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In Reply: We appreciate the efforts of Dr Folsom and colleagues to replicate our findings on nut consumption and risk of type 2 diabetes, and we agree that further research is needed given the limited data. However, we are concerned that overadjustment may have contributed to major change in their multivariate analysis, because fiber, magnesium, and monounsaturated and polyunsaturated fat are all major components of nuts and peanut butter. We also point out that such adjustment had negligible effects on the results in our analysis. We share their concern that nonspecificity of self-reported diabetes might have contributed to attenuation of the results in the Iowa Women's Health Study.

In response to the analysis of Folsom et al, we conducted an additional analysis stratifying by menopausal status, and the inverse association of nut consumption and diabetes risk persisted among premenopausal and postmenopausal women. Among premenopausal women the multivariate relative risk (RR) . . . [Full Text of this Article]

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