Intake of vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a European diabetic population.
We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and RR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits.
Nöthlings
Ute
U
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, 14558 Germany. ute.noethlings@dife.de
Schulze
Matthias B
MB
Weikert
Cornelia
C
Boeing
Heiner
H
van der Schouw
Yvonne T
YT
Bamia
Christina
C
Benetou
Vasiliki
V
Lagiou
Pagona
P
Krogh
Vittorio
V
Beulens
Joline W J
JW
Peeters
Petra H M
PH
Halkjaer
Jytte
J
Tjønneland
Anne
A
Tumino
Rosario
R
Panico
Salvatore
S
Masala
Giovanna
G
Clavel-Chapelon
Francoise
F
de Lauzon
Blandine
B
Boutron-Ruault
Marie-Christine
MC
Vercambre
Marie-Noël
MN
Kaaks
Rudolf
R
Linseisen
Jakob
J
Overvad
Kim
K
Arriola
Larraitz
L
Ardanaz
Eva
E
Gonzalez
Carlos A
CA
Tormo
Marie-Jose
MJ
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Key
Tim J A
TJ
Vineis
Paolo
P
Riboli
Elio
E
Ferrari
Pietro
P
Boffetta
Paolo
P
Bueno-de-Mesquita
H Bas
HB
van der A
Daphne L
DL
Berglund
Göran
G
Wirfält
Elisabet
E
Hallmans
Göran
G
Johansson
Ingegerd
I
Lund
Eiliv
E
Trichopoulo
Antonia
A
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004032:Diet / Q000706:statistics & numerical data*; D004435:Eating; D005060:Europe / Q000453:epidemiology; D007887:Fabaceae; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D012307:Risk Factors; D014675:Vegetables