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Holt RR, Ho E, Li X, Fam VW, Hedayati N, Keen CL, Charoenwoodhipong P, Hackman RM. Short-Term Cardiometabolic Response to Mango Intake in Postmenopausal Women. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2025:1-9. [PMID: 40105371 DOI: 10.1080/27697061.2025.2478937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Revised: 03/07/2025] [Accepted: 03/08/2025] [Indexed: 03/20/2025]
Abstract
BACKGROUND Consumption of mangos has been associated with improved diet quality, with reported reductions in systolic blood pressure and inflammatory biomarkers when consumed daily in robust amounts for six to eight weeks. Whether these changes could occur with a shorter intake period is unknown. METHODS This study explored the effect of two weeks of mango intake (330 g/d) on microvascular function and cardiometabolic markers in a group of relatively healthy postmenopausal women with an overweight or obese body mass index. Outcomes were compared to two weeks of baseline measures without mango intake. RESULTS The primary outcome measure, microvascular function did not significantly change, while supine systolic blood pressure, mean arterial pressure, mean pulse pressure, and fasting cholesterol were significantly reduced. No significant changes in platelet aggregation or adhesion markers were noted. To explore the results further, a small probe study was conducted comparing the intake of mango to a calorically-equivalent amount of white bread. Blood glucose rose in both groups one hour after consumption, but significantly less after mango intake. Insulin levels also rose one hour after intake of both foods, but remained elevated in response to white bread, suggesting a moderating effect of mangos on glucose absorption and metabolism. CONCLUSIONS Further research using amounts of mango typically consumed, over an extended period of time, are warranted.
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Affiliation(s)
- Roberta R Holt
- Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Esther Ho
- Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Xiang Li
- Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Vivien W Fam
- Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Nasim Hedayati
- Division of Vascular Surgery, Department of Surgery, University of California Davis, Sacramento, California, USA
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Prae Charoenwoodhipong
- Division of Food Science and Nutrition, Faculty of Agricultural Product Innovation and Technology, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Robert M Hackman
- Department of Nutrition, University of California, Davis, Davis, California, USA
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Tang SS, Zhao XF, An XD, Sun WJ, Kang XM, Sun YT, Jiang LL, Gao Q, Li ZH, Ji HY, Lian FM. Classification and identification of risk factors for type 2 diabetes. World J Diabetes 2025; 16:100371. [PMID: 39959280 PMCID: PMC11718467 DOI: 10.4239/wjd.v16.i2.100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 10/24/2024] [Accepted: 11/26/2024] [Indexed: 12/30/2024] Open
Abstract
The risk factors for type 2 diabetes mellitus (T2DM) have been increasingly researched, but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and understand all the risk factors, which are categorized in this paper into five categories: Social determinants, lifestyle, checkable/testable risk factors, history of illness and medication, and other factors, which are discussed in a narrative review. Meanwhile, this paper points out the problems of the current research, helps to improve the systematic categorisation and practicality of T2DM risk factors, and provides a professional research basis for clinical practice and industry decision-making.
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Affiliation(s)
- Shan-Shan Tang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Xue-Fei Zhao
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Xue-Dong An
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Wen-Jie Sun
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Xiao-Min Kang
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Yu-Ting Sun
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Lin-Lin Jiang
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Qing Gao
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Ze-Hua Li
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Hang-Yu Ji
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
| | - Feng-Mei Lian
- Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
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Chua KY, Li H, Sheng LT, Lim WS, Koh WP. Intake of vegetables and fruits at midlife and the risk of physical frailty in later life. J Nutr Health Aging 2024; 28:100374. [PMID: 39316896 DOI: 10.1016/j.jnha.2024.100374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/21/2024] [Accepted: 09/14/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES Our study evaluated the independent and overall associations of vegetable and fruit consumption at midlife with the likelihood of physical frailty in later life. We also investigated whether specific nutrients in these foods could have accounted for these associations, if present. DESIGN Prospective cohort study. SETTING A population-based cohort of Chinese adults followed over a period of 20 years in Singapore. PARTICIPANTS We used data from 11,959 subjects who participated in the baseline (1993-1998) and follow-up 3 (2014-2017) interviews of the Singapore Chinese Health Study. MEASUREMENTS At baseline, dietary intake was evaluated using a validated food frequency questionnaire. During the follow-up 3 visits, physical frailty was assessed using a modified Cardiovascular Health Study phenotype that included weakness, slowness, exhaustion and weight loss. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations with physical frailty. RESULTS Participants had mean ages of 52 years at baseline, and 72 years at follow-up 3. Baseline intake of vegetables, but not of fruits, showed a dose-dependent inverse relationship with physical frailty at follow-up 3 (Ptrend = 0.001). Compared to participants in the lowest quintile of vegetable intake, those in the highest quintile had reduced odds of frailty [OR (95% CI): 0.73 (0.60-0.89)]. Among the components of physical frailty, vegetable intake had the strongest inverse association with weakness defined by handgrip strength [OR (95% CI) between extreme quintiles: 0.62 (0.52-0.73); Ptrend < 0.001]. In models that were individually adjusted for nutrients, the vegetable-frailty association was attenuated and no longer statistically significant after adjusting for the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates. CONCLUSION Increased midlife intake of vegetables was associated with reduced odds of physical frailty in later life, and the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates could have accounted for this association.
