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Eating fresh fruit lowers risk for diabetes

Higher fresh fruit consumption was associated with a significantly lower risk for diabetes and a lower risk for major vascular complications and death among individuals with diabetes in China, according to an epidemiological study published in PLoS Medicine.

‘There is very limited evidence about the effects of fruit consumption on risks of death and major vascular complications among people with established diabetes,” Huaidong Du, PhD, MD, from the Nuffield Department of Population Health at the University of Oxford, and colleagues wrote. “Reliable assessment of the effects of fruit consumption on risk of incident diabetes and... on diabetic complications is urgently needed to improve dietary recommendations, especially in low- and middle-income countries such as China and other Asian countries where avoidance of sweet-tasting food (including fresh fruit) is common among diabetic patients.”

In this prospective study, researchers recruited Chinese adults aged 30 to 79 years between June 2004 to July 2008. During a follow-up period of 7 years, they recorded 9,504 new diabetes cases among 482,591 participants without previously diagnosed or screen-detected diabetes at baseline. Using Cox regression, the investigators associated each disease outcome with self-reported fresh fruit consumption and adjusted for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, BMI and family history of diabetes.

The results revealed that 18.8% of participants reported eating fresh fruit daily while 6.4% participants reported never/rarely consuming fruit (non-consumers). The proportion of non-consumers were about three times higher in individuals with previously diagnosed diabetes (18.9%) than those with screen-detected diabetes (6.7%) or no diabetes (6%). Du and colleagues observed that among those without diabetes at baseline, higher fruit consumption was linked to significantly lower risk for diabetes (HR = 0.88; 95% CI, 0.83-0.93) for daily vs. non-consumers. Higher fruit consumption was associated with lower risk for all-cause mortality (HR = 0.83; 95% CI, 0.74-0.93 per 100 g/day), microvascular complications (HR = 0.72; 95% CI, 0.61-0.87) and macrovascular complications (HR = 0.87; 95% CI, 0.82-0.93) among those with baseline diabetes. The estimated differences in 5-year absolute risk between daily and non-consumers were 1.9% for all-cause mortality, 1.1% for microvascular complications and 5.4% for macrovascular complications.

“Contrary to the common belief in China and many other low- and middle-income countries, fresh fruit consumption was not associated with an elevated blood glucose level in the present study, even in people with diabetes,” Du and colleagues wrote. “These findings have public health and clinical implications and provide strong evidence in support of current dietary guidelines that fresh fruit consumption should be recommended for all, including those with diabetes.”

There have been several other studies that have looked into the risk of developing diabetes. One suggested that a diet that is rich in cereal and vegetable fiber, but not fiber from fruit sources, may lower the risk for developing type 2 diabetes, while a second study suggested that men who increase their physical activity and women who lower their waist circumference may reduce some of their risk for progression from prediabetes to diabetes. – by Savannah Demko

Disclosure: Du reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.