This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (80)  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in JAMA  Topic Collections  • Women's Health  • Women's Health, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Rui Jiang, MD; JoAnn E. Manson, MD; Meir J. Stampfer, MD; Simin Liu, MD; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD

JAMA. 2002;288:2554-2560.

Context  Nuts are high in unsaturated (polyunsaturated and monounsaturated) fat and other nutrients that may improve glucose and insulin homeostasis.

Objective  To examine prospectively the relationship between nut consumption and risk of type 2 diabetes.

Design, Setting, and Participants  Prospective cohort study of 83 818 women from 11 states in the Nurses' Health Study. The women were aged 34 to 59 years, had no history of diabetes, cardiovascular disease, or cancer, completed a validated dietary questionnaire at baseline in 1980, and were followed up for 16 years.

Main Outcome Measure  Incident cases of type 2 diabetes.

Results  We documented 3206 new cases of type 2 diabetes. Nut consumption was inversely associated with risk of type 2 diabetes after adjustment for age, body mass index (BMI), family history of diabetes, physical activity, smoking, alcohol use, and total energy intake. The multivariate relative risks (RRs) across categories of nut consumption (never/almost never, <once/week, 1-4 times/week, and 5 times/week) for a 28-g (1 oz) serving size were 1.0, 0.92 (95% confidence interval [CI], 0.85-1.00), 0.84 (0.95% CI, 0.76-0.93), and 0.73 (95% CI, 0.60-0.89) (P for trend <.001). Further adjustment for intakes of dietary fats, cereal fiber, and other dietary factors did not appreciably change the results. The inverse association persisted within strata defined by levels of BMI, smoking, alcohol use, and other diabetes risk factors. Consumption of peanut butter was also inversely associated with type 2 diabetes. The multivariate RR was 0.79 (95% CI, 0.68-0.91; P for trend <.001) in women consuming peanut butter 5 times or more a week (equivalent to 140 g [5 oz] of peanuts/week) compared with those who never/almost never ate peanut butter.

Conclusions  Our findings suggest potential benefits of higher nut and peanut butter consumption in lowering risk of type 2 diabetes in women. To avoid increasing caloric intake, regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats.

Author Affiliations: Departments of Nutrition (Drs Jiang, Stampfer, Willett, and Hu) and Epidemiology (Drs Jiang, Manson, Stampfer, Liu, Willett, and Hu), Harvard School of Public Health; the Channing Laboratory (Drs Manson, Stampfer, Willett, and Hu); and the Division of Preventive Medicine (Drs Manson and Liu), Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Nut Consumption and Risk of Type 2 Diabetes
Emily D. Parker, Lisa J. Harnack, and Aaron R. Folsom
JAMA. 2003;290(1):38-39.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Adherence to the DASH Diet Is Inversely Associated With Incidence of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study
Liese et al.
Diabetes Care 2009;32:1434-1436.
ABSTRACT | FULL TEXT  

Regular Consumption of Nuts Is Associated with a Lower Risk of Cardiovascular Disease in Women with Type 2 Diabetes
Li et al.
J. Nutr. 2009;139:1333-1338.
ABSTRACT | FULL TEXT  

Prospective study of nut consumption, long-term weight change, and obesity risk in women
Bes-Rastrollo et al.
Am. J. Clin. Nutr. 2009;89:1913-1919.
ABSTRACT | FULL TEXT  

Nuts and health outcomes: new epidemiologic evidence
Sabate and Ang
Am. J. Clin. Nutr. 2009;89:1643S-1648S.
ABSTRACT | FULL TEXT  

Nuts and novel biomarkers of cardiovascular disease
Ros
Am. J. Clin. Nutr. 2009;89:1649S-1656S.
ABSTRACT | FULL TEXT  

Mastication of almonds: effects of lipid bioaccessibility, appetite, and hormone response
Cassady et al.
Am. J. Clin. Nutr. 2009;89:794-800.
ABSTRACT | FULL TEXT  

Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status: One-Year Results of the PREDIMED Randomized Trial
Salas-Salvado et al.
Arch Intern Med 2008;168:2449-2458.
ABSTRACT | FULL TEXT  

Nut consumption and risk of heart failure in the Physicians' Health Study I
Djousse et al.
Am. J. Clin. Nutr. 2008;88:930-933.
ABSTRACT | FULL TEXT  

Dietary Patterns and Risk of Incident Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)
Nettleton et al.
Diabetes Care 2008;31:1777-1782.
ABSTRACT | FULL TEXT  

Possible Benefit of Nuts in Type 2 Diabetes
Jenkins et al.
J. Nutr. 2008;138:1752S-1756S.
ABSTRACT | FULL TEXT  

