Raisins (dried grapes), fall into the traditional dried fruit category as they typically contain no added sugar.1 Raisins constituted the largest global production of a single dried fruit category at 1,234,000 metric tons (MT) in 2015/2016; 296,000 metric tons were produced by the United States, constituting 25% of global production, Turkey produced 196,000 MT, and China and Iran each produced 165,000 MT.2 Raisin production is expected to be 1.25 million MT in the 2016/17 season. In 2015 raisin supply also had the highest global value of the traditional dried fruits (dates, prunes, dried figs, and dried apricots) at 2,776 million United States Dollars. Worldwide consumption of raisins in 2016/2017 is expected to be 1.23 million tons.3

Several recent papers have reviewed various nutritional and metabolic aspects of raisins. A 2013 review article by Anderson et al.4 found that raisins reduce glycemia, insulinemia and CVD risk factors. The synergistic effect of raisins and nuts on human health has also been studied. Carughi et al.5 found numerous health benefits when consuming both raisins and nuts together. Restani's6 2016 review found support for “the suitability of raisins as a source of healthy compounds for human diet”.

In 2011, Bell reviewed the effects of dietary fiber, specifically the fiber found in raisins, on CVD risk, T2DM, cancer, non-cancer bowel disease, and general bowel health. Bell noted that raisins “consumed as a part of a nutrient-dense healthy diet, helped reduce CVD risk”.7 Kundu et al. conducted a review of the cancer chemoprevention effects of dried fruits and found the antioxidant and anti-inflammatory effects of raisins promising.8 This paper provides a comprehensive review of raisins and human health.

A literature review was conducted in Medline using the following descriptors: raisins, raisins and health, raisins and CVD, raisins and cancer, raisins and diabetes, raisins and fiber, raisins and colon health, raisins and antioxidants, raisins and inflammation, raisins and dental caries. The archives of the California Raisin Marketing Board were also reviewed. References in previously published raisin review articles were also reviewed for research on raisins.

The current US recommendation for Adequate Intake of dietary fiber is 38 g for males and 21 g for females (age ≥ 19 years) or 14 g/1,000 calories consumed,34 and the Korean Adequate Intake for dietary fiber is 12 g/1,000 calories consumed.35 Current average per capita consumption of dietary fiber in Korean is 12.24 g/1,000 kcals for adults.36 2005~2006 National Health and Nutrition Examination Survey (NHANES) data shows that average daily consumption of dietary fiber in the United States is 17.6 g and 13.7 g per day for males and females (age ≥ 19 years) respectively.37 Average daily consumption of fiber in certain Korean population groups and for the average US adult falls short of the recommendations.

Dried fruit and raisins are good sources of dietary fiber. When the Association of Official Analytical Chemists (AOAC) Analysis Method 2009.01 analytical method was used to determine the fiber content of raisin, which included some of the fermentable fibers, one serving of raisins contained 10% of the FDA's daily recommended fiber.38 The current FDA guidelines for listing fiber on the nutrition facts label does not include inulin and soluble fibers, so one serving of raisins (43 g) contains 1.6 g or 6% of Daily Value for fiber.39

In 2003 Camire and Dougherty40 assessed the dietary fiber composition per 100 g of three types of raisins. Soluble fiber composition was 1.42, 1.52, and 1.76, insoluble fiber composition was 3.63, 3.85, and 3.29, and total fiber composition was 5.05, 5.37 and 5.05, for natural sun-dried (SDR), artificially dried (dipped), and sulfur dioxide treated (golden) raisins g/100 g, respectively.40

Spiller et al.41 evaluated the effect of dietary fiber from sun-dried raisins on colonic function, bile acid content, and volatile fatty excretion in healthy adults in a crossover design study. For nine weeks, thirteen healthy subjects were daily fed 120 g of sun-dried raisins or 5 g of cream of tartar, which is equal to the tartaric acid content in raisins. Intestinal transit time was 42 hours on the baseline diet, 31 hours on cream of tartar diet, and 28 hours on the sun-dried raisin diet (p > 0.05). Sun-dried raisins increased fecal wt. (p < 0.05), with no change seen with the cream of tartar diet. Total bile acid concentration decreased from 1.42 to 1.09 mg per day with sun-dried raisins (p < 0.05), while no change was seen with cream of tartar subjects. Total short chain fatty acid excretion measures increased from 5.6 to 7.6 g for 4 days with sun-dried raisin diet.41

