Top

Published in:

01-03-2015 | Meta-Analysis

Fruit intake decreases risk of incident type 2 diabetes: an updated meta-analysis

Authors: Shuangshuang Li, Song Miao, Yubei Huang, Zhaolu Liu, Huan Tian, Xiuxiu Yin, Weihong Tang, Lyn M. Steffen, Bo Xi

Published in: Endocrine | Issue 2/2015

Abstract

Association between fruit intake and risk of type 2 diabetes is inconsistent. In this study, we performed a meta-analysis of all prospective cohort studies to clarify the association between fruit intake and risk of type 2 diabetes. Relevant studies were identified by searches of the PubMed and Embase databases up to November 2013. The summary relative risks of association were obtained using a fixed- or random-effects model. A total of nine prospective studies (403,259 participants, including 27,940 with incident type 2 diabetes) from seven publications were included in the meta-analysis of fruit intake and risk of type 2 diabetes. We found that individuals in the highest category of fruit intake had a reduced risk of type 2 diabetes (relative risk 0.92, 95 % confidence interval 0.86–0.97, p = 0.003) compared to those in the lowest category, with moderate evidence of between-study heterogeneity (I ² = 37.6 %, p = 0.12). There was an evident non-linear association of fruit intake with type 2 diabetes (P for nonlinearity <0.001). A non-linear threshold of 200 g/day of fruit intake was identified and the risk of type 2 diabetes reduced by about 13 % at this cut-off. Our findings are consistent with diet recommendations to consume about 200 g/day of fruits to prevent type 2 diabetes.

Available only for authorised users

J.E. Shaw, R.A. Sicree, P.Z. Zimmet, Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res. Clin. Pract. 87, 4–14 (2010)CrossRefPubMed

C.L. Gillies, K.R. Abrams, P.C. Lambert, N.J. Cooper, A.J. Sutton, R.T. Hsu, K. Khunti, Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 334, 299 (2007)CrossRefPubMedCentralPubMed

L. Dauchet, P. Amouyel, S. Hercberg, J. Dallongeville, Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J. Nutr. 136, 2588–2593 (2006)PubMed

F.J. He, C.A. Nowson, G.A. MacGregor, Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 367, 320–326 (2006)CrossRefPubMed

D. Aune, D.S. Chan, A.R. Vieira, D.A. Rosenblatt, R. Vieira, D.C. Greenwood, T. Norat, Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res. Treat. 134, 479–493 (2012)CrossRefPubMed

J. Liu, J. Wang, Y. Leng, C. Lv, Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: a meta-analysis of observational studies. Int. J. Cancer 133, 473–485 (2013)CrossRefPubMed

K.A. Meyer, L.H. Kushi, D.R. Jacobs Jr, J. Slavin, T.A. Sellers, A.R. Folsom, Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am. J. Clin. Nutr. 71, 921–930 (2000)PubMed

S. Liu, M. Serdula, S.J. Janket, N.R. Cook, H.D. Sesso, W.C. Willett, J.E. Manson, J.E. Buring, A prospective study of fruit and vegetable intake and the risk of type 2 diabetes in women. Diabetes Care 27, 2993–2996 (2004)CrossRefPubMed

J. Montonen, R. Järvinen, M. Heliövaara, A. Reunanen, A. Aromaa, P. Knekt, Food consumption and the incidence of type II diabetes mellitus. Eur. J. Clin. Nutr. 59, 441–448 (2005)CrossRefPubMed

10.

R. Villegas, X.O. Shu, Y.T. Gao, G. Yang, T. Elasy, H. Li, W. Zheng, Vegetable but not fruit consumption reduces the risk of type 2 diabetes in Chinese women. J. Nutr. 138, 574–580 (2008)PubMedCentralPubMed

11.

A.J. Cooper, N.G. Forouhi, Z. Ye, B. Buijsse, L. Arriola, B. Balkau, A. Barricarte, J.W. Beulens, H. Boeing, F.L. Büchner, C.C. Dahm, B. de Lauzon-Guillain, G. Fagherazzi, P.W. Franks, C. Gonzalez, S. Grioni, R. Kaaks, T.J. Key, G. Masala, C. Navarro, P. Nilsson, K. Overvad, S. Panico, J. Ramón Quirós, O. Rolandsson, N. Roswall, C. Sacerdote, M.J. Sánchez, N. Slimani, I. Sluijs, A.M. Spijkerman, B. Teucher, A. Tjonneland, R. Tumino, S.J. Sharp, C. Langenberg, E.J. Feskens, E. Riboli, N.J. Wareham, InterAct consortium. Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. Eur. J. Clin. Nutr. 66, 1082–1092 (2012)CrossRefPubMedCentralPubMed

12.

K. Kurotani, A. Nanri, A. Goto, T. Mizoue, M. Noda, M. Kato, M. Inoue, S. Tsugane, Japan Public Health Center-based Prospective Study Group. Vegetable and fruit intake and risk of type 2 diabetes: Japan Public Health Center-based Prospective Study. Br. J. Nutr. 109, 709–717 (2013)CrossRefPubMed

13.

I. Muraki, F. Imamura, J.E. Manson, F.B. Hu, W.C. Willett, R.M. van Dam, Q. Sun, Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 347, f5001 (2013)CrossRefPubMedCentralPubMed

14.

M. Hamer, Y. Chida, Intake of fruit, vegetables, and antioxidants and risk of type 2 diabetes: systematic review and meta-analysis. J. Hypertens. 25, 2361–2369 (2007)CrossRefPubMed

15.