Nut, Corn, and Popcorn Consumption and the Incidence of Diverticular Disease
Strate et al.
JAMA 2008;300:907-914.
ABSTRACT | FULL TEXT  

Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women
Bazzano et al.
Diabetes Care 2008;31:1311-1317.
ABSTRACT | FULL TEXT  

Effect of Nut Paste Enrichment on Physical Characteristics and Consumer Acceptability of Bread
Oliete et al.
Food Science and Technology International 2008;14:259-269.
ABSTRACT  

Fruit and Vegetable Intake and Mortality from Cardiovascular Disease Are Inversely Associated in Japanese Women but Not in Men
Nakamura et al.
J. Nutr. 2008;138:1129-1134.
ABSTRACT | FULL TEXT  

Effect of Nut Paste Enrichment on Wheat Dough Rheology and Bread Volume
Gomez et al.
Food Science and Technology International 2008;14:57-65.
ABSTRACT  

The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein
Wolever et al.
Am. J. Clin. Nutr. 2008;87:114-125.
ABSTRACT | FULL TEXT  

A Prospective Study of Overall Diet Quality and Risk of Type 2 Diabetes in Women
Fung et al.
Diabetes Care 2007;30:1753-1757.
ABSTRACT | FULL TEXT  

{alpha}-Tocopherol Intake and Plasma Concentration of Hispanic and Non-Hispanic White Elders Is Associated with Dietary Intake Pattern
Gao et al.
J. Nutr. 2006;136:2574-2579.
ABSTRACT | FULL TEXT  

Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors: A Randomized Trial
Estruch et al.
ANN INTERN MED 2006;145:1-11.
ABSTRACT | FULL TEXT  

The Maximal Amount of Dietary {alpha}-Tocopherol Intake in U.S. Adults (NHANES 2001-2002)
Gao et al.
J. Nutr. 2006;136:1021-1026.
ABSTRACT | FULL TEXT  

Nut and Seed Consumption and Inflammatory Markers in the Multi-Ethnic Study of Atherosclerosis
Jiang et al.
Am J Epidemiol 2006;163:222-231.
ABSTRACT | FULL TEXT  

Protein, body weight, and cardiovascular health
Hu
Am. J. Clin. Nutr. 2005;82:242S-247S.
ABSTRACT | FULL TEXT  

Dairy Consumption and Risk of Type 2 Diabetes Mellitus in Men: A Prospective Study
Choi et al.
Arch Intern Med 2005;165:997-1003.
ABSTRACT | FULL TEXT  

Improved Diet Quality with Peanut Consumption
Griel et al.
J. Am. Coll. Nutr. 2004;23:660-668.
ABSTRACT | FULL TEXT  

Including Walnuts in a Low-Fat/Modified-Fat Diet Improves HDL Cholesterol-to-Total Cholesterol Ratios in Patients With Type 2 Diabetes
Tapsell et al.
Diabetes Care 2004;27:2777-2783.
ABSTRACT | FULL TEXT  

Trends in the Prevalence and Ratio of Diagnosed to Undiagnosed Diabetes According to Obesity Levels in the U.S.
Gregg et al.
Diabetes Care 2004;27:2806-2812.
ABSTRACT | FULL TEXT  

Magnesium Intake and Risk of Type 2 Diabetes in Men and Women
Lopez-Ridaura et al.
Diabetes Care 2004;27:134-140.
ABSTRACT | FULL TEXT  

Cardiovascular Disease Resulting From a Diet and Lifestyle at Odds With Our Paleolithic Genome: How to Become a 21st-Century Hunter-Gatherer
O'Keefe and Cordain
Mayo Clin Proc. 2004;79:101-108.
ABSTRACT  

Progression of Age-Related Macular Degeneration: Association With Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake
Seddon et al.
Arch Ophthalmol 2003;121:1728-1737.
ABSTRACT | FULL TEXT  

Body Weight Issues in Preventing and Treating Type 2 Diabetes
Beebe
Diabetes Spectr. 2003;16:261-266.
FULL TEXT  

Plant-based foods and prevention of cardiovascular disease: an overview
Hu
Am. J. Clin. Nutr. 2003;78:544S-551.
ABSTRACT | FULL TEXT  

Nut Consumption and Risk of Type 2 Diabetes
Parker et al.
JAMA 2003;290:38-39.
FULL TEXT  

It's Not Nuts to Eat Nuts to Decrease Diabetes Risk
JWatch Women's Health 2003;2003:1-1.
FULL TEXT  

High nut consumption may reduce risk of diabetes
Josefson
BMJ 2002;325:1322-1322.
FULL TEXT