Another study also by Spiller et al.42 assessed the effect of SDR on intestinal transit time. Sixteen healthy adults were studied in three cycles of two weeks each. Subjects consumed 84, 126, or 168 g of SDR per day. Fecal weight increased from 168 g +/-14 g per day without raisins at baseline to 200 g +/-24 g per day with consumption of 168 g per day of raisins. Transit time decreased from 54 +/-6 hours without raisins to 42 +/-6 hours with consumption of 168 g of raisins.42

Although fructans are not included in the FDA definition of fiber,43 raisins are a good source providing over 5 g of fructans per 100 g. Fructans, not found in grapes, are created through the drying process of producing raisins.40 Fructans have been shown to improve gut microflora by increasing bifidobacteria and lactobacilli and possibly decreasing CVD risk through reduction of triglyceride and cholesterol levels.44

Mandalari et al.45 assessed the effect of SDR on in vitro composition of gut microbiota using a full model of a human gastrointestinal tract which included simulated mastication and dynamic gastric, duodenal and colonic models. They assessed bacterial counts at 0, 4, 8, and 24 hours after the addition of either raisins or fructooligosaccharides compared to a control. At 24 hours the beneficial lactobacilli bacteria increased in the raisin and fructo-oligosaccharides (FOS) conditions. Final counts of lactobacilli at 24 hours of fermentation were 2.24 × 10⁷ colony forming units (CFUs) lactobacilli per ml^-1 for the control, 1.51 × 10⁸ CFUs lactobacilli for the SDR, and 1.86 × 10⁹ CFUs lactobacilli for the FOS.45

Wijayabahu et al.46 conducted a raisin feeding study in 13 adult subjects. Subjects consumed one ounce of raisins, three times a day for fourteen days; adherence to the study protocol was high. Fecal samples were collected at the beginning, middle and end of the study period and gut microbiota composition was assessed. A significant reduction in the potentially pathogenic, Klebsiella species was observed from baseline to day fourteen. These findings suggest that raisins may provide a potential benefit by reducing enteric inflammation.46

The American Diabetes Association defines diabetes/diabetes mellitus as “a group of diseases characterized by high blood glucose levels that result from defects in the body's ability to produce and/or use insulin”.47 Glycemic Index (GI) describes the effect of carbohydrate consumption on blood glucose levels.48 Although there isn't a standard serving size for raisins, 2 tablespoons of raisins is one (fruit) exchange in the diabetic exchange list. One exchange or serving of raisins is about 15 grams of carbohydrate and 60 calories.49

Esfahani et al.48 found the glycemic index for raisins was 49 based on the glucose scale. Previous reports of glycemic index for raisins have ranged from 49~64. This discrepancy may be due to the populations that were studied. Jenkins et al.50 first reported the GI of raisins to be 64 from a study with only six subjects.50 More recently a study by Kim et al.51 reported GI values of 49 in sedentary individuals, 49 in individuals with prediabetes and 55 in aerobically trained adults. Bell52 determined raisins to have a low to moderate GI based on the studies available, which at that time it was a reasonable assessment.52

To determine a standard GI reference for raisins, Esfahani et al.48 conducted a partial randomized, crossover design study using standard GI methodology (ISO 26642:2010; International Organization for Standardization). Subjects were four males, six females with a mean age of 39 (SD 11) years and an average BMI of 26.4 (SD 6.2) kg/m². Blood was drawn for each subject on four separate days over a period of 2~8 weeks after a 10~14 hour overnight fast. Participants were instructed to maintain stable dietary and activity habits throughout the study. Samples were collected via finger-stick blood at 15, 30, 45, 60, 90 and 120 min. The glycemic index was determined to be low at 49. The low GI may be partially explained by the fiber content and sucrose and fructose ratio, which may enhance hepatic glucose uptake,49 and the polyphenols, phenolic acid, tannins, antioxidants, flavonoids, and resveratrol content of raisins.1053

Oettlé et al.54 compared processed snack meals and whole-food snack meals in 10 healthy participants. The areas under the insulin curve were 68% higher after the candy-bar than after a raisin-peanut snack, 75% higher after a cola drink with crisps and 52% higher after a banana-peanut snack.54