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Affiliation(s)
- Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore
| | - Huiqi Li
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li-Ting Sheng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore.
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Jafar TH, Tan NC, Gandhi M, Yoon S, Finkelstein E, Seng PMK, Ong R, Thiagarajah AG, Lee BL, To KC, Moosa AS. Evaluating a multicomponent intervention for managing kidney outcomes among patients with moderate or advanced chronic kidney disease (CKD): protocol for the Strategies for Kidney Outcomes Prevention and Evaluation (SKOPE) randomized controlled trial. Trials 2024; 25:730. [PMID: 39472975 PMCID: PMC11523586 DOI: 10.1186/s13063-024-08564-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 10/17/2024] [Indexed: 11/02/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) poses a global health challenge with high morbidity and mortality rates. Early detection and prompt intervention are critical in preventing progression to end-stage kidney disease (ESKD) and cardiovascular complications. Effective CKD management requires comprehensive care packages that integrate both pharmacological and non-pharmacological interventions within collaborative, team-based models, aiming to enhance patient outcomes and overall quality of life. The goal of the Strategies for Kidney Outcomes Prevention and Evaluation (SKOPE) study is to establish effective multicomponent intervention (MCI) strategies for evaluating and preventing kidney outcomes in patients with moderate to advanced CKD within primary care settings in Singapore. METHODS This study is a 3-year randomized controlled trial among 896 participants aged between 40 and 80 years with moderate or advanced CKD in five government-subsidized polyclinics in Singapore. The components of the MCI are (1) nurses/service coordinators trained as health coaches for motivational conversation and CKD-specific lifestyle counseling on diet and exercise, using a hybrid follow-up approach of in-person, telephone, and secure video meetings; (2) training physicians in algorithm-based standardized management of CKD; (3) subsidy on SGLT2i medications for CKD; and (4) regular CKD case review meetings. The primary outcome is the estimated glomerular filtration rate (eGFR) total slope from randomization to final follow-up at 36 months. DISCUSSION If shown to be effective, cost-effective, and acceptable, SKOPE should be considered for scaling country-wide and in similar regional healthcare systems. TRIAL REGISTRATION ClinicalTrials.gov NCT05295368. Registered on March 25, 2022.
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Affiliation(s)
- Tazeen Hasan Jafar
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore.
- Duke Global Health Institute, Durham, NC, USA.
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore
- Health Services Research Centre, SingHealth, Singapore, Singapore
| | - Mihir Gandhi
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Eric Finkelstein
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | | | - Ruiheng Ong
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Bing Long Lee
- National University Polyclinics, Singapore, Singapore
| | - Ka Chi To
- National University Polyclinics, Singapore, Singapore
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Wu C, Liu P, Yuan Z. Prospective association between fruit and vegetable intake and the risk of type 2 diabetes amongst Chinese adults: the China Health and Nutrition Survey. Int J Food Sci Nutr 2024; 75:81-91. [PMID: 37933616 DOI: 10.1080/09637486.2023.2278418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
This study aimed to prospectively explore the relationship between fruit and vegetable intake (FVI) and type 2 diabetes (T2D) risk amongst 13,175 Chinese adults. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of T2D events in relation to FVI. Results showed that the highest quintile of FVI was inversely associated with T2D risk in men (HR = 0.72, 95% CI: 0.50, 0.98) and women (HR = 0.74, 95% CI: 0.55, 0.97), whereas no such associations were observed between total vegetable intake and T2D in either men (HR = 0.92, 95% CI: 0.65, 1.26) or women (HR = 1.02, 95% CI: 0.77, 1.38). In addition, greater fruit intake was inversely associated with T2D risk in men (HR = 0.42, 95% CI: 0.28, 0.63) and women (HR = 0.64, 95% CI: 0.45, 0.90). Overall, FVI and total fruit intake were inversely associated with T2D risk amongst Chinese adults.
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Affiliation(s)
- Caifeng Wu
- Research Center, Chengdu Medical College, Chengdu, China
| | - Pingping Liu
- Hefei Yaohai District Center for Disease Control and Prevention, Hefei, China
| | - Zhanpeng Yuan
- School of Public Health, Wuhan University, Wuhan, China
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Yu H, Lee CM, Oh SW. Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort. Korean J Fam Med 2024; 45:44-50. [PMID: 37993763 PMCID: PMC10822724 DOI: 10.4082/kjfm.23.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND To determine the association between type 2 diabetes mellitus and the consumption of various fruits. METHODS The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40-69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels. RESULTS A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99-1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88-1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84-0.96; P<0.001) for grapes. CONCLUSION Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.
