Diabetes, Fruits, & Vegetables
Written by: Dr. Jelena Gligorijević, Chief Medical Officer, The Foundation for Fresh Produce
What is Diabetes Mellitus?
Diabetes mellitus is a group of metabolic diseases characterized by prolonged high blood glucose concentrations (hyperglycemia). Approximately one in nine adults worldwide[1] and one in ten adults in the United States[2] are living with diabetes. Over the past three decades, the prevalence of type 2 diabetes has increased dramatically across countries of all income levels, and this trend is projected to continue[3].
Diabetes contributes to a considerable increase in morbidity and mortality, which can be reduced by early diagnosis and treatment. Chronic untreated hyperglycemia typically leads to vascular complications and progressive organ damage, including coronary heart disease, peripheral vascular disease, cerebrovascular disease, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy[4].
Diabetes, along with its associated kidney complications, was responsible for over two million deaths globally in 2021. Additionally, elevated blood glucose levels contributed to approximately 11% of all cardiovascular-related deaths[3].
Non-modifiable risk factors for diabetes include older age, family history of diabetes, ethnicity, and history of gestational diabetes[5].
Modifiable risk factors for diabetes include overweight and obesity, unhealthy dietary patterns, physical inactivity, smoking, and elevated blood pressure. For both the prevention of type 2 diabetes and the mitigation of its complications, it is essential to address those modifiable risk factors[5,6].
Fresh Produce & Diabetes: Mechanisms of Action
Vegetables and fruit have been shown in numerous studies to exert a protective effect against diabetes. This protective effect is most commonly attributed to the high content of dietary fiber, phytonutrients and antioxidants found in vegetables and fruit[7-9].
Vegetables and fruits represent an important source of dietary fiber. Diets rich in dietary fiber play a crucial role in diabetes prevention and management, leading to notable improvements in glycemic control, lipid profiles, body weight regulation, and inflammatory markers. Dietary fiber helps delay the absorption of carbohydrates, which in turn reduces postprandial blood glucose levels. It also supports improved insulin sensitivity and promotes more effective insulin secretion, helping to counteract insulin resistance. Dietary fiber contributes significantly to the control of several markers, such as HbA1c, blood glucose, triglycerides, LDL, and body weight. Additionally, increased fiber intake has been linked to a lower risk of premature mortality in individuals with diabetes[10-12].
Fruits and vegetables also contain all sorts of phytochemicals including polyphenols, flavonoids and anti‐oxidants that may improve insulin sensitivity and could further decrease the risk of type 2 diabetes. In the context of diabetes prevention, particular attention has been given to specific types of fruits and vegetables due to their bioactive compounds. Berries, for example, are rich in anthocyanins, green leafy and yellow vegetables are notable sources of carotenoids while cruciferous vegetables contain substantial amounts of glucosinolates and other phytochemicals with potential antioxidant anti-diabetic properties[13,14].
Dietary patterns rich in fruits and vegetables are also critically important for the prevention and management of obesity and hypertension, which are major risk factors associated with diabetes. Fresh produce plays a vital role in both the prevention and treatment of overweight and obesity, primarily due to its low energy density, high micronutrient content, and abundance of dietary fiber, which enhances satiety[15-18]. Fresh produce is also widely recommended for the prevention and treatment of hypertension—another risk factor associated with diabetes—as it is naturally low in sodium and rich in potassium, dietary fiber, and essential micronutrients that contribute to blood pressure regulation and overall cardiovascular health[19-21].
Individuals with all types of diabetes should be encouraged to consume an adequate amount of dietary fiber as part of their overall dietary management. Key sources of dietary fiber include vegetables, pulses (such as beans, lentils, and chickpeas), whole fruits, and whole grain. These foods not only provide substantial amounts of fiber but are also rich in essential micronutrients and bioactive compounds that contribute to overall metabolic health. Integrating these fiber-rich foods into daily dietary patterns is a practical and evidence-based strategy for supporting long-term diabetes management and reducing the risk of comorbid conditions[10,11].
