Rui Jiang, MD; JoAnn E. Manson, MD; Meir J. Stampfer, MD; Simin Liu, MD; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD
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/Article Information
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.
Corresponding Author and Reprints: Rui Jiang, MD, Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115 (e-mail: rjiang@hsph.harvard.edu). Author Contributions: Study concept and design: Manson, Liu, Willett, Hu.
Acquisition of data: Jiang, Manson, Stampfer, Willett, Hu. Analysis and interpretation of data: Jiang, Manson, Stampfer, Willett, Hu. Drafting of the manuscript: Jiang, Hu. Critical revision of the manuscript for important intellectual content: Jiang, Manson, Stampfer, Liu, Willett, Hu. Statistical expertise: Jiang, Stampfer, Liu, Willett, Hu. Obtained funding: Manson, Willett, Hu. Administrative, technical, or material support: Manson, Stampfer, Willett, Hu. Study supervision: Willett, Hu. Funding/Support: This research was supported by grants DK58845 and CA87969 from the National Institutes of Health.
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