Elsevier

Preventive Medicine

Volume 32, Issue 1, January 2001, Pages 33-39
Preventive Medicine

Regular Article
Fruit and Vegetable Consumption and Diabetes Mellitus Incidence among U.S. Adults

https://doi.org/10.1006/pmed.2000.0772Get rights and content

Abstract

Background. Adequate fruit and vegetable intake may lower the risk of several chronic diseases, but little is known about how it affects the risk of diabetes mellitus.

Methods. We examined whether fruit and vegetable consumption was associated with diabetes incidence in a cohort of U. S. adults aged 25–74 years who were followed for about 20 years.

Results. In the analytic sample of 9,665 participants, 1,018 developed diabetes mellitus. The mean daily intake of fruits and vegetables as well as the percentage of participants consuming five or more fruits and vegetables per day was lower among persons who developed diabetes than among persons who remained free of this disease (P < 0.001). After adjustments for age, race or ethnicity, cigarette smoking, systolic blood pressure, use of antihypertensive medication, serum cholesterol concentration, body mass index, recreational exercise, nonrecreational exercise, and alcohol consumption, the hazard ratio for participants consuming five or more servings of fruits and vegetables per day compared with those consuming none was 0.73 (95% confidence interval (CI), 0.54–0.98) for all participants, 0.54 (95% CI, 0.36–0.81) for women, and 1.09 (95% CI, 0.63–1.87) for men. Adding education to the model changed the hazard ratios to 0.79 (95% CI, 0.59–1.06) for all participants, 0.61 (95% CI, 0.42–0.88) for women, and 1.14 (95% CI, 0.67–1.93) for men.

Conclusions. Fruit and vegetable intake may be inversely associated with diabetes incidence particularly among women. Education may explain partly this association.

References (51)

  • National diabetes fact sheet

    (1995)
  • CL Leibson et al.

    Relative contributions of incidence and survival to increasing prevalence of adult-onset diabetes mellitus: a population-based study

    Am J Epidemiol

    (1997)
  • MMWR Morb Mortal Wkly Rep

    (1997)
  • RJ Kuczmarski et al.

    Increasing prevalence of overweight among US adults

    JAMA

    (1994)
  • DA Galuska et al.

    Trends in overweight among U.S. adults from 1987–1993: results from a multistate telephone survey

    Am J Public Health

    (1996)
  • KM Flegal et al.

    Overweight and obesity in the United States: prevalence and trends, 1960–1994

    Int J Obes Relat Metab Disord

    (1998)
  • Diabetes Care

    (1998)
  • KM West

    Epidemiology of diabetes and its vascular lesions

    (1978)
  • AR Ness et al.

    Fruits and vegetables and cardiovascular disease: a review

    Int J Epidemiol

    (1997)
  • DA Snowdon et al.

    Does a vegetarian diet reduce the occurrence of diabetes?

    Am J Public Health

    (1985)
  • EJ M Feskens et al.

    Dietary factors determining diabetes and impaired glucose tolerance

    Diabetes Care

    (1995)
  • Plan and operation of the Health and Nutrition Examination Survey, United States—1971–1973

    (1973)
  • Plan and operation of the Health and Nutrition Examination Survey, United States—1971–1973

    (1977)
  • Plan and operation of the HANES I Augmentation Survey of Adults 25–74 years, United States—1974–1975

    (1978)
  • Plan and operation of the NHANES I Epidemiologic Followup Study, 1987

    (1992)
  • Cited by (260)

    View all citing articles on Scopus
    1

    To whom correspondence should be addressed at Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K26, Atlanta, GA 30341. Fax: (770) 488-6000. E-mail: [email protected].

    View full text