Table 4.
Pooled hazard ratios (95% confidence intervals) of type 2 diabetes* for consumption of fruit juice and fruits grouped by their glycemic index/glycemic load in Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study
| Variables | Consumption levels | Linear trend† | P value | |||||
|---|---|---|---|---|---|---|---|---|
| <1 serving/week | 1 serving/week | 2-4 servings/week | 5-6 servings/week | ≥1 serving/day | For trend | For heterogeneity | ||
| Glycemic load‡: | ||||||||
| High | 1.00 | 0.89 (0.81 to 0.98) | 0.89 (0.82 to 0.96) | 0.81 (0.74 to 0.88) | 0.83 (0.76 to 0.91) | 0.93 (0.91 to 0.96) | <0.001 | 0.13 |
| Moderate | 1.00 | 0.96 (0.90 to 1.03) | 0.96 (0.90 to 1.02) | 0.97 (0.90 to 1.05) | 1.03 (0.94 to 1.13) | 1.01 (0.98 to 1.04) | 0.61 | 0.85 |
| Low | 1.00 | 0.94 (0.89 to 1.01) | 0.96 (0.90 to 1.01) | 0.92 (0.86 to 1.00) | 0.93 (0.86 to 1.02) | 0.98 (0.94 to 1.01) | 0.14 | 0.04 |
| Glycemic index§: | ||||||||
| High | 1.00 | 0.99 (0.92 to 1.07) | 0.94 (0.88 to 1.01) | 0.92 (0.85 to 0.99) | 0.99 (0.91 to 1.07) | 0.98 (0.95 to 1.01) | 0.21 | 0.20 |
| Moderate | 1.00 | 0.96 (0.91 to 1.01) | 0.89 (0.84 to 0.94) | 0.87 (0.80 to 0.94) | 0.94 (0.85 to 1.05) | 0.94 (0.90 to 0.97) | <0.001 | 0.97 |
| Low | 1.00 | 0.90 (0.82 to 1.00) | 0.87 (0.80 to 0.94) | 0.85 (0.78 to 0.93) | 0.87 (0.80 to 0.95) | 0.97 (0.94 to 1.00) | 0.06 | 0.58 |
| Fruit juice¶ | 1.00 | 1.03 (0.96 to 1.11) | 1.05 (0.99 to 1.12) | 1.08 (1.01 to 1.16) | 1.21 (1.13 to 1.29) | 1.08 (1.05 to 1.11) | <0.001 | 0.38 |
*Adjusted for age (years), ethnicity (white, African American, Hispanic, or Asian), body mass index (<23, 23.0-24.9, 25.0-26.9, 27.0-28.9, 29.0-30.9, 31.0-32.9, 33.0-34.9, 35.0-36.9, 37.0-38.9, 39.0-40.9, 41.0-42.9, 43.0-44.9, ≥45.0, or missing), smoking status (never, former, current (1–14, 15–24, or ≥25 cigarettes/day), or missing), multivitamin use (yes or no), physical activity (<3, 3.0-8.9, 9.0-17.9, 18.0-26.9, ≥27.0 MET (metabolic equivalent of task) hours/week, or missing), family history of diabetes (yes or no), menopausal status and post-menopausal hormone use (premenopause, post-menopause (never, former, or current hormone use), or missing, for women), oral contraceptive use (yes, no, or missing, for Nurses’ Health Study II) total energy intake (kcal/day), and modified alternate healthy eating index score (fifths). Results were pooled using a fixed effects model.
†Linear trend was modeled based on every three servings/week increment.
‡High glycemic load fruits included prunes, bananas, grapes, raisins, apples, and pears (glycemic load per serving 8.1-19.2), moderate glycemic load fruits included cantaloupe, oranges, and blueberries (5.7-8.0), and low glycemic load fruits included peaches, plums, apricots, grapefruit, and strawberries (1.3-5.6). Fruit juice consumption (<1, 1, 2-4, or 5-6 servings/week, or ≥1 serving/day) was further adjusted, and consumption of high, moderate, and low glycemic load fruits was mutually adjusted.
§High glycemic index fruits included cantaloupe, bananas, grapes, raisins (glycemic index 60-70), moderate glycemic index fruits included prunes, blueberries, and grapefruit (47-59), and low glycemic index fruits included apples, pears, oranges, peaches, plums, apricots, and strawberries (34-46). Fruit juice consumption (<1, 1, 2-4, or 5-6 servings/week, or ≥1 serving/day) was further adjusted, and consumption of high, moderate, and low glycemic index fruits was mutually adjusted.
¶Fruit juice included apple, orange, grapefruit, and other. Total whole fruit consumption (<4, or 4-6 servings/week, or 1, 2, or ≥3 servings/day) was further adjusted.