The Association of Fruit and Vegetable Intake with High-Sensitivity C-Reactive Protein in Adults with and without Type 1 Diabetes

by | Jul 23, 2024 | 2024, Diabetes, Fruits and Vegetables, Recent Articles

Written by Harold Oster, MD. Results suggest an inverse association between vegetable and blueberry consumption and high-sensitivity C-reactive protein in adults without diabetes.

BlueberriesCardiovascular disease is the leading cause of death worldwide. Risk factors of heart disease include smoking, obesity, diabetes, and chronic inflammation. Levels of high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, are predictive of atherosclerosis and coronary events1. Chronic inflammation also plays a role in the pathogenesis of macrovascular complications in adults with type 1 diabetes (T1D)2. Berries and other fruits and vegetables have anti-inflammatory and antioxidant properties and may have beneficial effects on cardiovascular health3,4.

Mary M. Helm et al. studied the association between levels of hs-CRP and the intake of vegetables, fruit, and berries in adults with and without type 1 diabetes. The authors analyzed data gathered by the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study, an ongoing cohort study comparing the incidence and progression of coronary calcification in adults with and without T1D5. The data used for this study was collected by the CACTI group at two visits: baseline (2000-2002) and year three (2002-2004). Dietary intake was gathered by questionnaires and assessed for fruit and vegetable intake with the Mediterranean-style Dietary Pattern Score (MSDPS)6, the Dietary Approaches to Stop Hypertension score (DASH)7, and the Alternative Healthy Eating Index (AHEI)8. Scores on the three indices range from zero and ten, indicating adherence to the respective diets. Participants were questioned regarding potential covariables, including demographics, blood pressure, smoking, physical activity, body mass index, blood pressure, and hemoglobin A1C. Hs-CRP levels were measured at both visits.

The authors noted the following:

  • Based on inclusion criteria, data from 1416 participants between nineteen and fifty-six years old was used for the study. Six hundred fifty-two participants had T1D, and 764 were nondiabetic controls.
  • In nondiabetics, there was an increase in total vegetable consumption from baseline to year three. (2.97 vs 3.29 daily servings)
  • After adjustment for covariables, daily blueberry intake and hs-CRP levels were inversely associated in nondiabetics. For every one-serving increase, hs-CRP levels fell by 8.29% over three years.
  • In participants with T1D, there was no association between berry intake and hs-CRP levels.
  • There was no association between overall fruit intake and hs-CRP in diabetics or nondiabetics over the three-year study.
  • In non-diabetics, vegetable intake was inversely associated with hs-CRP levels. For every one-point increase in the DASH vegetable score, there was a 3.22% decrease in hs-CRP levels over three years. For AHEI, there was a decrease of 1.45%.
  • There was no significant association between vegetable intake and hs-CRP levels in those with T1D.

Results suggest that in nondiabetics, the intake of vegetables and blueberries is inversely associated with hs-CRP levels. The study’s limitations include its observational design and its use of questionnaires to assess food intake.

Source: Helm, Macy M., Arpita Basu, Leigh Ann Richardson, Lung-Chang Chien, Kenneth Izuora, Amy C. Alman, and Janet K. Snell-Bergeon. “Longitudinal Three-Year Associations of Dietary Fruit and Vegetable Intake with Serum hs-C-Reactive Protein in Adults with and without Type 1 Diabetes.” Nutrients 16, no. 13 (2024): 2058.

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/
4.0/).

Click here to read the full text study.

Posted July 23, 2024.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

References:

  1. Wang A, Liu J, Li C, et al. Cumulative Exposure to High-Sensitivity C-Reactive Protein Predicts the Risk of Cardiovascular Disease. J Am Heart Assoc. Oct 24 2017;6(10)doi:10.1161/jaha.117.005610
  2. Schram MT, Chaturvedi N, Schalkwijk CG, Fuller JH, Stehouwer CD. Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes–the EURODIAB Prospective Complications Study. Diabetologia. Feb 2005;48(2):370-8. doi:10.1007/s00125-004-1628-8
  3. Mattioli R, Francioso A, Mosca L, Silva P. Anthocyanins: A Comprehensive Review of Their Chemical Properties and Health Effects on Cardiovascular and Neurodegenerative Diseases. Molecules. Aug 21 2020;25(17)doi:10.3390/molecules25173809
  4. Bechthold A, Boeing H, Schwedhelm C, et al. Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2019;59(7):1071-1090. doi:10.1080/10408398.2017.1392288
  5. Horton WB, Snell-Bergeon JK. Hemoglobin A1c Variability Metrics Predict Coronary Artery Calcium and Cardiovascular Events in Type 1 Diabetes: The CACTI Study. The Journal of clinical endocrinology and metabolism. Jun 16 2023;108(7):e444-e449. doi:10.1210/clinem/dgad019
  6. Rumawas ME, Dwyer JT, McKeown NM, Meigs JB, Rogers G, Jacques PF. The development of the Mediterranean-style dietary pattern score and its application to the American diet in the Framingham Offspring Cohort. J Nutr. Jun 2009;139(6):1150-6. doi:10.3945/jn.108.103424
  7. Barnes TL, Crandell JL, Bell RA, Mayer-Davis EJ, Dabelea D, Liese AD. Change in DASH diet score and cardiovascular risk factors in youth with type 1 and type 2 diabetes mellitus: The SEARCH for Diabetes in Youth Study. Nutr Diabetes. Oct 14 2013;3(10):e91. doi:10.1038/nutd.2013.32
  8. Schwingshackl L, Bogensberger B, Hoffmann G. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies. J Acad Nutr Diet. Jan 2018;118(1):74-100.e11. doi:10.1016/j.jand.2017.08.024