TABLE 3.
Type 2 diabetes risk across categories of increasing temperate, subtropical, tropical, or glycemic index–grouped whole-fruit consumption by sex in the SCHS1
| Fruit intake |
|||||||||
| Never or rarely | <1 serving/wk | 1 serving/wk | 2–3 servings/wk | 4–6 servings/wk | ≥1 servings/d | Per 3 servings/wk2 | P-trend | P-interaction by sex | |
| Temperate fruit | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.03 | 0.5 | 1.3 | 2.9 | 5.0 | 8.1 | — | — | — |
| Cases/person-years, n | 602/53,761 | 760/71,207 | 935/84,640 | 1497/142,465 | 716/69,344 | 697/73,324 | — | — | — |
| Multivariable model | 1.00 (reference)4 | 0.95 (0.85, 1.06) | 0.98 (0.88, 1.09) | 0.96 (0.87, 1.05) | 0.94 (0.83, 1.05) | 0.86 (0.77, 0.97) | 0.96 (0.93, 0.99) | 0.008 | 0.04 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.9 | 5.0 | 8.1 | — | — | — |
| Cases/person-years, n | 302/28,827 | 331/31,839 | 370/35,444 | 609/57,710 | 289/27,536 | 294/27,892 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.99 (0.85, 1.16) | 1.02 (0.87, 1.19) | 1.03 (0.89, 1.19) | 0.99 (0.83, 1.17) | 0.97 (0.82, 1.16) | 0.98 (0.94, 1.03) | 0.43 | — |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.4 | 3.0 | 5.1 | 8.1 | — | — | — |
| Cases/person-years, n | 300/24,934 | 429/39,368 | 565/49,196 | 888/84,755 | 427/41,808 | 403/45,432 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.91 (0.78, 1.05) | 0.95 (0.82, 1.09) | 0.90 (0.79, 1.03) | 0.89 (0.76, 1.04) | 0.79 (0.67, 0.92) | 0.94 (0.91, 0.98) | 0.006 | — |
| Subtropical fruit | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.1 | 2.5 | 5.1 | 7.1 | — | — | — |
| Cases/person-years, n | 1095/102,474 | 956/89,589 | 748/71,784 | 1362/129,097 | 435/42,551 | 611/59,246 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.97 (0.89, 1.06) | 0.99 (0.90, 1.09) | 1.01 (0.93, 1.09) | 0.98 (0.88, 1.10) | 1.01 (0.90, 1.12) | 1.00 (0.97, 1.04) | 0.78 | 0.06 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.1 | 2.5 | 5.1 | 7.1 | — | — | — |
| Cases/person-years, n | 417/42,064 | 388/38,859 | 314/30,477 | 611/55,476 | 196/18,502 | 269/23,870 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.96 (0.84, 1.11) | 1.03 (0.89, 1.20) | 1.07 (0.94, 1.22) | 1.02 (0.85, 1.21) | 1.07 (0.91, 1.26) | 1.02 (0.98, 1.07) | 0.31 | |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.1 | 2.5 | 5.1 | 7.1 | — | — | — |
| Cases/person-years, n | 678/60,410 | 568/50,730 | 434/41,307 | 751/73,621 | 239/24,049 | 342/35,376 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.99 (0.88, 1.11) | 0.97 (0.86, 1.09) | 0.97 (0.87, 1.08) | 0.96 (0.83, 1.12) | 0.96 (0.84, 1.11) | 0.99 (0.95, 1.03) | 0.53 | — |
| Tropical fruit | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.4 | 2.8 | 5.0 | 10.0 | — | — | — |
| Cases/person-years, n | 413/40,372 | 658/63,014 | 952/88,157 | 1446/138,802 | 892/86,723 | 846/77,673 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.02 (0.91, 1.16) | 1.05 (0.93, 1.18) | 1.05 (0.94, 1.17) | 1.01 (0.89, 1.14) | 1.08 (0.95, 1.22) | 1.02 (0.99, 1.04) | 0.15 | 0.10 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.4 | 2.8 | 5.0 | 10.1 | — | — | — |
| Cases/person-years, n | 131/15,256 | 212/20,811 | 329/32,641 | 595/56,601 | 440/41,522 | 488/42,417 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.20 (0.97, 1.50) | 1.12 (0.91, 1.38) | 1.19 (0.98, 1.45) | 1.16 (0.95, 1.41) | 1.24 (1.01, 1.53) | 1.03 (1.00, 1.06) | 0.06 | — |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.4 | 2.8 | 5.0 | 9.5 | — | — | — |
| Cases/person-years, n | 282/25,116 | 446/42,203 | 623/55,516 | 851/82,201 | 452/45,201 | 358/35,256 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.95 (0.81, 1.10) | 1.02 (0.88, 1.17) | 0.98 (0.86, 1.13) | 0.94 (0.80, 1.10) | 0.99 (0.83, 1.17) | 1.00 (0.97, 1.04) | 0.99 | — |
| Lower–glycemic index fruit | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.8 | 5.4 | 9.5 | — | — | — |
| Cases/person-years, n | 450/42,468 | 489/45,831 | 598/54,717 | 1161/108,143 | 1203/111,935 | 1306/131,647 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.99 (0.87, 1.13) | 1.00 (0.89, 1.13) | 1.02 (0.91, 1.14) | 1.03 (0.92, 1.16) | 0.95 (0.85, 1.06) | 0.99 (0.97, 1.01) | 0.23 | 0.04 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.8 | 5.3 | 9.6 | — | — | — |
| Cases/person-years, n | 220/22,457 | 200/19,792 | 238/23,355 | 466/45,202 | 509/45,810 | 562/52,632 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.99 (0.82, 1.20) | 1.02 (0.85, 1.23) | 1.04 (0.88, 1.23) | 1.11 (0.94, 1.31) | 1.03 (0.87, 1.22) | 1.01 (0.98, 1.04) | 0.51 | — |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.8 | 5.4 | 9.5 | — | — | — |