Kanellos et al.55 analyzed the effect of raisin consumption on fasting glucose, glycated hemoglobin (HbA1_c), antioxidant status, and blood pressure in individuals with T2DM. Subjects were instructed to consume two fruit servings of raisins (36 g/d) in place of a snack with similar energy density. The comparator snack was not defined. A significant (p < 0.05) reduction was seen in diastolic blood pressure and an increase in total antioxidant potential in the raisin group compared with control. No significant differences were seen in fasting glucose or HbA1_c between the two groups.55

Bays et al.56 conducted a crossover design study of prediabetics at the Louisville Metabolic and Atherosclerotic Research Center (L-MARC) comparing the effect of raisin snacks to equal caloric refined grain snacks three times per day on CVD risk factors. There was a 36 mg/dL (23%) decrease in postprandial blood glucose, 32 mg/dL (19%) decrease in fasting glucose, and a 0.12% decrease in HbA1_c levels in the raisin group compared with the control. This study also showed improvements in systolic blood pressure.56 The reason for the partial incongruent findings between Bays56 and Kanellos55 might be the specificity of the comparator snack. Bays described the comparator snack to be a highly-refined carbohydrate and Kanellos did not give any description of the raisins replacement. If the raisins were substituted for a fruit snack a significant difference would not necessarily be expected.

The phytonutrients in raisins may protect against developing diabetes. In a study on T2DM and glycemic response to grapes or grape products, Zunino57 found that grapes and products derived from grapes may protect against inflammation related to T2DM. Resveratrol, quercetin, catechins and anthocyanins have potential for reducing hyperglycemia, improving pancreatic β-cell function and protecting against β-cell loss.57

According to the American Heart Association, heart disease describes a range of conditions that affect the heart and is often used interchangeably with the term cardiovascular disease (CVD).58 Polyphenols in raisins appear to reduce the absorption of cholesterol and also decrease plasma triglyceride concentrations .9

Puglisi 200833 found that consuming 1 cup raisins/day + increased walking produced a significant decrease in: systolic blood pressure (p = 0.008), plasma total cholesterol by 9.4% (p < 0.005), plasma LDL cholesterol, 13.7% (p < 0.001). This decrease in LDL cholesterol was explained by a significant (p < 0.001) increase in lipoprotein receptor messenger RNA abundance.59

Barnes et al.21 assessed the effect of raisins on oxidized LDL in subjects, (n = 32) that were randomly assigned into three groups and consumed either 2, 3.5, or 5.5 ounces of raisins per day for four weeks. Blood samples were drawn at baseline, 2, and 4 weeks, plasma antioxidant levels and circulating oxidized LDL levels were measured. Data were analyzed using the Tukey all pairwise comparison and Tukey-Kramer tests. Circulating oxidized LDL levels decreased significantly (p < 0.05) after 4 weeks with 3.5 oz. raisins/day and after 2 weeks with 5.5 oz. raisins/day.21

In animal model studies by Abdel-Hamid and Ayuob,60 raisins have shown a cardioprotective effect. Wister rats (n = 40) being fed a high cholesterol diet (HCD) were randomly divided into four groups (n = 10): control, raisinfed, HCD-fed and HCD +raisin fed group. At 13 weeks the animals were sacrificed, hearts were dissected and a histopathological examination and blood analysis was performed. Raisin administration with HCD significantly (p < 0.05) decreased low density lipoprotein levels from (86.59 ± 1.2 mg/dl to 34 ± 3.8 mg/dl) compared to the HCD alone. Blood glucose, insulin, cholesterol, and triglycerides all decreased significantly (p < 0.05) in the raisin+HCD compared to the HCD alone, while high density lipoprotein levels increased (18.4 ± 2.1, to 25.9 ± 1.3 mg/dl). Positive histological changes were also seen: decreased cardiomyocytes' degeneration, cellular infiltration, hemorrhages and blood vessels affection. Immunohistochemical findings were seen with the HCD+raisins: reduced fibrosis by decreasing the immunoexpression of alpha smooth muscle actin marker and significantly increased immuno-expression of endothelial nitric oxide synthase.60

