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To the Editor: Dr Jiang and colleagues¹ found a significant inverse association between consumption of nuts and peanut butter and incidence of type 2 diabetes, and concluded that higher nut consumption may lower diabetes risk. in response, we analyzed the relationship between nut consumption and incidence of type 2 diabetes in the Iowa Women's Health Study, a prospective cohort of 35988 postmenopausal women.²

In our analyses, we included women who were free of diabetes, heart disease, and cancer at baseline. We excluded women if they had implausible dietary intakes (<600 or ≥5000 kcal/d) or left 30 or more questions blank on a food frequency questionnaire. The questionnaire provided a single baseline measure of the consumption of nuts (serving size, 28.5 g) and peanut butter (serving size, 1 tablespoon) in 4 categories (<once/month, <1 time/week, 1-4 times/week, and ≥5 times/week). As described previously,² incident diabetes was ascertained by self-report in 4 . . . [Full Text of this Article]

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