Eat Your Fish or Go for Nuts

In this issue of JAMA Ophthalmology, Sala-Vila and coauthors¹ present a post hoc analysis of data from the 6-year Prevención con Dieta Mediterránea (PREDIMED) Study, a large 3-arm cardiovascular end point intervention study comparing a low-fat diet, a Mediterranean diet supplemented by olive oil, and a Mediterranean diet supplemented by tree nuts (walnuts, hazelnuts, and almonds). The analysis concerns the exploratory end point of incident diabetic retinopathy, not in association with study arm assignment, but in association with baseline intake of ω-3 fatty acids across all arms and including only the 3482 participants who had type 2 diabetes at baseline, when the participants’ mean age was 67 years.