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Eating vegetables may protect against post-renal transplantation diabetes
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By eating roughly 6 oz of vegetables per day, adults who undergo renal transplantation can cut their chances of developing posttransplantation diabetes by more than half, according to findings published in Diabetes Care.
“Although transplantation-specific risk factors for [posttransplantation diabetes] have been identified … additional risk factors equivalent to those for type 2 diabetes in the general population are assumed to contribute to the risk for [posttransplantation diabetes],” António W. Gomes-Neto, MD, from the department of internal medicine at the University Medical Center Groningen of the University of Groningen in the Netherlands, and colleagues wrote. “Diet is regarded as one of the main modifiable risk factors for the development of type 2 diabetes; in particular, diets characterized by high fruit and vegetable intake.”
Gomes-Neto and colleagues recruited 472 adults (mean age, 51 years; 44.4% women) who underwent a renal transplant at University Medical Center Groningen between November 2008 and March 2011. All participants completed a food frequency questionnaire after surgery. The questionnaires were used to assess how much and how frequently participants ate fruit and vegetables. The researchers found that participants ate a median of 99 g of fruit per day and 108 g of vegetables per day.
“It’s also relevant to address that renal transplant recipients eat little fruit and vegetables as shown in our study, even lower than the general population,” Gomes-Neto told Endocrine Today. “We do not know exactly why this is, but we think this might be the result of dietary restrictions aimed to limit potassium intake to prevent hyperkalemia in the pretransplantation period.”
Follow-up took place through Sept. 30, 2015, and participants were monitored for the development of posttransplantation diabetes. A fasting plasma glucose level of at least 7 mmol/L, HbA1c of at least 6.5% or the presence of diabetes symptoms or medications were among the indicators used to confirm the presence of the disease.
Although the researchers assessed both fruit and vegetable consumption, they found that there was no difference in diabetes risk associated with eating fruit.
“It might be that in our study variation of fruit intake was too low or too few events of [posttransplantation diabetes] occurred, or a combination of both, for us to observe an otherwise existing association,” the researchers wrote. “Alternatively, it might be that [renal transplant recipients] are particularly susceptible to the adverse effects of fructose.”
According to the researchers, there was a negative association between the odds of diabetes development and vegetable consumption (HR = 0.77; 95% CI, 0.63-0.94), and this held through all adjustment models. In addition, there was a 55% reduction in the odds of diabetes development for those who ate a median of 175 g of vegetables per day compared with those who ate a median of 53 g per day (HR = 0.45; 95% CI, 0.23-0.9). This association also remained constant through all adjustment models, according to the researchers, who noted that the most effective vegetables for reducing risk were those of the cruciferous (HR = 0.81; 95% CI, 0.69-0.96) and leafy green (HR = 0.7; 95% CI, 0.53-0.93) varieties.
“The exact biological mechanisms responsible for the protective effect of vegetable intake against the development of diabetes remain largely unknown, although several mechanisms have been proposed,” the researchers wrote. “Our results suggest that increasing vegetable intake may reduce the risk of [posttransplantation diabetes] in this population, at least to a considerable extent, by improving the metabolic profile.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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