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Affiliation(s)
- Hojun Yu
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
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Lai JS, Godfrey KM, Ong CN, Tan KH, Yap F, Chong YS, Chan JKY, Chan SY, Chong MFF. Perinatal Plasma Carotenoids and Vitamin E Concentrations with Glycemia and Insulin Resistance in Women during and after Pregnancy. Nutrients 2023; 15:4421. [PMID: 37892496 PMCID: PMC10610276 DOI: 10.3390/nu15204421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
We examined the associations of perinatal plasma carotenoids and E vitamers concentrations with glycemia, insulin resistance, and gestational and type 2 diabetes mellitus during pregnancy and post-pregnancy in GUSTO women. Plasma carotenoid and E vitamer concentrations were measured at delivery, and principal component analysis was used to derive the patterns of their concentrations. Fasting and 2 h glucose levels and fasting insulin were measured at 26-28 weeks gestation and 4-6 years post-pregnancy, with the derivation of homeostatic model assessment for insulin resistance (HOMA-IR). In 678 women, two carotenoid patterns (CP1: α- and β-carotene and lutein; CP2: zeaxanthin, lycopene, and β-cryptoxanthin) and one E vitamer pattern (VE: γ-, δ-, and α-tocopherols) were derived. A higher CP1 score (1-SD) was associated with lower gestational fasting glucose (β (95%CI): -0.06 (-0.10, -0.02) mmol/L) and lower gestational (-0.17 (-0.82, 0.01) mmol/L, p = 0.06) and post-pregnancy HOMA-IR (-0.11 (-0.15, -0.08) mmol/L). A higher VE score (1 SD) was associated with higher gestational and post-pregnancy fasting and 2 h glucose (gestational: 0.05 (0.01, 0.08) and 0.08 (0.01, 0.16); post-pregnancy: 0.19 (0.07, 0.31) and 0.24 (0.06, 0.42) mmol/L). Higher α- and β-carotene and lutein may be beneficial for gestational fasting glycemia, but higher vitamin E may increase gestational and post-pregnancy glycemia, although these findings require confirmation in cohorts with prospective longitudinal measurements of these vitamins.
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Affiliation(s)
- Jun S. Lai
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (Y.S.C.); (S.-Y.C.); (M.F.-F.C.)
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore;
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (Y.S.C.); (S.-Y.C.); (M.F.-F.C.)
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Jerry K. Y. Chan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (Y.S.C.); (S.-Y.C.); (M.F.-F.C.)
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Mary F.-F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (Y.S.C.); (S.-Y.C.); (M.F.-F.C.)
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore;
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Sheng LT, Jiang YW, Alperet DJ, Feng L, Pan A, Koh WP. Quantity and variety of fruit and vegetable intake in midlife and cognitive impairment in late life: a prospective cohort study. Br J Nutr 2023; 129:2084-2093. [PMID: 35282850 DOI: 10.1017/s0007114522000848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is limited evidence on fruit and vegetable intake in relation to cognitive function. This study aimed to evaluate the associations of quantity and variety in fruit and vegetable intake in midlife with cognitive impairment in late life. We used data from 16 737 participants of the Singapore Chinese Health Study, a population-based cohort study. The participants provided dietary data at recruitment at median age of 52·5 (range: 45-74) years and also participated in the third follow-up interview 20 years later at median age of 72·2 (range: 61-96) years. Quantity and variety of fruits and vegetables consumed at baseline were measured using a validated FFQ. Cognitive impairment at the third follow-up was defined using a Singapore-modified version of Mini-Mental State Examination. About 14·3 % participants had cognitive impairment. In multivariable logistic regression models, comparing extreme quartiles for intake of fruits and vegetables combined, the OR (95 % CI) associated with cognitive impairment was 0·83 (95 % CI: 0·73, 0·95; P-trend = 0·006) for quantity and 0·76 (95 % CI: 0·67, 0·87; P-trend< 0·001) for variety scores. Independently, those with increased variety of fruit intake or higher quantity of vegetable intake also had significantly 22 % and 15 % reduced odds of cognitive impairment, respectively. Finally, compared with those with low intake for both quantity and variety, those with both high quantity and variety for fruits and vegetables had 23 % reduction in odds of cognitive impairment. In conclusion, increase in quantity and variety of fruits and vegetables in midlife may reduce the risk of cognitive impairment in late life.
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Affiliation(s)
- Li-Ting Sheng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province430030, People's Republic of China
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu Province, People's Republic of China
| | - Yi-Wen Jiang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province430030, People's Republic of China
| | - Derrick Johnston Alperet
- A*STAR Graduate Academy, Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province430030, People's Republic of China
- Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou, Zhejiang, People's Republic of China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Liao YP, Zheng QX, Jiang XM, Chen XQ, Gao XX, Pan YQ. Fruit, vegetable, and fruit juice consumption and risk of gestational diabetes mellitus: a systematic review and meta-analysis : List of all authors. Nutr J 2023; 22:27. [PMID: 37208776 DOI: 10.1186/s12937-023-00855-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Fruit, vegetable, and fruit juice intake is associated with the risk of gestational diabetes mellitus (GDM). However, the conclusion is limited and conflicted. The purpose of this systematic review and meta-analysis is to investigate the association between fruit, vegetable, and fruit juice consumption and the risk of GDM. METHODS To find relevant studies, we searched PubMed, The Cochrane Library, Web of Science, Embase, ScienceDirect, PsycINFO, CINAHL, Ovid, EBSCO, CBM, CNKI, Wanfang Data, and VIP for the report on prospective cohort studies published from inception to April 8, 2022. Summary relative risks (RR) and 95% confidence intervals (Cis) were estimated using a random-effects model. RESULTS A total of 12 studies with 32,794 participants were included in the meta-analysis. Total fruit consumption was associated with a lower risk of GDM (RR = 0.92, 95% CI = 0.86-0.99). Whereas an increasing the consumption of vegetable, including all vegetable (RR = 0.95, 95% CI = 0.87-1.03), starchy vegetable (RR = 1.01, 95% CI = 0.82-1.26), and fruit juice (RR = 0.97, 95% CI = 0.91-1.04) was not associated with a reduction in the risk of GDM. In a dose‒response analysis of eight studies, a 3% reduction in risk of GDM for a 100 g/d increase in fruit consumption (RR = 0.97, 95% CI = 0.96-0.99). CONCLUSIONS The findings suggest that higher fruit consumption may reduce the risk of GDM, with a 3% reduction in the risk of GDM for every 100 g/d increase in fruit intake. Higher-quality prospective studies or randomized clinical trials are required to validate the effect of different variations of fruits, vegetables, and fruit juice consumption on the risk of GDM.
