Although the health benefits of diets including fresh fruit and vegetables are well established, the sugar content of fruit has led to uncertainty about associated risks of diabetes and of vascular complications of the disease.
Therefore, Huaidong Du of the University of Oxford and colleagues studied nearly 500,000 people participating in the China Kadoorie Biobank over seven years, documenting new cases of diabetes and recording the occurrence of vascular disease and death in people with pre-existing diabetes.
The researchers found that people who reported elevated consumption of fresh fruit had a lower associated risk of developing diabetes in comparison with other participants.
The data corresponded to an estimated 0.2% reduction in the absolute risk of diabetes over five years.
In people with diabetes, higher consumption of fresh fruit was associated with a lower risk of mortality, corresponding to an absolute decrease in risk of 1.9% at five years. They also had a lower risk of microvascular and macrovascular complications.
In addition to the health benefits of consuming fresh fruit, Du and colleagues emphasised the value of their findings for Asian populations where fruit consumption is commonly restricted in people with diabetes.
Significant lower risk
Writing in the journal PLOS Medicine, they stated: “Overall, 18.8% of participants reported consuming fresh fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%).
“Among those without diabetes at baseline, higher fruit consumption was associated with significantly lower risk of developing diabetes, with a clear dose–response relationship. Among those with baseline diabetes, higher fruit consumption was associated with lower risks of all-cause mortality.”
The main limitation of this observational study is that the effects of fruit consumption can be difficult to distinguish from those of participants’ other dietary and behavioural characteristics.
However, the academics concluded: “To our knowledge, this is the first large prospective study demonstrating similar inverse associations of fruit consumption with both incident diabetes and diabetic complications. These findings suggest that a higher intake of fresh fruit is potentially beneficial for primary and secondary prevention of diabetes. For individuals who have already developed diabetes, restricted consumption of fresh fruit, which is common in many parts of the world, e.g., China and other Asian countries, should not be encouraged.”
Source: PLOS Medicine
“Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults”.
Authors:Huaidong Du, et al.