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Introduction: Nuts, when eaten alongside other nutritionally rich foods, may decrease obesity and related chronic disease risks, which are high among African American women in the rural South. We monitored changes in nut intake, other obesity-related foods (fruits, vegetables, red or processed meats, added sugars), and body mass index (BMI) over a 2-year weight loss intervention among 383 overweight and obese African American women in rural Alabama and Mississippi., Methods: Two dietary recalls were administered at 4 points over 24 months. Mann-Whitney tests compared differences in median food group intake between nut consumers and non-nut consumers, and t tests identified BMI differences between groups. Mixed linear models tested the relationship between nut intake and intake of the select food groups, and between nut intake and BMI over time., Results: Overall nut consumers ate more fruits and vegetables and less red meat than non-nut consumers. Nut consumers had lower BMI values than non-nut consumers. Weight loss by the end of the intervention was significant for nut consumers but not for non-nut consumers, even after accounting for kilocalorie consumption and physical activity engagement., Conclusion: Nut consumption is associated with consumption of other nutritionally rich foods and lower BMI among African American women in rural Alabama and Mississippi. Future interventions should target increasing daily nut intake, decreasing added sugar intake, and identifying strategies to encourage positive dietary changes to continue after an intervention.

Objective: Nut consumption decreases risk for obesity and chronic diseases, which are prevalent among African-American women in the rural southeastern United States. The quantity and quality of nut intake in this population is unclear. We examined the amount, source, and quality of nut consumption among overweight and obese African-American women in rural Alabama and Mississippi., Methods: Two 24-hour dietary recalls were administered to 426 women. Mann-Whitney tests, t-tests, and linear regression models identified differences in added sugar and sodium intake between nut consumers and non-consumers, differences in mean nut, added sugar, and sodium intake between stand-alone and incorporated nut sources, and a relationship between nut intake and added sugar and sodium intake., Results: Forty-two percent of participants consumed nuts, and 16% met federal recommendations for nut intake. Nut consumption was mainly from incorporated sources (65%), which were higher in added sugar (p < .001) and sodium (p < .001), and lower in nut quantity (p < .001) than stand-alone sources. Nut consumers consumed more daily added sugar (p = .004) and sodium (p = .04) than non-consumers., Conclusion: Suboptimal quantity and quality of nut intake may impede the health benefits of nut consumption among African-American women in the rural South., Competing Interests: Statement All authors of this article declare they have no conflicts of interest.