Hassannejad R, et al. - The population-based longitudinal study was conducted on a sub-sample of the Isfahan Cohort Study (ICS) to determine the relationships between long-term nuts intake and the risk of metabolic syndrome (MetS). The sample consisted of one thousand, three hundred eighty-seven adults, aged >= 35 years. Using the Logistic and Cumulative Logit regressions with considering mixed random effects, the longitudinal relationship between the trend of nuts intake and the risk and severity of MetS was investigated. After a 13-year follow-up period in a cohort of the Iranian population, nuts intake showed a significant, inverse association with the risk and severity of MetS.