***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Walnuts are rich in polyunsaturated fatty acids and have been shown to improve various cardiometabolic risk factors . We aim ed to investigate the association between walnut intake and incident type 2 diabetes  in 2 large cohort studies : the Nurses ’ Health Study ( NHS ) and NHS II . We prospect ively followed 58,063 women aged 52–77 y in NHS ( 1998–2008 ) and 79,893 women aged 35–52 y in NHS II ( 1999–2009 ) without diabetes , cardiovascular disease , or cancer at baseline .  Consumption of walnuts and other nuts was assessed every 4 y using vali date d food frequency question naires .  Self-reported type 2 diabetes was confirmed by a vali date d supplemental question naire . We documented a total of 5930 incident type 2 diabetes cases during 10 y of follow-up . In the multivariable-adjusted Cox proportional hazards model without body mass index ( BMI ) , walnut consumption was associated with a lower risk of type 2 diabetes , and the HRs ( 95 % CIs ) for participants consuming 1–3 servings/mo ( 1 serving = 28 g ) , 1 serving/wk , and ≥2 servings/wk of walnuts were 0.93 ( 0.88–0.99 ) , 0.81 ( 0.70–0.94 ) , and 0.67 ( 0.54–0.82 ) compared with women who never/rarely consumed walnuts ( P-trend < 0.001 ) . Further adjustment for up date d BMI slightly attenuated the association and the HRs ( 95 % CIs ) were 0.96 ( 0.90–1.02 ) , 0.87 ( 0.75–1.01 ) , and 0.76 ( 0.62–0.94 ) , respectively ( P-trend = 0.002 ) . The consumption of total nuts ( P-trend < 0.001 ) and other tree nuts ( P-trend = 0.03 ) was also inversely associated with risk of type 2 diabetes , and the associations were largely explained by BMI . Our results suggest that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women Almonds , together with other nuts , reduce serum cholesterol levels and may reduce the risk of coronary heart disease . There is much current interest in the relation of coronary heart disease to postpr and ial events . We have therefore assessed the effects of varying amounts of almonds on the postpr and ial blood glucose response to a carbohydrate meal . Our aim was to assess the effect of adding almonds to a bread meal .  Nine healthy volunteers ( 2 women , 7 men ; mean age , 27.8 years ; mean body mass index , 22.9 kg/m2 ) were r and omly fed with 3 test meals and 2 white bread control meals on separate days . Subjects were fed the meals after a 10- to 12-hour overnight fast . Each meal contained 50 g of available carbohydrate from white bread eaten alone or with 30 , 60 , or 90 g ( approximately 1 , 2 , or 3 oz ) of almonds .  Capillary finger-prick blood sample s for glucose analysis were obtained at 0 , 15 , 30 , 45 , 60 , 90 , and 120 minutes . Glycemic responses were assessed by calculating the incremental area under the 2-hour blood glucose curve . The addition of almonds to white bread result ed in a progressive reduction in the glycemic index of the composite meal in a dose-dependent manner for the 30-g ( 105.8 + /- 23.3 ) , 60-g ( 63.0 + /- 9.0 ) , and 90-g ( 45.2 + /- 5.8 ) doses of almonds ( r = -0.524 , n = 36 , P = .001 ) . We conclude that , in addition to lowering serum cholesterol levels , almonds may also reduce the glycemic impact of carbohydrate foods with which they are eaten The authors aim ed to evaluate the association of the traditional Mediterranean diet and major food groups with incidence of and mortality from cerebrovascular disease ( CBVD ) in a Mediterranean population . The study population was a cohort of 23,601 participants from the Greek segment of the EPIC Study ( European Prospect i ve Investigation into Cancer and Nutrition ) who were free of cardiovascular diseases and cancer at baseline ( 1994 - 1999 ) .  Diet was assessed by means of a vali date d food frequency question naire . A 10-point scale integrating key Mediterranean diet characteristics was used to assess the participants ' degree of adherence to this diet . During a median follow-up period of 10.6 years ( 1994 - 2009 ) , 395 confirmed incident cases and 196 deaths from CBVD were recorded . Using Cox proportional hazards regression and adjusting for potential confounders , increased adherence to the Mediterranean diet , as measured by 2-point increments in score , was inversely associated with CBVD incidence ( adjusted hazard ratio = 0.85 , 95 % confidence interval : 0.74 , 0.96 ) and mortality ( adjusted hazard ratio = 0.88 , 95 % CI : 0.73 , 1.06 ) . These inverse trends were mostly evident among women and with respect to ischemic rather than hemorrhagic CBVD and were largely driven by consumption of vegetables , legumes , and olive oil . These data provide support for an inverse association of adherence to the Mediterranean diet with CBVD incidence and mortality BACKGROUND Dietary carbohydrates may influence the development of  type 2 ( non-insulin-dependent ) diabetes  , for example , through effects on blood glucose and insulin concentrations . OBJECTIVE We examined the relations of baseline intake of carbohydrates , dietary fiber , dietary magnesium , and carbohydrate-rich foods and the glycemic index with incidence of diabetes . DESIGN This was a prospect i ve cohort