***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Prospect i ve data relating fruit and vegetable intake to cardiovascular disease ( CVD ) risk are sparse , particularly for women . OBJECTIVE In a large , prospect i ve cohort of women , we examined the hypothesis that higher fruit and vegetable intake reduces CVD risk . DESIGN In 1993 we assessed fruit and vegetable intake among 39876 female health professionals with no previous history of CVD or cancer by use of a detailed food-frequency question naire . We subsequently followed these women for an average of 5 y for incidence of nonfatal myocardial infa rct ion ( MI ) , stroke , percutaneous transluminal coronary angioplasty , coronary artery bypass graft , or death due to CVD . RESULTS During 195647 person-years of follow-up , we documented 418 incident cases of CVD including 126 MIs . After adjustment for age , r and omized treatment status , and smoking , we observed a significant inverse association between fruit and vegetable intake and CVD risk . For increasing quintiles of total fruit and vegetable intake ( median servings/d : 2 . 6 , 4.1 , 5.5 , 7.1 , and 10.2 ) , the corresponding relative risks ( RRs ) were 1.0 ( reference ) , 0.78 , 0.72 , 0.68 , and 0.68 ( 95 % CI comparing the 2 extreme quintiles : 0.51 , 0.92 ; P : for trend = 0.01 ) . An inverse , though not statistically significant , trend remained after additional adjustment for other known CVD risk factors , with RRs of 1.0 , 0.75 , 0.83 , 0.80 , and 0.85 ( 95 % CI for extreme quintiles : 0.61 , 1.17 ) . After excluding participants with a self-reported history of diabetes , hypertension , or high cholesterol at baseline , the multivariate-adjusted RR was 0.45 when extreme quintiles were compared ( 95 % CI : 0.22 , 0.91 ; P : for trend = 0.09 ) . Higher fruit and vegetable intake was also associated with a lower risk of MI , with an adjusted RR of 0.62 for extreme quintiles ( 95 % CI : 0.37 , 1.04 ; P : for trend = 0.07 ) . CONCLUSION These data suggest that higher intake of fruit and vegetables  may be protective against CVD and support current dietary guidelines to increase fruit and vegetable intake Observational epidemiologic studies have shown that a high consumption of fruits and vegetables is associated with a decreased risk of chronic diseases . Little is known about the bioavailability of constituents from vegetables and fruits and the effect of these constituents on markers for disease risk . Currently , the recommendation is to increase intake of a mix of fruits and vegetables ( " five a day " ) . We investigated the effect of this recommendation on plasma carotenoids , vitamins and homocysteine concentrations in a 4-wk dietary controlled , parallel intervention study . Male and female volunteers ( n = 47 ) were allocated r and omly to either a daily 500-g fruit and vegetable ( " high " ) diet or a 100-g fruit and vegetable ( " low " ) diet . Analyzed total carotenoid , vitamin C and folate concentrations of the daily high diet were 13.3 mg , 173 mg and 228.1 microg , respectively . The daily low diet contained 2.9 mg carotenoids , 65 mg vitamin C and 131.1 microg folate . Differences in final plasma levels between the high and low group were as follows : lutein , 46 % [ 95 % confidence interval ( CI ) 28 - 64 ] ; beta-cryptoxanthin , 128 % ( 98 - 159 ) ; lycopene , 22 % ( 8 - 37 ) ; alpha-carotene , 121 % ( 94 - 149 ) ; beta-carotene , 45 % ( 28 - 62 ) ; and vitamin C , 64 % ( 51 - 77 ) ( P < 0.05 ) . The high group had an 11 % ( -18 to -4 ) lower final plasma homocysteine and a 15 % ( 0.8 - 30 ) higher plasma folate concentration compared with the low group ( P < 0.05 ) . This is the first trial to show that a mix of fruits and vegetables , with a moderate folate content , decreases plasma homocysteine concentrations in humans BACKGROUND Dietary carbohydrates may influence the development of  type 2 ( non-insulin-dependent ) diabetes  , for example , through effects on blood glucose and insulin concentrations . OBJECTIVE We examined the relations of baseline intake of carbohydrates , dietary fiber , dietary magnesium , and carbohydrate-rich foods and the glycemic index with incidence of diabetes . DESIGN This was a prospect i ve cohort study of 35988 older Iowa women initially free of diabetes . During 6 y of follow-up , 1141 incident cases of diabetes were reported . RESULTS  Total grain , whole-grain , total dietary fiber , cereal fiber , and dietary magnesium intakes  showed strong inverse associations with incidence of diabetes after adjustment for potential nondietary confounding variables . Multivariate-adjusted relative risks of diabetes were 1.0 , 0.99 , 0.98 , 0.92 , and 0.79 ( P for trend : 0.0089 ) across quintiles of whole-grain intake ; 1.0 , 1.09 , 1.00 , 0.94 , and 0.78 ( P for trend : 0.005 ) across quintiles of total dietary fiber intake ; and 1.0 , 0.81 , 0.82 , 0.81 , and 0.67 ( P for trend : 0.0003 ) across quintiles of dietary