Higher vegetable intake is associated with lower diabetes risk: cross-sectional evidence from the STEPS 2016 survey in Iran.

Abstract

Background: Evidence on the association between dairy products, fruit, and vegetable (FV) intake and the risk of diabetes and pre-diabetes is inconsistent across populations, particularly in Middle Eastern countries. Therefore, this study examined the association between dairy products and FV intake with pre-diabetes and diabetes risk in Iranian adults.

Methods: This nationwide Stepwise Approach to Surveillance (STEPS) survey conducted from April to November 2016 in 30 provinces of Iran with 30,541 participants over 18 years of age living in rural or urban Iran were selected for further investigation. Fasting blood sugar (FBS) was assessed by an autoanalyzer. Dietary intake was assessed using the world health organization (WHO) STEPwise questionnaire. Food intakes were categorized as follows: fruit and dairy product consumption: less than 1, 1, 2, and more than 2 servings; and vegetable intake: more than 3, 3, 2, and less than 2 servings/day. Multinomial logistic regression was used to evaluate associations between FV and dairy products intake with FBS levels, adjusting for body mass index, age, gender, physical activity, education, marital status, area of residency, smoking history, occupation, and wealth index.

Results: In the adjusted model, the inverse relationship between vegetable intake and diabetes remained significant. Specifically: two servings/day (odds ratio (OR) = 0.46; 95% confidence interval (CI): 0.31-0.66), three servings/day (OR = 0.52; 95% CI: 0.36-0.76), more than three servings/day (OR = 0.55; 95% CI: 0.36-0.85) were each associated with significantly reduced odds of diabetes. No significant associations were observed between diabetes risk and fruit or dairy intake in the adjusted model.

Conclusions: Higher vegetable consumption was inversely associated with diabetes risk in this cross-sectional study, whereas no significant associations were observed for fruit or dairy intake. These findings suggest a potential protective role of vegetable intake; however, causal inferences cannot be made, and longitudinal studies are required to confirm these associations.