study of 35988 older Iowa women initially free of diabetes . During 6 y of follow-up , 1141 incident cases of diabetes were reported . RESULTS  Total grain , whole-grain , total dietary fiber , cereal fiber , and dietary magnesium intakes  showed strong inverse associations with incidence of diabetes after adjustment for potential nondietary confounding variables . Multivariate-adjusted relative risks of diabetes were 1.0 , 0.99 , 0.98 , 0.92 , and 0.79 ( P for trend : 0.0089 ) across quintiles of whole-grain intake ; 1.0 , 1.09 , 1.00 , 0.94 , and 0.78 ( P for trend : 0.005 ) across quintiles of total dietary fiber intake ; and 1.0 , 0.81 , 0.82 , 0.81 , and 0.67 ( P for trend : 0.0003 ) across quintiles of dietary magnesium intake . Intakes of total carbohydrates , refined grains , fruit and vegetables , and soluble fiber and the glycemic index were unrelated to diabetes risk . CONCLUSION These data support a protective role for grains ( particularly whole grains ) , cereal fiber , and dietary magnesium in the development of diabetes in older women Adherence to the Mediterranean diet ( MD ) has been reported to improve CHD prognosis and to be inversely associated with CHD mortality . The aim of the present study was to investigate the association of adherence to the MD with CHD incidence and mortality in the Greek European Prospect i ve Investigation into Cancer and Nutrition cohort , a population with traditional Mediterranean roots . In a general population sample of 23,929 adult men and women with no CVD or cancer at enrolment , a vali date d FFQ was interviewer-administered , sociodemographic , physical activity and other characteristics were recorded , and arterial blood pressure and anthropometric characteristics were measured . In a median period of 10 years , 636 incident CHD cases and 240 CHD deaths were recorded . Associations of adherence to the MD , operationalised through a nine-component score ( 0 , poor ; 9 , excellent ) , with CHD incidence and mortality were evaluated through Cox regression controlling for potentially confounding variables . A two-point increase in the MD score was associated with lower CHD mortality by 25 % ( 95 % CI 0.57 , 0.98 ) among women and 19 % ( 95 % CI 0.67 , 0.99 ) among men . The association of adherence to the MD with CHD incidence was again inverse , but weaker ( hazard ratios 0.85 ( 95 % CI 0.71 , 1.02 ) among women and 0.98 ( 95 % CI 0.87 , 1.10 ) among men ) . With respect to score components , only meat among men ( positively ) and fruits and nuts among women ( inversely ) were associated with both the incidence of and mortality from CHD . The MD , as an integral entity , is inversely associated with CHD incidence and , particularly , mortality Background and Purpose — Few dietary protein sources have been studied prospect ively in relation to stroke . We examined the relation between foods that are major protein sources and risk of stroke . Methods — We prospect ively followed 84 010 women aged 30 to 55 years at baseline and 43 150 men aged 40 to 75 years at baseline without diagnosed cancer , diabetes , or cardiovascular disease .  Diet was assessed repeatedly by a st and ardized and vali date d question naire . We examined the association between protein sources and incidence of stroke using a proportional hazard model adjusted for stroke risk factors . Results — During 26 and 22 years of follow-up in women and men , respectively , we documented 2633 and 1397 strokes , respectively . In multivariable analyses , higher intake of red meat was associated with an elevated risk of stroke , whereas a higher intake of poultry was associated with a lower risk . In models estimating the effects of exchanging different protein sources , compared with 1 serving/day of red meat , 1 serving/day of poultry was associated with a 27 % ( 95 % CI , 12%–39 % ) lower risk of stroke , nuts with a 17 % ( 95 % CI . 4%–27 % ) lower risk , fish with a 17 % ( 95 % CI , 0%–30 % ) lower risk , low-fat dairy with an 11 % ( 95 % CI , 5%–17 % ) lower risk , and whole-fat dairy with a 10 % ( 95 % CI , 4%–16 % ) lower risk . We did not see significant associations with exchanging legumes or eggs for red meat . Conclusions — These data suggest that stroke risk may be reduced by replacing red meat with other dietary sources of protein CONTEXT Nuts are high in unsaturated ( polyunsaturated and monounsaturated ) fat and other nutrients that may improve glucose and insulin homeostasis . OBJECTIVE To examine prospect ively the relationship between nut consumption and risk of  type 2 diabetes .  DESIGN , SETTING , AND PARTICIPANTS Prospect i ve 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 vali date d dietary question naire 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 , or = 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 > or = 140 g [ 
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Mixed evidence was seen for publication bias , but analyses by using the Duval and Tweedie trim- and -fill method did not appreciably alter results .
This systematic review supports inverse associations between eating nuts and incident IHD and diabetes and eating legumes and incident IHD