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Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies

BMJ 2013; 347 doi: (Published 29 August 2013) Cite this as: BMJ 2013;347:f5001

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Re: Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies

Muraki et al. found that “Greater consumption of specific whole fruits… is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk.” (1) This fascinating study brought to mind some other articles that might shine more light on these interesting findings.

Dietary fiber is more than roughage. It is food – prebiotics – for gastrointestinal microflora. (2) In return a healthy composition of microflora can promote the health of the host in part by producing short chain fatty acids (SCFA). A healthy composition of microflora is important for tempering inflammation. (2, 3, 4) A diet that includes prebiotics helps reduce inflammation by modulating microflora and reduces the risk of type 2 diabetes among other chronic diseases. (2, 3, 5, 6, 7, 8, 9) Fruit influences gastrointestinal microflora which may be one of the mechanisms by which a diet rich in fruit promotes health. (10, 11, 12, 13, 14) Thus a whole-plant-food-rich diet might promote health in part through prebiotic activity. (15)

About the author:

(1) Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM, Sun Q. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013 Aug 28;347:f5001. doi: 10.1136/bmj.f5001.
(2) Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013 Apr 22;5(4):1417-35.
(3) Carvalho BM, Saad MJ. Influence of gut microbiota on subclinical inflammation and insulin resistance. Mediators Inflamm. 2013;2013:986734.
(4) Cani PD, Neyrinck AM, Fava F, Knauf C, Burcelin RG, Tuohy KM, Gibson GR, Delzenne NM. Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia. 2007 Nov;50(11):2374-83.
(5) Yasuda A, Inoue KI, Sanbongi C, Yanagisawa R, Ichinose T, Yoshikawa T, Takano H. Dietary supplementation with fructooligosaccharides attenuates airway inflammation related to house dust mite allergen in mice. Int J Immunopathol Pharmacol. 2010 Jul-Sep;23(3):727-35.
(6) Xiao S, Fei N, Pang X et al A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome. FEMS Microbiol Ecol. 2013 Sep 30. doi: 10.1111/1574-6941.12228. [Epub ahead of print]
(7) Tuohy KM, Conterno L, Gasperotti M, Viola R Up-regulating the human intestinal microbiome using whole plant foods, polyphenols, and/or fiber. J Agric Food Chem. 2012 Sep 12;60(36):8776-82.
(8) Geurts L, Neyrinck AM, Delzenne NM, Knauf C, Cani PD. Gut microbiota controls adipose tissue expansion, gut barrier and glucose metabolism: novel insights into molecular targets and interventions using prebiotics. Benef Microbes. 2013 Jul 25:1-15. [Epub ahead of print]
(9) Bekkering P, Jafri I, van Overveld FJ, Rijkers GT. The intricate association between gut microbiota and development of Type 1, Type 2 and Type 3 diabetes. Expert Rev Clin Immunol. 2013 Nov;9(11):1031-41.
(10) Vong MH, Stewart ML In vitro bacterial fermentation of tropical fruit fibres. Benef Microbes. 2013 Sep 1;4(3):291-5.
(11) Vendrame S, Guglielmetti S, Riso P, Arioli S, Klimis-Zacas D, Porrini M. Six-week consumption of a wild blueberry powder drink increases bifidobacteria in the human gut. J Agric Food Chem. 2011 Dec 28;59(24):12815-20.
(12) Parkar SG, Rosendale D, Paturi G, Herath TD, Stoklosinski H, Phipps JE, Hedderley D, Ansell J. In vitro utilization of gold and green kiwifruit oligosaccharides by human gut microbial populations. Plant Foods Hum Nutr. 2012 Sep;67(3):200-7.
(13) Thuaytong W, Anprung P. Bioactive compounds and prebiotic activity in Thailand-grown red and white guava fruit (Psidium guajava L.). Food Sci Technol Int. 2011 Jun;17(3):205-12.
(14) Sembries S, Dongowski G, Jacobasch G, Mehrländer K, Will F, Dietrich H. Effects of dietary fibre-rich juice colloids from apple pomace extraction juices on intestinal fermentation products and microbiota in rats. Br J Nutr. 2003 Sep;90(3):607-15.
(15) Blaut M. Relationship of prebiotics and food to intestinal microflora. Eur J Nutr. 2002 Nov;41 Suppl 1:I11-6.

Competing interests: No competing interests

13 November 2013
Celia M. Ross
Science Journalist
Wilmington DE, USA