title: A prospective study of the association between quantity and variety of fruit and vegetable intake and incident type 2 diabetes.
abstract: OBJECTIVE
  The association between quantity of fruit and vegetable (F&V) intake and risk of type 2 diabetes (T2D) is not clear, and the relationship with variety of intake is unknown. The current study examined the association of both quantity and variety of F&V intake and risk of T2D.
  
  
  METHODS
  We examined the 11-year incidence of T2D in relation to quantity and variety of fruit, vegetables, and combined F&V intake in a case-cohort study of 3,704 participants (n = 653 diabetes cases) nested within the European Prospective Investigation into Cancer and Nutrition-Norfolk study, who completed 7-day prospective food diaries. Variety of intake was derived from the total number of different items consumed in a 1-week period. Multivariable, Prentice-weighted Cox regression was used to estimate hazard ratios (HRs) and 95% CIs.
  
  
  RESULTS
  A greater quantity of combined F&V intake was associated with 21% lower hazard of T2D (HR 0.79 [95% CI 0.62-1.00]) comparing extreme tertiles, in adjusted analyses including variety. Separately, quantity of vegetable intake (0.76 [0.60-0.97]), but not fruit, was inversely associated with T2D in adjusted analysis. Greater variety in fruit (0.70 [0.53-0.91]), vegetable (0.77 [0.61-0.98]), and combined F&V (0.61 [0.48-0.78]) intake was associated with a lower hazard of T2D, independent of known confounders and quantity of intake comparing extreme tertiles.
  
  
  CONCLUSIONS
  These findings suggest that a diet characterized by a greater quantity of vegetables and a greater variety of both F&V intake is associated with a reduced risk of T2D.
authors.affiliation: MRCEpidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, U.K.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Cooper
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sharp
authors.forename: Marleen A H
authors.initials: MA
authors.lastname: Lentjes
authors.forename: Robert N
authors.initials: RN
authors.lastname: Luben
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Nita G
authors.initials: NG
authors.lastname: Forouhi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000517:prevention & control*; D015930:Diet Records; D004435:Eating; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables