In Reply We appreciate Dr Feinman’s comments on our recent publication of changes in red meat consumption and subsequent risk of type 2 diabetes mellitus (T2DM).1 Dr Feinman claimed that “Pan et al1 do not conform to most of these rules and their conclusion seems unwarranted” for causal inference based on the criteria of Hill.2 We would like to take this opportunity to clarify several assertions made by Dr Feinman.