Abstract
BackgroundDiabetes mellitus has become a worldwide health problem. Whether fruit juice is beneficial in glycemic control is still inconclusive. This study aimed to synthesize evidence from randomized controlled trials on fruit juice in relationship to glucose control and insulin sensitivity.MethodsA strategic literature search of PubMed, EMBASE, and the Cochrane Library (updated to March, 2014) was performed to retrieve the randomized controlled trials that evaluated the effects of fruit juice on glucose control and insulin sensitivity. Study quality was assessed using the Jadad scale. Weighted mean differences were calculated for net changes in the levels of fasting glucose, fasting insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR) using fixed- or random-effects model. Prespecified subgroup and sensitivity analyses were performed to explore the potential heterogeneity.ResultsTwelve trials comprising a total of 412 subjects were included in the current meta-analysis. The numbers of these studies that reported the data on fasting glucose, fasting insulin, HbA1c and HOMA-IR were 12, 5, 3 and 3, respectively. Fruit juice consumption did not show a significant effect on fasting glucose and insulin concentrations. The net change was 0.79 mg/dL (95% CI: −1.44, 3.02 mg/dL; P = 0.49) for fasting glucose concentrations and −0.74 µIU/ml (95% CI: −2.62, 1.14 µIU/ml; P = 0.44) for fasting insulin concentrations in the fixed-effects model. Subgroup analyses further suggested that the effect of fruit juice on fasting glucose concentrations was not influenced by population region, baseline glucose concentration, duration, type of fruit juice, glycemic index of fruit juice, fruit juice nutrient constitution, total polyphenols dose and Jadad score.ConclusionThis meta-analysis showed that fruit juice may have no overall effect on fasting glucose and insulin concentrations. More RCTs are warranted to further clarify the association between fruit juice and glycemic control.
Highlights
Diabetes mellitus is one of the most challenging health problems globally
An additional 39 articles were excluded for the following reasons: 22 articles did not have the data on outcome measures, 9 articles treated the subjects with multi-component supplement, 8 articles did not report enough details of SD or baseline or endpoint or mean difference for primary or secondary outcome measures [30,31,32,33,34,35,36,37]
Our meta-analysis showed that fruit juice consumption did not significantly affect fasting glucose and insulin concentrations
Summary
Diabetes mellitus is one of the most challenging health problems globally. As reported by the International Diabetes Federation (IDF), more than 371 million people worldwide have diabetes in 2012, and this number is projected to increase to 552 million people by 2030 if no urgent action is taken [1,2]. It has been demonstrated that fruit juice is deficient in fiber, other important preventive nutritional components, such as antioxidants and phytochemicals (e.g. polyphenols), are present in fruit juice [24] In view of these dual properties of fruit juice, great concern has been aroused to identify the effect of fruit juice on T2DM risk. Several RCT studies have been conducted to evaluate the association between fruit juicy consumption and glycemic control, but the results have been conflicting We conducted this meta-analysis to synthesize evidence from previous RCTs and provide a more precise estimate of the effect of fruit juice on glucose control and insulin sensitivity based on the PRISMA guidelines. This study aimed to synthesize evidence from randomized controlled trials on fruit juice in relationship to glucose control and insulin sensitivity
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