A study by Anderson et al.61 conducted at the L-MARC compared the effect of consuming either 90 calories of raisins or an alternative high carbohydrate snack, three times per day, on cardiovascular risk factors in mildly hypercholesterolemic or hypertensive subjects. The CVD risk factors studied were systolic blood pressure, diastolic blood pressure and waist circumference. Of the risk factors studied, those that changed significantly from baseline to week 12 of the study were: systolic blood pressure [-4.8% to -7.2% (-6.0 to -10.2 mmHg)], and diastolic pressure [-2.5% to -6.4% (-2.4 to -5.2 mmHg)]. There was a non-significant (p > 0.05) decrease in waist circumference of 0.4% in the raisin group. This same study showed significant improvement in 2-hour postprandial glucose (-13 mg/dL) and HbA1c (-0.12%) in the raisin group. The difference in blood pressure may be partially explained by the large difference in potassium content between groups. Raisins and high carbohydrate snacks contained 220 mg and 23 mg per serving respectively.61

Bruce et al.62 assessed the effect of a high phytochemicalrich (HPC) diet including three 42 g boxes/d of raisins versus a refined-food diet on serum antioxidants and lipoproteins. In a direct crossover design study, women with hyperlipidemia (n = 12) consumed a refined diet for 4 weeks followed by the HPC diet. There was a decrease in serum lipids in the HPC diet, total cholesterol 13% (p < 0.05) and LDL cholesterol 16% (p < 0.001).62

Raisin consumption has been shown to improve athletic performance. Sacheck et al.63 compared the effect of three isocaloric snacks in 115 young soccer players (ages 9.01 ± 0.9) including: a raisin/nut bar, a peanut butter graham bar or a rice cereal bar. Following a 50 minute game of moderate to vigorous activity, the only difference subjects reported was more feelings of fatigue was associated with consuming the rice cereal (high sugar, low flavonoid) bar while results for the other two bars were not significantly different.63

Kern et al.64 compared the effect of commercial carbohydrate supplements and raisins on cycling performance. Forty-five minutes prior to exercise, participants (four males, four females) were randomly given a pre-determined amount (1 g carbohydrate per kilogram body weight) of either sports gels or raisins. Participants then completed a 45-minute constant intensity ride followed by a 15-minute performance ride. Researchers found no difference in performance between sports gels and raisins and concluded that sports gels and raisins produce equal work output.64

Endurance athletes have been known to use a wide variety of carbohydrate supplements like gels, shots, bars and chews. However, natural foods that are high in carbohydrate can offer the same benefits during sports performance as commercial carbohydrate supplements. Rietschier et al.65 studied the effects of sun-dried raisins and sports jelly beans as carbohydrate supplements during 10K time trials. Participants (10 male cyclists) were asked to complete a 2-hour glycogen depletion period followed by a 10K time trial. During the time trial, cyclists were given 1 of 2 carbohydrate supplements (sports jelly beans or sun-dried raisins). The results showed no significant difference between 10K time trials for the sports jelly beans or the sun-dried raisins.65

A third study by Too et al.66 conducted at the University of California Davis tested the effect of sun-dried raisins vs. sports chews in running performance. Eleven male runners completed an 80-minute glycogen depletion, exercising at 75% VO2max, followed by a 5K timed trial. The participants completed the trial in all three conditions (trials with water, raisins, and sport chews) separated by seven days. The researchers found no significant difference between sun-dried raisins and sports chews for the time to complete the 5K. Times to complete the 5K were 20.6 ± 2.6, 20.7 ± 2.5 and 21.6 ± 2.7 min for raisins, chews, and water respectively. Times were significantly shorter (p ≤ 0.05) for both raisins and chews compared to the water control.66

Nutritional analysis by Apfel et al.67 comparing raisins to sports chews showed that carbohydrate, sugar, fiber, protein and carbohydrate content was 96 g, 80 g, 6.4 g and 3.2 g respectively for raisins while content of the sports chew was 96 g, 48 g, 0 g and 0 g respectively. The mineral content of the raisins was 32 mg sodium, 952 mg potassium, 68 mg calcium, 44 mg magnesium, 136 mg phosphorus and 8 mg folate. The sports chews contained 280 mg sodium, 80 mg potassium, and 0 mg calcium, magnesium, phosphorus and folate. The vitamin content of raisins was 3.2 mg vitamin C, 4.8 mg vitamin K and 16 mg vitamin E while the sports chews were void of these vitamins. Overall raisins provided a more nutrient dense alternative to sports chews.67

