Fruit and vegetable consumption and diabetes mellitus incidence among US adults

Background. Adequate fruit and vegetable intake may lower the risk of sever al chronic diseases, but little is known about how it affects the risk of d iabetes mellitus. Methods. We examined whether fruit and vegetable consumption was associated with diabetes incidence in a cohort of U.S. adults aged 25-74 years who we re followed for about 20 years. Results. In the analytic sample of 9,665 participants, 1,018 developed diab etes mellitus. The mean daily intake of fruits and vegetables as well as th e percentage of participants consuming five or more fruits and vegetables p er day was lower among persons who developed diabetes than among persons wh o remained free of this disease (P < 0.001). After adjustments for age, rac e or ethnicity, cigarette smoking, systolic blood pressure, use of antihype rtensive medication, serum cholesterol concentration, body mass index, recr eational exercise, nonrecreational exercise, and alcohol consumption, the h azard ratio for participants consuming five or more servings of fruits and vegetables per day compared with those consuming none was 0.73 (95% confide nce interval (CI), 0.54-0.98) for all participants, 0.54 (95% CI, 0.36-0.81 ) for women, and 1.09 (95% CI, 0.63-1.87) for men. Adding education to the model changed the hazard ratios to 0.79 (95% CI, 0.59-1.06) for all partici pants, 0.61 (95% CI, 0.42-0.88) for women, and 1.14 (95% CI, 0.67-1.93) for men. Conclusions. Fruit and vegetable intake may be inversely associated with di abetes incidence particularly among women. Education may explain partly thi s association.