The aim of this study was to investigate the independent effects of fruit and vegetable intake on the incidence of type 2 diabetes. This meta-analysis included 6 studies which resulted in 223,512 participants. Results showed that increasing the amount of green leafy vegetables by 1.15 servings a day in a diet could help reduce the risk of type 2 diabetes by 14%. Moreover, the data did not reveal any significant relationship between the consumption of fruits, vegetables, or fruits and vegetables combined on the incidence of diabetes, but a trend towards the benefit of consuming greater quantities was observed. In order to explain the significant heterogeneity observed between studies, a sensitivity analysis was performed for different factors such as sex, location, length of follow-up and classification of food groups, but no interactions were found. These results emphasize the importance of promoting the consumption of green leafy vegetables in the diet to reduce type 2 diabetes and the need to increase the use of nutritional biomarkers to reduce heterogeneity between nutritional observational studies. In their editorial comment, Mann J and Aune D underlined the necessity of evaluating the impact of measurement errors in the dietary assessment when analyzing data in nutritional studies. They also highlighted the fact that the message to the public concerning fruit and vegetable intake must remain clear and simple.
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