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Affiliation(s)
- Yan-Ping Liao
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Shangjie Zhen, Minhou County, Fuzhou City, 350000, Fujian Province, China
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
| | - Qing-Xiang Zheng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China.
| | - Xiao-Qian Chen
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
| | - Xiao-Xia Gao
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Shangjie Zhen, Minhou County, Fuzhou City, 350000, Fujian Province, China
| | - Yu-Qing Pan
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
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Ebbeling CB, Ludwig DS. Treatment for childhood obesity: Using a biological model to inform dietary targets. J Pediatr 2022; 255:22-29. [PMID: 36509158 DOI: 10.1016/j.jpeds.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - David S Ludwig
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Inverse Association of Fruit and Vegetable Consumption with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus. Nutrients 2022; 14:nu14214559. [PMID: 36364821 PMCID: PMC9657780 DOI: 10.3390/nu14214559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to investigate the association of fruit and vegetable consumption with nonalcoholic fatty liver disease (NAFLD) in Chinese patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 2667 Chinese patients with T2DM aged 18 to 76 years from March 2017 to October 2021. Dietary intake was assessed using a food frequency questionnaire, and prevalent NAFLD was diagnosed with abdominal ultrasonography. High fruit−vegetable consumption was determined using ≥500 g/day consumption of both fruit and vegetable, and both fruit and vegetable consumption were divided into three categories of <200 g/day (low), 200−400 g/day (median) and >400 g (high). The primary outcome measurement was multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the prevalence of NAFLD in relation to the highest fruit and (or) vegetable intake compared with the lowest. Secondary analyses were conducted to assess the effects of either fruit or vegetable intake on the fatty liver index (FLI) using multivariable linear regressions. There were 1694 men and 973 women in this study, and 1445 (54.06%) participants had prevalent NAFLD. Patients with high fruit−vegetable intake had a lower prevalence of NAFLD than those with low fruit−vegetable intake (52.04% vs. 56.48%), but this difference was not statistically significant (p = 0.065). Vegetable intake had a significantly inverse association with NAFLD (OR: 0.68, 95% CI: 0.52−0.90), but this association was not pronounced with fruit intake (OR: 1.23, 95% CI: 0.89−1.69) or fruit−vegetable intake (OR: 0.90, 95% CI: 0.73−1.10). Additional analyses showed that an increase in vegetable intake was linearly associated with a significant reduction in FLI (β: −1.028, 95% CI: −1.836, −0.219). In conclusion, higher vegetable consumption was associated with lower odds of NAFLD in Chinese patients with T2DM, which suggested that increased vegetable intake might protect patients with diabetes against NAFLD.
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12
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Ning C, Jiao Y, Wang J, Li W, Zhou J, Lee YC, Ma DL, Leung CH, Zhu R, David Wang HM. Recent advances in the managements of type 2 diabetes mellitus and natural hypoglycemic substances. FOOD SCIENCE AND HUMAN WELLNESS 2022. [DOI: 10.1016/j.fshw.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Barouti AA, Tynelius P, Lager A, Björklund A. Fruit and vegetable intake and risk of prediabetes and type 2 diabetes: results from a 20-year long prospective cohort study in Swedish men and women. Eur J Nutr 2022; 61:3175-3187. [PMID: 35435501 PMCID: PMC9363331 DOI: 10.1007/s00394-022-02871-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/08/2022] [Indexed: 12/29/2022]
Abstract
Purpose To investigate the association between fruit and vegetable intake (FVI) and the risk of developing prediabetes and type 2 diabetes (T2D) in a Swedish prospective cohort study. Methods Subjects were 6961 men and women aged 35–56 years old at baseline, participating in the Stockholm Diabetes Prevention Program cohort. By design, the cohort was enriched by 50% with subjects that had family history of diabetes. Anthropometric measurements, oral glucose tolerance tests and questionnaires on lifestyle and dietary factors were carried out at baseline and two follow-up occasions. Cox proportional hazard models were used to estimate hazard ratios with 95% CIs. Results During a mean follow-up time of 20 ± 4 years, 1024 subjects developed T2D and 870 prediabetes. After adjustments for confounders, the highest tertile of total FVI was associated with a lower risk of developing T2D in men (HR 0.76, 95% CI 0.60–0.96). There was also an inverse association between total fruit intake and prediabetes risk in men, with the HR for the highest tertile being 0.76 (95% CI 0.58–1.00). As for subtypes, higher intake of apples/pears was inversely associated with T2D risk in both sexes, whereas higher intakes of banana, cabbage and tomato were positively associated with T2D or prediabetes risk in either men or women. Conclusion We found an inverse association between higher total FVI and T2D risk and between higher fruit intake and prediabetes risk, in men but not in women. Certain fruit and vegetable subtypes showed varying results and require further investigation. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02871-6.
