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  • Original Article
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Carbohydrates, glycemic index and diabetes mellitus

Fruit and vegetable intake and the association with glucose parameters: a cross-sectional analysis of the Let’s Prevent Diabetes Study



Dietary recommendations for the prevention of type 2 diabetes mellitus include the message to consume 400 g fruit and vegetables per day. Measurement of habitual diet is inherently difficult, yet errors due to self-report can be eliminated by the use of nutritional biomarkers. The aim of this study was to determine plasma vitamin C concentrations as a biomarker for fruit and vegetable intake in individuals identified at high risk of diabetes. Fruit and vegetables may confer benefit via their antioxidant capacity, thus we also measured urinary F2-isoprostanes as a marker for oxidative stress.


Participants recruited from a high-risk population as part of a diabetes prevention trial provided fasting blood samples and a spot urine sample for the quantification of plasma vitamin C and F2-isoprostanes, respectively. We compared glycaemic parameters by the increments of the standard deviation of plasma vitamin C using multiple regression models.


Mean plasma vitamin C of participants was 39.3 μmol/l (s.d. 21.8). In the unadjusted model, 1 s.d. plasma vitamin C was significantly and inversely associated with HbA1c, fasting and 2 h blood glucose (P0.0001). Relationships remained significant after adjustment for demographic variables and confounding factors. No significant association was observed between plasma vitamin C and urinary F2-isoprostanes.


The data adds to the evidence that small lifestyle changes may influence glucose regulation. The role that fruit and vegetables independently have should be investigated further.

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We thank both Dr Jayne Woodside and Dr Sarah Gilchrist from Queens University Belfast for their analysis of plasma vitamin C. The project was supported by The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge on-going support from NIHR-CLAHRC, The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care—Leicestershire, Northamptonshire and Rutland. The Let’s Prevent Diabetes study is registered with ISRCTN - reference ISRCTN80605705.

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Correspondence to P Carter.

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KK and MJD have received grants from the National Institute of Health Research (NIHR) for studies on the prevention of type 2 diabetes. DT is employed by and conducted analysis of urinary F2-isoprostane at Unilever, Colworth, UK, all consumables and reagents were provided by Unilever.

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Carter, P., Gray, L., Talbot, D. et al. Fruit and vegetable intake and the association with glucose parameters: a cross-sectional analysis of the Let’s Prevent Diabetes Study. Eur J Clin Nutr 67, 12–17 (2013).

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