Fruits and vegetables

Suggested

2 studies · 1 recommendation

Last updated: February 25, 2026

Suggested2 studies

Higher fruit and vegetable intake linked to substantially lower type 2 diabetes risk

Two large European cohort studies totaling over 23,500 participants demonstrate a strong inverse association between fruit and vegetable consumption and type 2 diabetes incidence. In the EPIC-InterAct case-cohort study (9,682 diabetes cases, 12,595 subcohort members across seven countries), dietary patterns rich in fruits and vegetables reduced diabetes risk by 8–13% per standard deviation increase in adherence (HRs 0.87–0.92). The EPIC-Norfolk nested case-control study (318 cases, 926 controls) found that objective biomarkers of fruit and vegetable intake — plasma vitamin C, beta-carotene, and lutein — showed even stronger protection: individuals in the highest quartile had 81% lower odds of developing diabetes compared to the lowest (OR 0.19, 95% CI: 0.12–0.32). This association persisted after adjusting for BMI and waist circumference (OR 0.60 per s.d. increase), confirming benefits beyond weight management alone.

Evidence

The association between a biomarker score for fruit and vegetable intake and incident type 2 diabetes: the EPIC-Norfolk study.

Authors: Cooper, AJM, Forouhi, NG, Khaw, K-T, Luben, RN, Sharp, SJ, Wareham, NJ

Published: November 12, 2014

In a nested case-control study within the EPIC-Norfolk cohort (318 incident diabetes cases, 926 controls, aged 40-79, baseline 1993-1997), a composite biomarker score (CB-score) combining plasma vitamin C, beta-carotene, and lutein was inversely associated with incident type 2 diabetes. Compared to the lowest quartile (Q1), odds ratios for Q2, Q3, and Q4 were 0.70 (95% CI: 0.49-1.00), 0.34 (95% CI: 0.23-0.52), and 0.19 (95% CI: 0.12-0.32), respectively, after adjusting for demographic and lifestyle factors. Per standard deviation increase in CB-score, the OR was 0.49 (95% CI: 0.40-0.58). After additional adjustment for BMI and waist circumference, the association remained significant at OR 0.60 (95% CI: 0.49-0.74) per s.d. change.

View Source →

Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study.

Authors: InterAct Consortium

Published: February 1, 2014

In this case-cohort study nested within the EPIC cohort (9,682 incident diabetes cases and 12,595 subcohort participants from seven European countries), three RRR-derived dietary patterns commonly characterized by high fruit and vegetable intake showed inverse associations with type 2 diabetes. Per 1-SD increase in adherence, HRs were 0.91 (95% CI: 0.86–0.96), 0.92 (95% CI: 0.84–1.01), and 0.87 (95% CI: 0.82–0.92) after multivariable adjustment including body size. These associations held across countries despite heterogeneity partly explained by differences in participant age and dietary intake distribution.

View Source →