Context

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, …