Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women

Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women Lydia A. Bazzano , MD, PHD 1 , Tricia Y. Li , MD, MS 2 , Kamudi J. Joshipura , BDS, MS, SCD 3 and Frank B. Hu , MD, PHD 4 1 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 2 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 3 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, the University of Puerto Rico, Medical Sciences Campus, School of Dentistry, San Juan, Puerto Rico, and the Harvard School of Dental Medicine, Boston, Massachusetts 4 Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts, and the Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts Corresponding author: Lydia A. Bazzano, lbazzano{at}tulane.edu Abstract OBJECTIVE —The purpose of this study was to examine the association between fruit, vegetable, and fruit juice intake and development of type 2 diabetes. RESEARCH DESIGN AND METHODS —A total of 71,346 female nurses aged 38–63 years who were free of cardiovascular disease, cancer, and diabetes in 1984 were followed for 18 years, and dietary information was collected using a semiquantitative food frequency questionnaire every 4 years. Diagnosis of diabetes was self-reported. RESULTS —During follow-up, 4,529 cases of diabetes were documented, and the cumulative incidence of diabetes was 7.4%. An increase of three servings/day in total fruit and vegetable consumption was not associated with development of diabetes (multivariate-adjusted hazard ratio 0.99 [95% CI 0.94–1.05]), whereas the same increase in whole fruit consumption was associated with a lower hazard of diabetes (0.82 [0.72–0.94]). An increase of 1 serving/day in green leafy vegetable consumption was associated with a modestly lower hazard of diabetes (0.91 [0.84–0.98]), whereas the same change in fruit juice intake was associated with an increased hazard of diabetes (1.18 [1.10–1.26]). CONCLUSIONS —Consumption of green leafy vegetables and fruit was associated with a lower hazard of diabetes, whereas consumption of fruit juices may be associated with an increased hazard among women. Footnotes Published ahead of print at http://care.diabetesjournals.org on 4 April 2008. L.A.B. had full access to all of the data in the study and takes responsibility for the integrity and the accuracy of the d