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Fruit and vegetable intake and cardiovascular risk factors in people with newly diagnosed type 2 diabetes.

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Lamb, MJE 
Griffin, SJ 
Sharp, SJ 
Cooper, AJM 


BACKGROUND/OBJECTIVES: The cardiovascular benefit of increasing fruit and vegetable (F&V) intake following diagnosis of diabetes remains unknown. We aimed to describe how quantity and variety of F&V intake, and plasma vitamin C, change after diagnosis of type 2 diabetes and examine whether these changes are associated with improvements in cardiovascular risk factors. SUBJECTS/METHODS: A total of 401 individuals with screen-detected diabetes from the ADDITION-Cambridge study were followed up over 5 years. F&V intake was assessed by food frequency questionnaire and plasma vitamin C at baseline, at 1 year and at 5 years. Linear mixed models were used to estimate associations of changes in quantity and variety of F&V intake, and plasma vitamin C, with cardiovascular risk factors and a clustered cardiometabolic risk score (CCMR), where a higher score indicates higher risk. RESULTS: F&V intake increased in year 1 but decreased by year 5, whereas variety remained unchanged. Plasma vitamin C increased at 1 year and at 5 years. Each s.d. increase (250g between baseline and 1 year and 270g between 1 and 5 years) in F&V intake was associated with lower waist circumference (-0.92 (95% CI: -1.57, -0.27) cm), HbA1c (-0.11 (-0.20, -0.03) %) and CCMR (-0.04 (-0.08, -0.01)) at 1 year and higher high-density lipoprotein (HDL)-cholesterol (0.04 (0.01, 0.06) mmol/l) at 5 years. Increased plasma vitamin C (per s.d., 22.5 μmol/l) was associated with higher HDL-cholesterol (0.04 (0.01, 0.06) mmol/l) and lower CCMR (-0.07 (-0.12, -0.03)) between 1 and 5 years. CONCLUSIONS: Increases in F&V quantity following diagnosis of diabetes are associated with lower cardiovascular risk factors. Health promotion interventions might highlight the importance of increasing, and maintaining increases in, F&V intake for improved cardiometabolic health in patients with diabetes.



Adult, Aged, Ascorbic Acid, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diet, Diet Surveys, Eating, Female, Follow-Up Studies, Fruit, Glycated Hemoglobin, Humans, Linear Models, Lipoproteins, HDL, Male, Middle Aged, Risk Assessment, Risk Factors, United Kingdom, Vegetables, Waist Circumference

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Eur J Clin Nutr

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Springer Science and Business Media LLC
Medical Research Council (MC_UU_12015/4)
MRC (1435170)
NIHR Central Commissioning Facility (NIHRDH-RP-PG-0606-1259)
Medical Research Council (G0001164)
Wellcome Trust (061895/Z/00/Z)
The ADDITION-Cambridge study was supported by the Wellcome Trust (grant G061895), the Medical Research Council (grant G0001164), the National Institute for Health Research (NIHR) Health Technology Assessment Programme (grant 08/116/300), National Health Service R&D support funding (including the Primary Care Research and Diabetes Research Networks). SJG received support from the Department of Health NIHR Programme Grant funding scheme (grant RP-PG-0606-1259). Bio-Rad provided equipment for HbA1c testing during the screening phase.