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Affiliation(s)
- Afroditi Alexandra Barouti
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Diabetes, Academic Specialist Center, Region Stockholm, Stockholm, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Björklund
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Diabetes, Academic Specialist Center, Region Stockholm, Stockholm, Sweden.
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14
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Halvorsen RE, Elvestad M, Molin M, Aune D. Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies. BMJ Nutr Prev Health 2022; 4:519-531. [PMID: 35028521 PMCID: PMC8718861 DOI: 10.1136/bmjnph-2020-000218] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/28/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The association between intake of fruit and vegetables and their subtypes, and the risk of type 2 diabetes has been investigated in several studies, but the results have been inconsistent. OBJECTIVE We conducted an updated systematic review and dose-response meta-analysis of prospective studies on intakes of fruit and vegetables and fruit and vegetable subtypes and the risk of type 2 diabetes. DESIGN PubMed and Embase databases were searched up to 20 October 2020. Prospective cohort studies of fruit and vegetable consumption and type 2 diabetes mellitus were included. Summary relative risks (RRs) and 95% CIs were estimated using a random effects model. RESULTS We included 23 cohort studies. The summary RR for high versus low intake and per 200 g/day were 0.93 (95% CI: 0.89 to 0.98, I2=0%, n=10 studies) and 0.98 (95% CI: 0.95 to 1.01, I2=37.8%, n=7) for fruit and vegetables combined, 0.93 (95% CI: 0.90 to 0.97, I2=9.3%, n=20) and 0.96 (95% CI: 0.92 to 1.00, I2=68.4%, n=19) for fruits and 0.95 (95% CI: 0.88 to 1.02, I2=60.4%, n=17) and 0.97 (95% CI: 0.94 to 1.01, I2=39.2%, n=16) for vegetables, respectively. Inverse associations were observed for apples, apples and pears, blueberries, grapefruit and grapes and raisins, while positive associations were observed for intakes of cantaloupe, fruit drinks, fruit juice, brussels sprouts, cauliflower and potatoes, however, most of these associations were based on few studies and need further investigation in additional studies. CONCLUSIONS This meta-analysis found a weak inverse association between fruit and vegetable intake and type 2 diabetes risk. There is indication of both inverse and positive associations between intake of several fruit and vegetables subtypes and type 2 diabetes risk, however, further studies are needed before firm conclusions can be made.
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Affiliation(s)
- Rine Elise Halvorsen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Mathilde Elvestad
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Marianne Molin
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway.,Department of Nutrition, Bjørknes University College, Oslo, Norway
| | - Dagfinn Aune
- Department of Nutrition, Bjørknes University College, Oslo, Norway.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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15
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Liu M, Liu C, Zhang Z, Zhou C, Li Q, He P, Zhang Y, Li H, Qin X. Quantity and variety of food groups consumption and the risk of diabetes in adults: A prospective cohort study. Clin Nutr 2021; 40:5710-5717. [PMID: 34743048 DOI: 10.1016/j.clnu.2021.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Evidence remains inconsistent regarding the association between quantity of food groups and diabetes, and remains scarce regarding the relation of dietary diversity with diabetes. OBJECTIVE We aimed to evaluate the prospective relation of variety and quantity of 12 major food groups with new-onset diabetes. METHODS A total of 16,117 participants who were free of diabetes at baseline from China Health and Nutrition Survey were included. Dietary intake and variety score were measured by three consecutive 24-h dietary recalls combined with a household food inventory in each survey round. The study outcome was new-onset diabetes, defined as self-reported physician-diagnosed diabetes during the follow-up period. Cox proportional hazards models and restricted cubic spline analysis were used to estimate hazard ratios (HR) and dose-response relation, respectively. RESULTS During a median follow-up duration of 9.0 years, a total of 1088 (6.7%) participants developed new-onset diabetes. Overall, there was a significant inverse association between dietary variety score and the risk of new-onset diabetes (per one point increment; HR, 0.85; 95% CI, 0.80-0.90). In addition, there were U-shaped associations of refined grains, whole grains, nuts, red meat, poultry, processed meat, dairy products, and aquatic products intake with diabetes, and L-shaped associations of legumes, vegetables, fruits, and eggs intake with diabetes (all P values for nonlinearity <0.001). CONCLUSION Our results suggested that greater variety of food groups consumption was associated with significantly lower risk of new-onset diabetes. Furthermore, when the quantity of food groups intakes was relatively low, there was a negative correlation between the quantity of each different food group consumption and diabetes risk; however, when intake exceeded certain thresholds, the risks of new-onset diabetes increased or reached a plateau.
