Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis

Patrice Carter, Laura J Gray, Jacqui Troughton, Kamlesh Khunti, Melanie J Davies, Patrice Carter, Laura J Gray, Jacqui Troughton, Kamlesh Khunti, Melanie J Davies

Abstract

Objective: To investigate the independent effects of intake of fruit and vegetables on incidence of type 2 diabetes.

Design: Systematic review and meta-analysis.

Data sources: Medline, Embase, CINAHL, British Nursing Index (BNI), and the Cochrane library were searched for medical subject headings and keywords on diabetes, prediabetes, fruit, and vegetables. Expert opinions were sought and reference lists of relevant articles checked.

Study selection: Prospective cohort studies with an independent measure of intake of fruit, vegetables, or fruit and vegetables and data on incidence of type 2 diabetes.

Results: Six studies met the inclusion criteria; four of these studies also provided separate information on the consumption of green leafy vegetables. Summary estimates showed that greater intake of green leafy vegetables was associated with a 14% (hazard ratio 0.86, 95% confidence interval 0.77 to 0.97) reduction in risk of type 2 diabetes (P=0.01). The summary estimates showed no significant benefits of increasing the consumption of vegetables, fruit, or fruit and vegetables combined.

Conclusion: Increasing daily intake of green leafy vegetables could significantly reduce the risk of type 2 diabetes and should be investigated further.

Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that (1) no financial support for the submitted work from anyone other than their employer; (2) no financial relationships with commercial entities that might have an interest in the submitted work in the previous 3 years; (3) no spouses, partners, or children with relationships with commercial entities that may be relevant to the submitted work; and (4) KK and MJD have received grants from the National Institute of Health Research (NIHR) for studies on the prevention of type 2 diabetes.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787889/bin/carp775189.f1_default.jpg
Fig 1 Process of study selection
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787889/bin/carp775189.f2_default.jpg
Fig 2 Hazard ratios for incidence in diabetes type 2 for highest versus lowest intake of vegetables. Weights are from random effects analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787889/bin/carp775189.f3_default.jpg
Fig 3 Hazard ratios for incidence in diabetes type 2 for highest versus lowest intake of fruit. Weights are from random effects analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787889/bin/carp775189.f4_default.jpg
Fig 4 Hazard ratios for incidence in diabetes type 2 for highest versus lowest intake of fruit and vegetables combined. Weights are from random effects analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787889/bin/carp775189.f5_default.jpg
Fig 5 Hazard ratios for incidence in diabetes type 2 for highest versus lowest intake of green leafy vegetables. Weights are from random effects analysis

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