An additional study by Byrne et al.68 supports the use of raisins in exercise, as well as in an impaired fasting glucose population. The researchers analyzed serum glucose and insulin responses to three pre-exercise snacks before, during and after exercise. Twenty men with and without impaired fasting glucose participated in this study. The snacks compared were a natural fruit snack of raisins, an energy bar or a glucose solution. This study aimed to determine if the natural snack would yield more desirable glucose and insulin concentrations than the other snacks. Glucose concentrations were higher in the impaired fasting glucose group with all snacks. The energy bar snack reduced glycemia but not insulinemia and the raisins lowered both the postprandial glycemic and insulinemic responses compared to the glucose solution.68

Kalman et al.69 compared the effects of isocaloric snack of raisins versus granola bars on feelings of energy in mothers over a 14-day study period. Moms reported a significant increase in energy when they consumed raisins and granola bars as snacks; when comparing the two snacks, raisins were associated with higher energy scores for 13 of 14 test days (p = 0.002). Neither snack showed a change in subject weight.69

Raisins may provide a less expensive, more nutrient dense, yet equally effective, source of energy during endurance exercise.

Raisins contribute to dietary nutrient density and may increases satiety compared to other commonly consumed snacks. Patel et al.70 measured ad libitum consumption of a variety of snacks, in children ages 8~11 years old. After receiving standardized breakfasts, morning snacks and lunches, children were randomly offered one of four snacks: raisins, grapes, potato chips or chocolate chip cookies, and told to eat until comfortably full. Satiety measured before and at 15, 30, and 45 min after snack consumption showed that children consumed the least calories from grapes and raisins and the greatest from cookies. Snacking on grapes and raisins also led to lower cumulative food intake (calories of all meals combined) compared to other snacks, while grapes also lowered appetite compared to all other snacks.70

Patel et al.71 studied the effect a pre-meal snack containing raisins on total calorie intake in children. In experiment 1, participants received either an ad libitum snack (grapes, raisins, almond and nut mixture or water control) and then were offered an ad libitum pizza meal. In experiment 1, children consumed significantly lower cumulative calories when consuming raisins and water compared to grapes and nut/raisin mixture. In experiment 2, participants were offered a 150-calorie snack (grapes, raisins, almond and raisin mixture or water control) which was followed by an ad libitum pizza meal. In experiment 2, children consumed lower cumulative calories after consuming raisins and water. The authors concluded that a premeal snack of raisins reduced total calories consumed at a meal and did not increase cumulative energy intake.71

Raisins have been thought to be important in the etiology of dental caries because of high sugar content and suspected stickiness. Yet three conditions are required to promote dental caries: low oral pH, food sticking to teeth, and active cariogenic bacteria in the biofilm.72 Rivero-Cruz73 and Wu et al.74 assessed the antimicrobial agents of Thompson's seedless raisins against select oral pathogens. Eight compounds derived from raisins that are known to have oral antimicrobial effect were studied in vitro to determine their individual antimicrobial effects. They were assessed as to their impact on Streptococcus mutans (S. mutans) and Porphyromonas gingivalis (P. gingivalis). The compounds oleanolic, oleanolic aldehyde, and 5-(hydroxymethyl)-2-furfural were active against P. gingivalis, and those three compounds are found on the skin of grapes and raisin; in addition to rutin which was effective against S. mutans.73

Wu74 assessed the effects of grapes on oral health in an in vitro and an in vivo study. In vitro grape seed extract reduced demineralization in artificial root carie lesions. In vivo oleanolic acid suppressed adherence of S. mutans biofilms. In vivo raisins and raisin containing bran cereal did not reduce plaque pH below 6.0 in 7~11 year old subjects.