P. Carter, L.J. Gray, J. Troughton, K. Khunti, M.J. Davies, Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 341, c4229 (2010)CrossRefPubMedCentralPubMed

16.

D.F. Stroup, J.A. Berlin, S.C. Morton, I. Olkin, G.D. Williamson, D. Rennie, D. Moher, B.J. Becker, T.A. Sipe, S.B. Thacker, Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 283, 2008–2012 (2000)CrossRefPubMed

17.

Wells GA, Shea B, O’connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed October 2013

18.

R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Control. Clin. Trials 7, 177–188 (1986)CrossRefPubMed

19.

N. Mantel, W. Haenszel, Statistical aspects of the analysis of data from retrospective studies of disease. J. Natl. Cancer Inst. 22, 719–748 (1959)PubMed

20.

J.P. Higgins, S.G. Thompson, J.J. Deeks, D.G. Altman, Measuring inconsistency in meta-analyses. BMJ. 327, 557–560 (2003)CrossRefPubMedCentralPubMed

21.

S. Greenland, M.P. Longnecker, Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am. J. Epidemiol. 135, 1301–1309 (1992)PubMed

22.

N. Orsini, R. Bellocco, S. Greenland, Generalized least squares for trend estimation of summarized dose–response data. Stata J. 6, 40–57 (2006)

23.

Y. Rong, L. Chen, T. Zhu, Y. Song, M. Yu, Z. Shan, A. Sands, F.B. Hu, L. Liu, Egg consumption and risk of coronary heart disease and stroke: dose–response meta-analysis of prospective cohort studies. BMJ. 346, e8539 (2013)CrossRefPubMedCentralPubMed

24.

D.E. Threapleton, D.C. Greenwood, C.E. Evans, C.L. Cleghorn, C. Nykjaer, C. Woodhead, J.E. Cade, C.P. Gale, V.J. Burley, Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 347, f6879 (2013)CrossRefPubMedCentralPubMed

25.

E. Riboli, T. Norat, Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk. Am. J. Clin. Nutr. 78, 559S–569S (2003)PubMed

26.

P. Royston, A strategy for modelling the effect of a continuous covariate in medicine and epidemiology. Stat. Med. 19, 1831–1847 (2000)CrossRefPubMed

27.

M. Egger, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 315, 629–634 (1997)CrossRefPubMedCentralPubMed

28.

G.A. Colditz, J.E. Manson, M.J. Stampfer, B. Rosner, W.C. Willett, F.E. Speizer, Diet and risk of clinical diabetes in women. Am. J. Clin. Nutr. 55, 1018–1023 (1992)PubMed

29.

L.A. Bazzano, T.Y. Li, K.J. Joshipura, F.B. Hu, Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 31, 1311–1317 (2008)CrossRefPubMedCentralPubMed

30.

K. Esposito, C.M. Kastorini, D.B. Panagiotakos, D. Giugliano, Prevention of type 2 diabetes by dietary patterns: a systematic review of prospective studies and meta-analysis. Metab. Syndr. Relat. Disord. 8, 471–476 (2010)CrossRefPubMed

31.

Esposito K, Chiodini P, Maiorino MI, Bellastella G, Panagiotakos D, Giugliano D. Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies. Endocrine:1-10 (2014)

32.

K. Hodgson, B. Govan, N. Ketheesan, J. Morris, Dietary composition of carbohydrates contributes to the development of experimental type 2 diabetes. Endocrine 43, 447–451 (2013)CrossRefPubMed

33.

A.H. Harding, N.J. Wareham, S.A. Bingham, K. Khaw, R. Luben, A. Welch, N.G. Forouhi, Plasma vitamin C level, fruit and vegetable consumption, and the risk of new-onset type 2 diabetes mellitus: the European prospective investigation of cancer—Norfolk prospective study. Arch. Intern. Med. 168, 1493–1499 (2008)CrossRefPubMed

34.

M. Gordon, Dietary antioxidants in disease prevention. Nat. Prod. Rep. 13, 265–273 (1996)CrossRefPubMed

35.

D. Montero, G. Walther, C.D. Stehouwer, A.J. Houben, J.A. Beckman, A. Vinet, Effect of antioxidant vitamin supplementation on endothelial function in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Obes. Rev. (2013). doi:10.1111/obr.12114 PubMed

36.

A.D. Liese, A.K. Roach, K.C. Sparks, L. Marquart, R.B. D’Agostino Jr, E.J. Mayer-Davis, Whole-grain intake and insulin sensitivity: the insulin resistance atherosclerosis study. Am. J. Clin. Nutr. 78, 965–971 (2003)PubMed

Title: Fruit intake decreases risk of incident type 2 diabetes: an updated meta-analysis
Authors: Shuangshuang Li
Song Miao
Yubei Huang
Zhaolu Liu
Huan Tian
Xiuxiu Yin
Weihong Tang
Lyn M. Steffen
Bo Xi
Publication date: 01-03-2015
Publisher: Springer US
Published in: Endocrine / Issue 2/2015
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-014-0351-6

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2015

A case of nephrotic syndrome hidden by Cushing’s disease

Relationship between autoantibodies combination, metabolic syndrome components and diabetic complications in autoimmune diabetes in adults

Relationship between dyslipidemia and albuminuria in prediabetic adults: The Korea National Health and Nutrition Examination Survey 2011–2012

Alterations of the daily rhythms of HPT axis induced by chronic unpredicted mild stress in rats

Prevalence and clinical characteristics of blepharoptosis in patients with diabetes in the Korea National Health and Nutrition Examination Survey (KNHANES) 2009–2010

Metformin in women with PCOS, CONS

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials