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Systematic review
Increased consumption of green leafy vegetables, but not fruit, vegetables or fruit and vegetables combined, is associated with reduced incidence of type 2 diabetes
  1. Katherine Esposito1,
  2. Dario Giugliano1
  1. 1Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
  1. Correspondence to Katherine Esposito
    Department of Geriatrics and Metabolic Diseases, Second University of Naples, Piazza L Miraglia 2, 80138 Naples, Italy; katherine.esposito{at}

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Medicine is science of uncertainty, affirmed by William Osler. We have two certainties about type 2 diabetes. The first certainty relates to its constant increase worldwide: the recent report on Health in the USA 20091 showed that 15% or more of the adult population aged 65 years and older is taking antidiabetic drugs, with an absolute increase of 6% compared with the years 1988–1994. The second certainty relates to diabetes-related death: in the USA, diabetes is the third cause of death for women and the fourth for men.2 Although lifestyle interventions can prevent type 2 diabetes, current nutritional recommendations for the primary prevention of type 2 diabetes are limited, with little that is truly evidence based.3

Fruit and vegetable consumption is one element of a healthy diet. Fruit and vegetable intake varies considerably among countries, reflecting economic, cultural and agricultural environments. Insufficient intake of fruit and vegetables is estimated to cause around 14% of gastrointestinal cancer deaths, …

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  • Competing interests None.