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Meta-Analysis
. 2014 Nov 5;4(11):e005497.
doi: 10.1136/bmjopen-2014-005497.

Fruit and Vegetable Intake and Risk of Type 2 Diabetes Mellitus: Meta-Analysis of Prospective Cohort Studies

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Free PMC article
Meta-Analysis

Fruit and Vegetable Intake and Risk of Type 2 Diabetes Mellitus: Meta-Analysis of Prospective Cohort Studies

Min Li et al. BMJ Open. .
Free PMC article

Abstract

Objective: To clarify and quantify the potential dose-response association between the intake of fruit and vegetables and risk of type 2 diabetes.

Design: Meta-analysis and systematic review of prospective cohort studies.

Data source: Studies published before February 2014 identified through electronic searches using PubMed and Embase.

Eligibility criteria for selecting studies: Prospective cohort studies with relative risks and 95% CIs for type 2 diabetes according to the intake of fruit, vegetables, or fruit and vegetables.

Results: A total of 10 articles including 13 comparisons with 24,013 cases of type 2 diabetes and 434,342 participants were included in the meta-analysis. Evidence of curve linear associations was seen between fruit and green leafy vegetables consumption and risk of type 2 diabetes (p=0.059 and p=0.036 for non-linearity, respectively). The summary relative risk of type 2 diabetes for an increase of 1 serving fruit consumed/day was 0.93 (95% CI 0.88 to 0.99) without heterogeneity among studies (p=0.477, I(2)=0%). For vegetables, the combined relative risk of type 2 diabetes for an increase of 1 serving consumed/day was 0.90 (95% CI 0.80 to 1.01) with moderate heterogeneity among studies (p=0.002, I(2)=66.5%). For green leafy vegetables, the summary relative risk of type 2 diabetes for an increase of 0.2 serving consumed/day was 0.87 (95% CI 0.81 to 0.93) without heterogeneity among studies (p=0.496, I(2)=0%). The combined estimates showed no significant benefits of increasing the consumption of fruit and vegetables combined.

Conclusions: Higher fruit or green leafy vegetables intake is associated with a significantly reduced risk of type 2 diabetes.

Figures

Figure 1
Figure 1
Process of literature search and study selection.
Figure 2
Figure 2
Random effects analysis of fully adjusted studies for highest versus lowest intake of fruit and risk of type 2 diabetes.
Figure 3
Figure 3
Dose–response analyses of fruit intake and risk of type 2 diabetes.
Figure 4
Figure 4
Random effects analysis of fully adjusted studies for highest versus lowest intake of vegetables and risk of type 2 diabetes.
Figure 5
Figure 5
Random effects analysis of fully adjusted studies for highest versus lowest intake of green leafy vegetables and risk of type 2 diabetes.
Figure 6
Figure 6
Dose–response analyses of green leafy vegetables intake and risk of type 2 diabetes.

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