Utreja et al.75 conducted a randomized control study in twenty 7~11 year old children studying the effects of raisin bran flakes, commercial raisin bran cereal and experimental raisin bran cereals. The positive control was 10% sucrose and the negative control was 10% sorbitol. Levels of pH were measured at 2, 5, 10, 15 and 20 min. Results of this study found that consumption of raisins and experimental raisin bran did not reduce pH below 6.0 over the 30-minute testing period, while bran flakes and sugar-coated raisin bran flakes significantly reduced the pH after ten min.75

Issa et al.76 conducted research on the enamel demineralization properties of eight different whole and juiced fruits and vegetables. Although the differences in demineralization were not significant between products, raisins had the lowest amount of demineralization of all test foods.76

Wong et al.72 conducted a review of literature on raisins and oral health. This study found that raisin consumption did not lower oral pH less than 5.5 and consuming raisins suppressed S. mutans. In addition, raisins even though they are rated by consumers as being a “sticky” food, do not stick to teeth and are cleared from the mouth.7577

Hindi et al.78 investigated the antimicrobial activity of black raisins against gram positive and gram negative bacteria and yeast. Gram positive bacteria included: Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae. Gram negative bacteria included: Pseudomonas aeruginosa, Salmonella typhi, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter spp., Acinetobacter, E. coli, and Serratia spp. In the study, petri dishes were prepared for analysis of the adhesion of bacteria on oral epithelial cells. In addition, a biofilm formation assay was used to determine the anti-biofilm properties of raisins. There was an inverse correlation between raisins and gram negative bacteria. The active components of black raisins that are effective in inhibition of E. coli bacteria include: Catechin/Flavonoids, Gallic acid/Phenolic acid, and Protocatechuic acid. Flavonoids, also found in raisins, inhibit Bacillus, Shigella, Salmonella, Vibrio, and E. coli species. In addition, Ferulic acid/ Phenolic acid inhibit E. coli and Salmonella spp, Protocatechuic acid inhibits E. coli spp.78 Although raisins show antibacterial activities in vitro and against oral pathogens, raisins do not exhibit anti-adherence properties against E. coli in the urinary tract as demonstrated with other dried fruits.79

Raisins have been considered a choking hazard by many groups, including the American Academy of Pediatrics (AAP) until their review in 201180 when they removed raisins from the list of choking hazards. It seems odd that raisins were ever considered a choking risk as their small size, irregular shape and malleable texture does not match the AAP's statement that “choking is most commonly caused by any solid, round, cylindrical, or conforming object that has the same diameter as and fits easily into a child's upper airway”.80 In 2008 Altkorn et al.81 published data from twenty six US and Canadian hospitals concerning aspiration and choking. Raisins were not reported as a cause; peanuts and hot dogs caused the highest frequency of injury and mortality, respectively.81

Keast and colleagues,82 analyzed the NHANES 1999 ~2004 adult data and found that 7% of the population consumes dried fruit. Dried fruit consumers, defined as consuming (1/8 cup -equivalent fruit or more per day), had significantly higher Healthy Eating Index scores (measured with the Healthy Eating Index-2005) than non-consumers, with significantly (p < 0 .01) greater consumption of dietary fiber (+6.6 g/d), vitamins A (+173 µg retinol activity equivalent per day), E (+1.5 mg α-tocopherol per day), C (+20 mg/d), and K (+20 mg/d), calcium (+103 mg/d), phosphorus (+126 mg/d); magnesium (+72 mg/d), and potassium (+432 mg/d). In addition, dried fruit consumers ate less solid fats, alcohol, and added sugars. Dried fruit consumers were also found to have lower BMIs and waist circumferences.82

McGill et al.83 analyzed the 2003~2008 NHANES data for children ages 2 to 19 years (n = 9,622) and adults 20+ years (n = 12,251) found that consumers of grape products (grapes, raisins and grape juice) had higher Healthy Eating Index-2005 scores and higher intake of total and whole fruit along with lower intakes of solid fat, added sugar, and calories compared with non-consumers. Adult consumers of grape products consumed more total and dark green/ orange vegetables. For both adults and children, grape product consumers consumed significantly more of the shortfall nutrients for Americans: dietary fiber, calcium and potassium and other key nutrients: vitamin A, C, and magnesium.83