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Affiliation(s)
- Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Qinqin Li
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
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16
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Sun H, Dong H, Zhang Y, Lan X, Pang X, Cai C, Bai D, Zhang J, Li F, Zeng G. Specific fruit but not total fruit intake during early pregnancy is inversely associated with gestational diabetes mellitus risk: a prospective cohort study. Public Health Nutr 2021; 24:4054-4063. [PMID: 33947494 PMCID: PMC10195381 DOI: 10.1017/s1368980021001920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Fruit intake may influence gestational diabetes mellitus (GDM) risk. However, prospective evidence remains controversial and limited. The current study aimed to investigate whether total fruit and specific fruit intake influence GDM risk. DESIGN A prospective cohort study was conducted. Dietary information was collected by a 3-d 24-h dietary recall. All participants underwent a standard 75-g oral glucose tolerance test at 24-28 gestational weeks. Log-binomial models were used to estimate the association between fruit intake and GDM risk, and the results are presented as relative risks (RR) and 95 % CI. SETTING Southwest China. PARTICIPANTS Totally, 1453 healthy pregnant women in 2017. RESULTS Total fruit intake was not associated with lower GDM risk (RR of 1·03 (95 % CI 0·83, 1·27) (Ptrend = 0·789)). The RR of GDM risk was 0·73 for the highest anthocyanin-rich fruit intake quartile compared with the lowest quartile (95 % CI 0·56, 0·93; Ptrend = 0·015). A higher grape intake had a linear inverse association with GDM risk (Q4 v. Q1: RR = 0·65; 95 % CI 0·43, 0·98; Ptrend = 0·044), and after further adjustment for anthocyanin intake, the inverse association tended to be non-linear (Q4 v. Q1: RR = 0·65; 95 % CI 0·44, 0·98; Ptrend = 0·079). However, we did not find an association between glycaemic index-grouped fruit, glycaemic load-grouped fruit or other fruit subtype intake and GDM risk. CONCLUSIONS In conclusion, specific fruit intake (particularly anthocyanin-rich fruit and grapes) but not total fruit intake was inversely associated with GDM risk.
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Affiliation(s)
- Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Yiqi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Xi Lan
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Xinxin Pang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Congjie Cai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Dan Bai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Ju Zhang
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, SC, People’s Republic of China
| | - Fei Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
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17
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Jia X, Xuan L, Dai H, Zhu W, Deng C, Wang T, Li M, Zhao Z, Xu Y, Lu J, Bi Y, Wang W, Chen Y, Xu M, Ning G. Fruit intake, genetic risk and type 2 diabetes: a population-based gene-diet interaction analysis. Eur J Nutr 2021; 60:2769-2779. [PMID: 33399975 PMCID: PMC8275558 DOI: 10.1007/s00394-020-02449-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Whether the association between fruit and type 2 diabetes (T2D) is modified by the genetic predisposition of T2D was yet elucidated. The current study is meant to examine the gene-dietary fruit intake interactions in the risk of T2D and related glycemic traits. METHODS We performed a cross-sectional study in 11,657 participants aged ≥ 40 years from a community-based population in Shanghai, China. Fruit intake information was collected by a validated food frequency questionnaire by asking the frequency of consumption of typical food items over the previous 12 months. T2D-genetic risk score (GRS) was constructed by 34 well established T2D common variants in East Asians. The risk of T2D, fasting, 2 h-postprandial plasma glucose, and glycated hemoglobin A1c associated with T2D-GRS and each individual single nucleotide polymorphisms (SNPs) were tested. RESULTS The risk of T2D associated with each 1-point of T2D-GRS was gradually decreased from the lower fruit intake level (< 1 times/week) [the odds ratio (OR) and 95% confidence interval (CI) was 1.10 (1.07-1.13)], to higher levels (1-3 and > 3 times/week) [the corresponding ORs and 95% CIs were 1.08 (1.05-1.10) and 1.07 (1.05-1.08); P for interaction = 0.04]. Analyses for associations with fasting, 2 h-postprandial plasma glucose and glycated hemoglobin A1c demonstrated consistent tendencies (all P for interaction ≤ 0.03). The inverse associations of fruit intake with risk of T2D and glucose traits were more prominent in the higher T2D-GRS tertile. CONCLUSIONS Fruit intakes interact with the genetic predisposition of T2D on the risk of diabetes and related glucose metabolic traits. Fruit intake alleviates the association between genetic predisposition of T2D and the risk of diabetes; the association of fruit intake with a lower risk of diabetes was more prominent in population with a stronger genetic predisposition of T2D.
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Affiliation(s)
- Xu Jia
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Xuan
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huajie Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chanjuan Deng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Lu X, Lu J, Fan Z, Liu A, Zhao W, Wu Y, Zhu R. Both Isocarbohydrate and Hypercarbohydrate Fruit Preloads Curbed Postprandial Glycemic Excursion in Healthy Subjects. Nutrients 2021; 13:nu13072470. [PMID: 34371978 PMCID: PMC8308803 DOI: 10.3390/nu13072470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the impact of fruit preloads on the acute postprandial glycemic response (PGR) and satiety response of a rice meal in healthy female subjects based on iso-carbohydrate (IC) and hyper-carbohydrate (HC) contents, respectively. The IC test meals including (1) rice preload (R + 35R), (2) orange preload (O + 35R), (3) apple preload (A + 35R) and (4) pear preload (P + 35R), contained 50.0 g available carbohydrates (AC) where the preload contributed 15.0 g and rice provided 35.0 g. The HC meals included (1) orange preload (O + 50R), (2) apple preload (A+50R) and (3) pear preload (P + 50R), each containing 65.0 g AC, where the fruits contributed 15.0 g and rice provided 50.0 g. Drinking water 30 min before the rice meal was taken as reference (W + 50R). All the preload treatments, irrespective of IC or HC meals, resulted in remarkable reduction (p < 0.001) in terms of incremental peak glucose (IPG) and the maximum amplitude of glycemic excursion in 180 min (MAGE0–180), also a significant decrease (p < 0.05) in the area of PGR contributed by per gram of AC (AAC), compared with the W + 50R. Apple elicited the lowest PGR among all test meals, as the A + 35R halved the IPG and slashed the incremental area under the curve in 180 min (iAUC0–180) by 45.7%, while the A + 50R reduced the IPG by 29.7%, compared with the W + 50R. All the preload meals and the reference meal showed comparable self-reported satiety in spite of the difference in AC. In conclusion, pre-meal consumption of three fruits effectively curbed post-meal glycemia even in the case of a 30% extra carbohydrate load.