| Cases/person-years, n | 230/20,011 | 289/26,039 | 360/31,362 | 695/62,941 | 694/66,125 | 744/79,015 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.97 (0.81, 1.15) | 0.99 (0.83, 1.16) | 0.99 (0.85, 1.16) | 0.97 (0.83, 1.13) | 0.88 (0.75, 1.03) | 0.97 (0.94, 1.00) | 0.03 | — |
| Moderate–glycemic index fruit | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.6 | 5.1 | 9.0 | — | — | — |
| Cases/person-years, n | 773/70,586 | 1511/137,957 | 1261/121,864 | 967/95,665 | 433/43,287 | 262/25,382 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.00 (0.91, 1.09) | 0.96 (0.87, 1.05) | 0.92 (0.83, 1.02) | 0.89 (0.79, 1.01) | 0.91 (0.78, 1.06) | 0.95 (0.92, 0.99) | 0.02 | 0.76 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.6 | 5.1 | 8.8 | — | — | — |
| Cases/person-years, n | 290/29,770 | 595/53,718 | 520/51,243 | 465/43,275 | 198/19,551 | 127/11,691 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.11 (0.96, 1.28) | 0.98 (0.85, 1.14) | 1.00 (0.85, 1.16) | 0.88 (0.73, 1.06) | 0.90 (0.71, 1.13) | 0.94 (0.88, 1.00) | 0.04 | — |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.5 | 1.3 | 2.6 | 5.1 | 9.1 | — | — | — |
| Cases/person-years, n | 483/40,816 | 916/84,239 | 741/70,621 | 502/52,390 | 235/23,736 | 135/13,691 | — | — | — |
| Multivariable model | 1.00 (reference) | 0.94 (0.84, 1.05) | 0.95 (0.84, 1.07) | 0.88 (0.77, 1.00) | 0.91 (0.77, 1.08) | 0.92 (0.74, 1.13) | 0.97 (0.91, 1.02) | 0.22 | — |
| Higher–glycemic index fruit5 | |||||||||
| All | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.3 | 2.6 | 5.0 | 8.8 | — | — | — |
| Cases/person-years, n | 536/54,841 | 1010/94,602 | 1270/119,884 | 1308/126,513 | 609/56,967 | 474/41,934 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.08 (0.97, 1.20) | 1.11 (1.01, 1.23) | 1.09 (0.99, 1.21) | 1.11 (0.98, 1.26) | 1.20 (1.04, 1.37) | 1.05 (1.01, 1.08) | 0.007 | 0.02 |
| Men | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.4 | 2.6 | 5.0 | 9.1 | — | — | — |
| Cases/person-years, n | 156/19,509 | 323/31,794 | 493/47,263 | 596/56,463 | 323/29,729 | 304/24,490 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.22 (1.00, 1.48) | 1.30 (1.08, 1.56) | 1.30 (1.08, 1.56) | 1.28 (1.05, 1.56) | 1.51 (1.22, 1.86) | 1.08 (1.03, 1.13) | 0.0015 | — |
| Women | |||||||||
| Intake, servings/wk | 0.0 | 0.6 | 1.3 | 2.6 | 5.0 | 8.5 | — | — | — |
| Cases/person-years, n | 380/35,332 | 687/62,808 | 777/72,621 | 712/70,050 | 286/27,238 | 170/17,444 | — | — | — |
| Multivariable model | 1.00 (reference) | 1.02 (0.90, 1.16) | 1.04 (0.92, 1.18) | 1.01 (0.88, 1.15) | 1.05 (0.89, 1.23) | 0.99 (0.81, 1.20) | 1.01 (0.96, 1.06) | 0.80 | — |
Temperate fruit included apples, pears, apricots and peaches, grapes, and persimmon. Subtropical fruit included oranges and tangerines. Tropical fruit included bananas, papayas, mangos, pineapple, watermelon, honeydew melon, and cantaloupe. Lower–glycemic index fruit included apricots and peaches, apples, oranges, pears, and persimmon. Moderate–glycemic index fruit included tangerines, mango, papaya, and grapes. Higher–glycemic index fruit included bananas, honeydew melon, pineapple, cantaloupe, and watermelon. Data were analyzed with the use of Cox proportional hazards regression. Sex was not included as a covariate in sex-stratified models. Multivariable models were adjusted for age at baseline interview (years), sex, dialect group (Hokkien or Cantonese), year of baseline interview (1993–1995 or 1996–1998), total daily energy intake (kilocalories per day), physical activity (no moderate, vigorous, or strenuous activity; <4 h moderate activity/wk or <2 h vigorous or strenuous activity/wk; and ≥4 h moderate activity/wk or ≥2 h vigorous or strenuous activity/wk), education (no formal education; primary school education; and secondary school, A levels, or university), smoking status (never smoker, ex-smoker, and current smoker of 1–12 or ≥13 cigarettes/d), alcohol intake (0, <5, and ≥5 g/d), BMI (in kg/m2), total vegetable intake (grams per day), unsweetened soy intake (servings per day), saturated fat intake (percentage of kilocalories), dairy intake (grams per day), soft drink consumption (glasses per day), coffee intake (cups per day), black and green tea intake (cups per day), and fruit- and vegetable-juice intake (servings per day) and were mutually adjusted for climate-grouped or glycemic index–grouped fruit.
Estimated on the basis of every increment of 3 servings/wk.
Medians (all such values).
HR; 95% CI in parentheses (all such values).
Significant after Bonferroni correction.