Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies
Abstract
Objective To determine whether individual fruits are differentially associated with risk of type 2 diabetes.
Design Prospective longitudinal cohort study.
Setting Health professionals in the United States.
Participants
66 105 women from the Nurses’ Health Study (1984-2008), 85 104 women
from the Nurses’ Health Study II (1991-2009), and 36 173 men from the
Health Professionals Follow-up Study (1986-2008) who were free of major
chronic diseases at baseline in these studies.
Main outcome measure Incident cases of type 2 diabetes, identified through self report and confirmed by supplementary questionnaires.
Results
During 3 464 641 person years of follow-up, 12 198 participants
developed type 2 diabetes. After adjustment for personal, lifestyle, and
dietary risk factors of diabetes, the pooled hazard ratio of type 2
diabetes for every three servings/week of total whole fruit consumption
was 0.98 (95% confidence interval 0.96 to 0.99). With mutual adjustment
of individual fruits, the pooled hazard ratios of type 2 diabetes for
every three servings/week were 0.74 (0.66 to 0.83) for blueberries, 0.88
(0.83 to 0.93) for grapes and raisins, 0.89 (0.79 to 1.01) for prunes,
0.93 (0.90 to 0.96) for apples and pears, 0.95 (0.91 to 0.98) for
bananas, 0.95 (0.91 to 0.99) for grapefruit, 0.97 (0.92 to 1.02) for
peaches, plums, and apricots, 0.99 (0.95 to 1.03) for oranges, 1.03
(0.96 to 1.10) for strawberries, and 1.10 (1.02 to 1.18) for cantaloupe.
The pooled hazard ratio for the same increment in fruit juice
consumption was 1.08 (1.05 to 1.11). The associations with risk of type 2
diabetes differed significantly among individual fruits (P<0.001 in
all cohorts).
Conclusion Our findings
suggest the presence of heterogeneity in the associations between
individual fruit consumption and risk of type 2 diabetes. Greater
consumption of specific whole fruits, particularly blueberries, grapes,
and apples, is significantly associated with a lower risk of type 2
diabetes, whereas greater consumption of fruit juice is associated with a
higher risk.
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