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Affiliation(s)
- Xuejiao Lu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
| | - Jiacan Lu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
| | - Zhihong Fan
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China
- Correspondence: ; Tel.: +86-10-62737717
| | - Anshu Liu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
| | - Wenqi Zhao
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
| | - Yixue Wu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
| | - Ruixin Zhu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (X.L.); (J.L.); (A.L.); (W.Z.); (Y.W.); (R.Z.)
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19
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Park HA. Fruit Intake to Prevent and Control Hypertension and Diabetes. Korean J Fam Med 2021; 42:9-16. [PMID: 33524250 PMCID: PMC7884895 DOI: 10.4082/kjfm.20.0225] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/11/2020] [Indexed: 01/10/2023] Open
Abstract
Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.
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Affiliation(s)
- Hyun Ah Park
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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21
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Wu C, Liu P, Yuan Z. Fruit and vegetable intake is inversely associated with type 2 diabetes in Chinese women: results from the China Health and Nutrition Survey. Int J Food Sci Nutr 2020; 72:208-218. [PMID: 32552185 DOI: 10.1080/09637486.2020.1780567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study aimed to evaluate the associations between fruit and vegetable (FV) intake and the risk of prediabetes or type 2 diabetes (T2D). It is a cross-sectional study that involved 6802 participants aged 18-65 years. Dietary intake and other variables were assessed by questionnaires. The prevalence of prediabetes and T2D was ascertained by self-report and analyses of fasting blood samples. In the multiple logistic regression models, FV intake was negatively associated the risk of T2D in women (OR = 0.45, 95% CI: 0.28, 0.71), whereas no such association was observed in men (OR = 0.98, 95% CI: 0.65, 1.47). Furthermore, FV consumption was inversely associated with prediabetes risk in men and women. Results suggested that higher intake of FV was associated with a decreased risk of T2D or prediabetes in Chinese women and a reduced risk of prediabetes in men only.
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Affiliation(s)
- Caifeng Wu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Pingping Liu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhanpeng Yuan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China.,Hubei Provincial Key Laboratory for Applied Toxicology, Wuhan, China
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22
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Lu J, Zhao W, Wang L, Fan Z, Zhu R, Wu Y, Zhou Y. Apple Preload Halved the Postprandial Glycaemic Response of Rice Meal on in Healthy Subjects. Nutrients 2019; 11:nu11122912. [PMID: 31810219 PMCID: PMC6950014 DOI: 10.3390/nu11122912] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/20/2019] [Accepted: 11/22/2019] [Indexed: 12/12/2022] Open
Abstract
This study aimed to investigate the possible glycemic effect of apple preload on acute postprandial glycemic responses (GRs) of a following rice meal, comparing with its co-ingestion counterpart and an apple sugar solution preload, based on equal carbohydrates intake. In a randomized crossover trial, 18 healthy female subjects consumed (1) rice, (2) co-ingestion of apple and rice (A+R), (3) apple preload and rice (PA+R), and (4) rice with sugar solution preload (same sugar profile as in apple) (PSS+R). Acute postprandial GR tests and subjective satiety tests were carried out for each test food. Compared with rice reference, the PA+R achieved a 50% reduction of the iAUC0-120, a 51.4% reduction of the average peak value, and a 52.6% reduction of glycemic excursion in 240 min, while the PSS+R showed 29.7% and 31.6% reduction of peak value and glycemic excursion, respectively. No significant differences were found between R and PA+R in any of the satiety characteristics. Compared with rice control, apple preload of 15 g available carbohydrates remarkably lowered the acute postprandial GR without negative effect on satiety. The sugar component may partly contribute to the glycemic suppressing effect of the apple preload.
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23
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Seah JYH, Ong CN, Koh WP, Yuan JM, van Dam RM. A Dietary Pattern Derived from Reduced Rank Regression and Fatty Acid Biomarkers Is Associated with Lower Risk of Type 2 Diabetes and Coronary Artery Disease in Chinese Adults. J Nutr 2019; 149:2001-2010. [PMID: 31386157 PMCID: PMC6825830 DOI: 10.1093/jn/nxz164] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/10/2019] [Accepted: 06/18/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Combinations of circulating fatty acids may affect the risk of type 2 diabetes (T2D) and coronary artery disease (CAD). No previous studies have identified a dietary pattern predicting fatty acid profiles using reduced rank regression (RRR) and evaluated its associations with the risk of T2D and CAD. OBJECTIVE The aim of this study was to derive a dietary pattern to explain variation in plasma fatty acid concentrations using RRR and evaluate these in relation to risk of T2D and CAD. METHODS We derived a dietary pattern using fatty acid concentrations from 711 controls of a nested case-control study in the Singapore Chinese Health Study using RRR with 36 food and beverages as predictors and 19 fatty acid biomarkers as responses. Dietary pattern scores were then calculated for the full cohort of men and women (mean age: 56 y). We followed up 45,411 and 58,065 participants for incident T2D and CAD mortality, respectively. Multivariable Cox regression models were used to estimate HRs and 95% CIs. RESULTS We identified a dietary pattern high in soy, vegetables, fruits, tea, tomato products, bread, fish, margarine and dairy, and low in rice, red meat, coffee, alcohol, sugar-sweetened beverages, and eggs. This pattern predicted higher circulating n-3 (ω-3) PUFAs (18:3n-3, 20:3n-3, 20:5n-3), odd-chain fatty acids (15:0, 17:0), 18:2n-6 and 20:1, and lower 20:4n-6 and 16:1. During a mean follow-up of 11 y and 19 y, 5207 T2D and 3016 CAD mortality events, respectively, were identified. Higher dietary pattern scores were associated with a lower risk of T2D [multivariable-adjusted HR comparing extreme quintiles, 0.86 (95% CI: 0.79, 0.95); P-trend <0.001] and CAD mortality [HR, 0.76 (95% CI: 0.68, 0.86); P-trend <0.001]. CONCLUSIONS Dietary patterns reflecting higher circulating n-3 PUFAs, odd-chain fatty acids, and linoleic acid may be associated with lower T2D and CAD risk in Chinese adults. This trial was registered at www.clinicaltrials.gov as NCT03356340.