Raisin have been shown to be associated with improved diet quality and nutrient intake when consumed with other grape products or dried fruits. Fulgoni et al.84 examined raisin consumption alone in adults using data from NHANES 2001~2012. Raisin consumers (n = 458, 60.1% female) were defined as reporting consumption of any amount of raisins during the first 24-hour diet recall. Consumers compared to non-consumers had higher total Healthy Eating Index scores (61.4 ± 1.0 vs. 49.1 ± 0.2) and lower BMIs (27.3 ± 0.4 vs. 28.8 ± 0.1 kg/m²) and waist circumferences (94.1 ± 0.1 vs. 97.8 ± 0.2 cm) respectively. The nutrients of concern for under consumption were higher in the raisin consumers vs non-consumers: dietary fiber (22.1 ± 1 vs. 16.5 ± 0.1 g/d) and potassium (3,084 ± 77 vs. 2,665 ± 10 mg/d) respectively, calcium and vitamin D were not significantly different. Intakes for raisin consumers were higher than non-consumers for: vitamin C (117 ± 8 vs. 94.4 ± 1.2 mg/d), vitamin E (8.9 ± 0.5 vs. 7.3 ± 0.1 mg AT/d), and magnesium (355 ± 11 vs. 290 ± 1 mg/d) respectively, and lower for intakes of saturated fatty acids (21. 2 ± 0.9 vs. 25.0 ± 0.1 g/day), added sugars (14.9 ± 0.7 vs. 18.0 ± 0.2 tsp equivalents/day), and sodium (3,190 ± 78 vs. 3,541 ± 17 mg/day) respectively. Adult raisin consumers were 39% less likely [odds ratio (OR): 0.61, 99th confidence interval (CI): 0.41, 0.89] to be overweight or obese.84

Raisin consumption among children (2~18 years of age) has also been linked to health benefits.85 Fulgoni et al. defined raisin consumers (n = 154) as those who consumed any amount of raisins during a 24-hour period. The Healthy Eating Index-2010 scores among consumers were higher than non-raisin consumers (55.5 ± 1.7 vs. 45.1 ± 0.3) respectively. The largest differences in sub-component scores for raisin consumers as compared to non-consumers were for calories from solid fats, added sugars, and alcohol, (13.7 ± 0.8 vs. 10.2 ± 0.1) and whole fruit (3.8 ± 0.2 vs. 2.1 ± 0.04). Additionally, nutrients of concern for under consumption in children: dietary fiber (16.3 ± 0.8 vs. 13.2 ± 0.1 g/d), magnesium (255 ± 7 vs. 228 ± 1 mg/d), and potassium (2,578 ± 110 vs. 2,221 ± 15 mg/d) were significantly higher in raisin consumers compared to non-consumers respectively. Added sugar, a nutrient of public health concern for overconsumption was lower among raisin consumers compared to nonconsumers (15.7 ± 1.1 vs. 19.7 ± 0.2 tsp equivalents).85

Additionally, recent data analysis of NHANES 2001~2012 data by Fulgoni et al.86 showed that consumption of raisin-containing foods (RCFs) was associated with higher nutrient intake and diet quality in children and adults. Most notable, Healthy Eating Index-2010 diet scores were higher in RCFs consumers vs. non-consumers (58.6 ± 0.6 vs. 54.3 ± 0.4) and (50.0 ± 0.5 vs. 45.5 ± 0.2) for adults and children respectively. Dietary fiber and potassium were significantly higher while saturated fat and sodium was significantly lower for RCFs consumers, vitamin A, folate, iron and magnesium intakes were all significantly higher for adult consumers.86

Raisins have some of the highest polyphenolic content and antioxidant ORAC levels compared with traditional dried fruits and compare favorably with many other fruits as well.11121314151617 Many of the polyphenols in raisins are well assimilated and bioavailable.1018192021222324252627 Raisins have sufficient fiber to reduce transit time and positively affect gut microbes.383940414243444546 Raisins reduce risk factors for CVD and T2DM, total and LDL cholesterol, blood pressure and blood sugar compared to carbohydrate controls.92133545556575859606162 Raisins improve athletic performance compared to a water control and perform equal to sports energy gels, shots and jelly beans at producing sustained energy during long term athletic competitions.63646566676869 Although the effect of raisins on inflammatory markers is mixed, the cancer chemopreventive effects in vitro studies on cancer cell lines is promising.23282930313233 Raisins produce an oral environment that is non-cariogenic and do not fit the APP criterion for a choking hazard.7173747576777880