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Diet and diabetes risk: More (fruit and vegetables) is less

June 14, 2016

Healthy diets rich in fruit and vegetables have the potential to reduce incidence of type 2 diabetes, according to a new research article by Ambika Satija and colleagues published in PLOS Medicine.

Existing studies suggest a lower incidence of type 2 diabetes in people reporting a diet rich in fruit, vegetables and whole grains, and a higher incidence in those reporting consumption of red and processed meat. US dietary recommendations accordingly emphasize a shift from diets rich in meat to those rich in vegetables. Satija and colleagues aimed to provide greater detail on the food types and combinations associated with risk of type 2 diabetes. The authors made use of large prospective cohorts which have systematically gathered information from more than 200,000 US health professionals over more than 20 years, drawing on regular self-reported information on diet and with more than 16,000 documented cases of type 2 diabetes.

Using a systematic plant-based diet index (in which plant-derived foods received positive scores and animal-derived foods reverse scores), the results show that, after adjusting for body mass index, a plant-rich diet was associated with a reduced risk of type 2 diabetes by about 20% (hazard ratio 0.80, 95% CI 0.74-0.87). A healthier version of this plant-based diet index, in which healthier plant-derived foods such as fruit and vegetables were given positive scores, but less healthy plant-derived foods such as refined grains and fruit juices, and animal-derived foods, were given reverse scores, was associated with a diabetes risk further reduced by about 34% (hazard ratio 0.66, 95% CI 0.61-0.72). Finally, a less healthy plant-based diet index (in which less healthy plant-derived foods received positive scores, and healthier plant-derived foods and animal-derived foods reverse scores) was associated with a greater risk of diabetes. Although these findings are based on observational studies with a risk of bias, they provide information on the healthy plant-based dietary components and combinations which should be recommended to combat the increasing population-level threat of type 2 diabetes.
Research Article


This work was supported by research grants DK58845, UM1 CA186107, UM1 CA176726, and UM1 CA167552 from the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

All authors have read the journal's policy and have the following competing interests: EBR received a research grant from the USDA/Blueberry Highbush Council.


Satija A, Bhupathiraju SN, Rimm EB, Spiegelman D, Chiuve SE, Borgi L, et al. (2016) Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies. PLoS Med 13(6): e1002039. doi:10.1371/journal.pmed.1002039

Author Affiliations:

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America Department of Global Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America Renal Division, Brigham and Women's Hospital, Boston, Massachusetts, United States of America Harvard Medical School, Boston, Massachusetts, United States of America



Ambika Satija
Harvard T.H. Chan School of Public Health 677 Huntington Avenue Boston, MA 02115


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