As part of diabetes management, the American Diabetes Association recommends filling half of the plate with non-starchy vegetables at each meal to support glycemic control, weight management, and overall metabolic health[22].
The post Diabetes, Fruits, & Vegetables, written by Dr. Jelena Gligorijević, first appeared in The Foundation for Fresh Produce’s Have A Plant® blog.
References
1. International Diabetes Federation. Diabetes Atlas [Internet]. [cited 2025 August]. Available from: https://diabetesatlas.org/
2. U.S. Centers for disease control and prevention CDC. A Report Card: Diabetes in the United States Infographic [Internet]. [cited 2025 August]. Available from: https://www.cdc.gov/diabetes/communication-resources/diabetes-statistics.html
3. World Health Organization. Diabetes [Internet]. [cited 2025 August]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
4. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008 Nov;88(11):1254-64.
5. Bellou V, Belbasis L, Tzoulaki I, Evangelou E. Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PLoS One. 2018 Mar 20;13(3):e0194127.
6. U.S. Centers for disease control and prevention CDC. Diabetes Risk Factors [Internet]. [cited 2025 August]. Available from: https://www.cdc.gov/diabetes/risk-factors/index.html
7. Wang PY, Fang JC, Gao ZH, Zhang C, Xie SY. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta-analysis. J Diabetes Investig. 2016 Jan;7(1):56-69.
8. Bazzano LA, Li TY, Joshipura KJ, Hu FB. Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care. 2008 Jul;31(7):1311-7.
9. Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010 Aug 18;341:c4229.
10. Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Med. 2020 Mar 6;17(3):e1003053.
11. Wang PY, Fang JC, Gao ZH, Zhang C, Xie SY. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta-analysis. J Diabetes Investig. 2016 Jan;7(1):56-69.
12. Nitzke D, Czermainski J, Rosa C, Coghetto C, Fernandes SA, Carteri RB. Increasing dietary fiber intake for type 2 diabetes mellitus management: A systematic review. World J Diabetes. 2024 May 15;15(5):1001-1010.
13. Hamer M, Chida Y. Intake of fruit, vegetables, and antioxidants and risk of type 2 diabetes: systematic review and meta-analysis. J Hypertens. 2007 Dec;25(12):2361-9.
14. Ceriello A, Motz E. Is oxidative stress the pathogenic mechanism underlying insulin resistance, diabetes, and cardiovascular disease? The common soil hypothesis revisited. Arterioscler Thromb Vasc Biol. 2004 May;24(5):816-23.
15. Durrer Schutz D, Busetto L, Dicker D, Farpour-Lambert N, Pryke R, Toplak H, Widmer D, Yumuk V, Schutz Y. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019;12(1):40-66.
16. Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, Toplak H; Obesity Management Task Force of the European Association for the Study of Obesity. European Guidelines for Obesity Management in Adults. Obes Facts. 2015;8(6):402-24.
17. Lattimer JM, Haub MD. Effects of dietary fiber and its components on metabolic health. Nutrients 2010; 2: 1266–89.
18. Liu S, Willett WC, Manson JE, et al Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle‐aged women. Am J Clin Nutr 2003; 78: 920–27.
19. Madsen H, Sen A, Aune D. Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies. Eur J Nutr. 2023 Aug;62(5):1941-1955.
20. Borgi L, Muraki I, Satija A, Willett WC, Rimm EB, Forman JP. Fruit and Vegetable Consumption and the Incidence of Hypertension in Three Prospective Cohort Studies. Hypertension. 2016 Feb;67(2):288-93.
21. Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr. 2012 Sep;51(6):637-63
22. American Diabetes Association. How to Make Healthy Eating Choices. [Internet]. [cited 2025 July]. Available from: https://diabetes.org/food-nutrition/eating-healthy
