title: Nut consumption is associated with lower incidence of type 2 diabetes: The Tehran Lipid and Glucose Study.
abstract: OBJECTIVE
  Nuts are rich in unsaturated fatty acids as well as other bioactive constituents. The present study investigated the association between nut consumption and the incidence of type 2 diabetes mellitus (T2DM) in a Middle Eastern population.
  
  
  METHODS
  The study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), in which 1984 participants (920 men and 1064 women) free of DM, aged≥20 years, were followed from phase III (2005-2008) to phase V (2011-2014). Dietary data were obtained from valid and reliable food-frequency questionnaires at baseline. Using multiple logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, with adjustments for age, gender, BMI, serum cholesterol and triglycerides, smoking and energy intake.
  
  
  RESULTS
  Study participants' means±SD of age and of BMI were 40.1±13.1 years and 27.0±4.8kg/m2, respectively. The median±SE of their total daily consumption of nuts was 1.19±0.11 servings. After 6.2±0.7 years of follow-up, 150 cases of T2DM were confirmed. On comparing those who consumed ≥4 servings/week with those who consumed <1 serving/week, the age-/energy-adjusted OR of incident T2DM for total nut consumption was 0.64 (95% CI: 0.36-1.12; P for trend = 0.03). In a fully adjusted model, nut consumption was associated with a lower risk of T2DM, and the ORs (95% CIs) of risk for those consuming 2-3.99 and ≥4 servings/week of nuts were 0.51 (0.26-0.97) and 0.47 (0.25-0.90), respectively, compared with those consuming <1 serving/week (P<0.001 for trend).
  
  
  CONCLUSIONS
  Our findings suggest that consuming ≥4 servings/week of nuts reduced the risk of T2DM compared with <1 serving/week.
authors.affiliation: Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Teheran, I.R., Iran.
authors.forename: G
authors.initials: G
authors.lastname: Asghari
authors.affiliation: Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Teheran, I.R., Iran; School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Teheran, I.R., Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Ghorbani
authors.affiliation: Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Teheran, I.R., Iran. Electronic address: mirmiran@endocrine.ac.ir.
authors.forename: P
authors.initials: P
authors.lastname: Mirmiran
authors.affiliation: Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Teheran, I.R., Iran.
authors.forename: F
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009754:Nuts; D011795:Surveys and Questionnaires
keywords: Incidence; Nuts; Type 2 diabetes