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Affiliation(s)
- Jowy Y H Seah
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore
- NUS Graduate School for Integrative Sciences and Engineering, NUS, Singapore
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore
- NUS Environmental Research Institute, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore
- NUS Graduate School for Integrative Sciences and Engineering, NUS, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, NUS and National University Health System, Singapore
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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Gayer BA, Avendano EE, Edelson E, Nirmala N, Johnson EJ, Raman G. Effects of Intake of Apples, Pears, or Their Products on Cardiometabolic Risk Factors and Clinical Outcomes: A Systematic Review and Meta-Analysis. Curr Dev Nutr 2019; 3:nzz109. [PMID: 31667463 PMCID: PMC6813372 DOI: 10.1093/cdn/nzz109] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/06/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022] Open
Abstract
Apples and pears contain nutrients that have been linked to cardiovascular health. We conducted a systematic review and meta-analysis to summarize related research. Medline, Cochrane Central, and Commonwealth Agricultural Bureau databases were searched for publications on apple or pear intake and cardiovascular disease (CVD)/ cardiometabolic disease (CMD). Studies in adults (healthy or at risk for CVD) that quantified apple or pear intake were included. Random-effects models meta-analysis was used when ≥3 studies reported the same outcome. In total, 22 studies were eligible including 7 randomized controlled trial, 1 nonrandomized trial, and 14 prospective observational studies. In RCTs, apple intake significantly decreased BMI, but made no difference in body weight, serum lipids, blood glucose, or blood pressure. In observational studies, apple or pear intake significantly decreased risk of cerebrovascular disease, cardiovascular death, type 2 diabetes mellitus, and all-cause mortality. No association was reported for cerebral infarction or intracerebral hemorrhage. In conclusion, apple or pear intake significantly decreased BMI and risk for CVD outcomes.
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Affiliation(s)
- Bridget A Gayer
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Esther E Avendano
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
| | - Emily Edelson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Nanguneri Nirmala
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
| | - Elizabeth J Johnson
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Gowri Raman
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
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25
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Green leafy and cruciferous vegetable consumption and risk of type 2 diabetes: results from the Singapore Chinese Health Study and meta-analysis. Br J Nutr 2018; 119:1057-1067. [PMID: 29457582 DOI: 10.1017/s0007114518000119] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Several previous prospective studies suggest that consumption of green leafy and cruciferous vegetables may lower the risk of type 2 diabetes (T2D). We investigated the association between consumption of different types of vegetables in relation to T2D risk in an Asian Population. We included 45 411 participants (age range: 45-74 years) of the Singapore Chinese Health Study (SCHS) free of diabetes, cancer or CVD at baseline (1993-1998). Dietary information was collected using a validated FFQ. Physician-diagnosed incident diabetes was reported at follow-up I (1999-2004) and II (2006-2010) interviews. Cox proportional hazards regression was used to estimate hazard ratio (HR) and 95 % CI of T2D risk. An updated meta-analysis was also conducted to summarise results for green leafy and cruciferous vegetables. During 494 741 person-years of follow-up, 5207 incident T2D occurred. After adjustment for potential confounders, neither total vegetables (top v. bottom quintile HR=1·08; 95 % CI 0·98, 1·18, P trend=0·66) nor specific vegetables including dark green leafy vegetables (HR=1·05; 95 % CI 0·96, 1·15, P trend=0·21) and cruciferous vegetables (HR=0·97; 95 % CI 0·88, 1·06, P trend=0·29) were substantially associated with risk of T2D. A meta-analysis (eleven studies with 754 729 participants and 58 297 cases) including the SCHS and all previous prospective studies suggested borderline significant inverse associations between green leafy (summary relative risk (RR)=0·91; 95 % CI 0·84, 1·00) and cruciferous vegetable consumption (RR=0·87; 95 % CI 0·76, 1·00) and T2D risk, with moderate-to-high heterogeneity. In conclusion, green leafy or cruciferous vegetable consumption was not substantially associated with risk of T2D in an Asian population. Meta-analysis of available cohort data indicated that evidence for a beneficial effect of green leafy or cruciferous vegetable consumption on T2D risk is not convincing.
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