Fruit but not fruit juice to lower type 2 diabetes risk — AusDiab study

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People who consume two servings of fruit per day have 36% lower odds of developing type 2 diabetes than those who consume less than half a serving, found a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Diabetes is a huge public health burden. Approximately 463m adults worldwide were living with diabetes in 2019, and by 2045 this number is expected to rise to 700m. An estimated 374m people are at increased risk of developing type 2 diabetes, the most common form of the disease. A healthy diet and lifestyle can play a major role in lowering a person's diabetes risk.

"We found people who consumed around 2 servings of fruit per day had a substantially lower risk of developing type 2 diabetes over the next five years than those who consumed less than half a serving of fruit per day," said study author Dr Nicola Bondonno of Edith Cowan University's Institute for Nutrition Research in Perth, Australia. "We did not see the same patterns for fruit juice. These findings indicate that a healthy diet and lifestyle which includes the consumption of whole fruits is a great strategy to lower your diabetes risk."

The researchers studied data from 7,675 participants from the Baker Heart and Diabetes Institute's Australian Diabetes, Obesity and Lifestyle Study who provided information on their fruit and fruit juice intake through a food frequency questionnaire. They found participants who ate more whole fruits had 36 percent lower odds of having diabetes at five years. The researchers found an association between fruit intake and markers of insulin sensitivity, meaning that people who consumed more fruit had to produce less insulin to lower their blood glucose levels.

"This is important because high levels of circulating insulin (hyperinsulinemia) can damage blood vessels and are related not only to diabetes, but also to high blood pressure, obesity and heart disease," Bondonno said.

Study details:

Associations between fruit intake and risk of diabetes in the AusDiab cohort

Authors: Nicola P Bondonno, Raymond J Davey, Kevin Murray, Simone Radavelli-Bagatini, Catherine P Bondonno, Lauren C Blekkenhorst, Marc Sim, Dianna J Magliano, Robin M Daly, Jonathan E Shaw, Joshua R Lewis, Jonathan M Hodgson.

Published 1 June 2021 in The Journal of Clinical Endocrinology & Metabolism

Abstract

Context
Fruit, but not fruit juice, intake is inversely associated with type 2 diabetes mellitus (T2DM). However, questions remain about the mechanisms by which fruits may confer protection.

Objective
The aims of this work were to examine associations between intake of fruit types and 1) measures of glucose tolerance and insulin sensitivity and 2) diabetes at follow-up.

Methods
Among participants of the Australian Diabetes, Obesity and Lifestyle Study, fruit and fruit juice intake was assessed by food frequency questionnaire at baseline. Associations between fruit and fruit juice intake and 1) fasting plasma glucose, 2-hour postload plasma glucose, updated homeostasis model assessment of insulin resistance of β-cell function (HOMA2-%β), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin levels at baseline and 2) the presence of diabetes at follow-up (5 and 12 years) were assessed using restricted cubic splines in logistic and linear regression models.

Results
This population of 7675 Australians (45% males) had a mean ± SD age of 54 ± 12 years at baseline. Total fruit intake was inversely associated with serum insulin and HOMA2-%β, and positively associated with HOMA2-%S at baseline. Compared to participants with the lowest intakes (quartile 1), participants with moderate total fruit intakes (quartile 3) had 36% lower odds of having diabetes at 5 years (odds ratio, 0.64; 95% CI, 0.44-0.92), after adjusting for dietary and lifestyle confounders. Associations with 12-year outcomes were not statistically significant.

Conclusion
A healthy diet including whole fruits, but not fruit juice, may play a role in mitigating T2DM risk.

 

Full AusDiab study (Open access)

 

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