and B in urine [118,119], significantly improved fasting insulin, insulin sensitivity assessed by HOMA-IR, and IL-6 and significantly decreased DNA damage assessed by urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine (a measure of oxidative stress) [121].