magnesium intake . Intakes of total carbohydrates , refined grains , fruit and vegetables , and soluble fiber and the glycemic index were unrelated to diabetes risk . CONCLUSION These data support a protective role for grains ( particularly whole grains ) , cereal fiber , and dietary magnesium in the development of diabetes in older women To determine the relations of diet with risk of clinical noninsulin-dependent diabetes , we analyzed data from a prospect i ve cohort of 84360 US women . During 6 y of follow-up we identified 702 definite incident cases . Because body mass index ( BMI ) is a powerful risk factor for diabetes , we examined the relations of fat ( including type ) , fiber , sucrose , and other components of diet to risk of diabetes , among women with BMI s ( in kg/m2 ) less than 29 kg/m2 . After controlling for body mass index , previous weight change , and alcohol intake , we observed no associations between intakes of energy  , protein , sucrose ,  carbohydrate  ,  or fiber and risk of diabetes . Compared with women in the lowest quintile of energy-adjusted intake , and relative risks ( and tests for trend ) for those in the highest quintile were 0.61 ( P trend = 0.03 ) for vegetable fat , 0.62 ( P trend = 0.008 ) for potassium , 0.70 ( P trend = 0.005 ) for calcium , and 0.68 ( P trend = 0.02 ) for magnesium . These inverse associations were attenuated among obese women ( BMI s greater than or equal to 29 ) We examined associations between fruit and vegetable intake and the incidence of type 2 diabetes ( T2D ) in a population -based prospect i ve study of 64,191 women with no history of T2D or other chronic diseases at study recruitment and with valid dietary information .  Dietary intake was assessed by in-person interviews using a vali date d FFQ . During 297,755 person-years of follow-up , 1608 new cases of T2D were documented . We used a Cox regression model to evaluate the association of  fruit and vegetable intake  ( g/d ) with the risk of T2D . Quintiles of vegetable intake and T2D were inversely associated . The relative risk for T2D for the upper quintile relative to the lower quintile of  vegetable  intake was 0.72 ( 95%CI : 0.61 - 0.85 ; P < 0.01 ) in multivariate analysis . Individual vegetable groups were all inversely and significantly associated with the risk of T2D . Fruit intake was not associated with the incidence of diabetes  in this population . Our data suggest that vegetable consumption may protect against the development of T2D Objective : To compare the dietary intake of Chinese people living in Pan Yu , Hong Kong , San Francisco and Sydney with respect to cardiovascular health , using the Mediterranean diet score , examining the effects of age , gender , urbanization and acculturation on the diet score . Subjects : A total of 500 men and 510 women in Hong Kong were recruited as a territory-wide stratified r and om sample . Subjects were recruited in response to  local advertisements for the other three sites : Pan Yu , 58 men , 95 women ; San Francisco , 166 men , 192 women ; Sydney , 95 men , 73 women . Method : Food-frequency question naire over a 7 week period . A high/healthy score was taken as ≥4 for men and ≥3 for women , representing a dietary pattern beneficial for cardiovascular health . Results : In Hong Kong , more women in the middle age group ( 35–54 ) had a high score than other age groups , and overall more women had high scores than men . In comparing the four geographical regions , Pan Yu had the highest number of subjects with high score , and Hong Kong had the lowest . With the exception of the younger population and men in Hong Kong , the percentage of the population with a high score in all sites is greater than among elderly Greeks consuming a more traditional heart-healthy Mediterranean diet . Conclusion : Considerable variations in Chinese dietary patterns exist with respect to age , gender and geographic location . Overall , the Chinese diet is comparable to the Mediterranean diet and may be expected to have similar health benefits that have been documented for the traditional Mediterranean diet . European Journal of Clinical Nutrition ( 2001 ) 55 , The authors investigated the association of dietary patterns and  type 2 diabetes  in a 4-year prospect i ve study of 36,787 adults in the Melbourne Collaborative Cohort Study ( 1990 - 1994 ) . A total of 31,641 ( 86 % ) participants completed follow-up , and 365 cases were identified . Four factors with eigenvalues of greater than 2 were identified using the principal factor method with 124 foods/beverages , followed by orthogonal rotation . Variables with factor loadings having absolute values of 0.3 or greater were used in interpreting the factors . Odds ratios for diabetes incidence across quintiles of factor scores were computed by use of logistic regression , adjusting for age , energy intake , family history of diabetes , country of birth , and other factor scores . Factor 1 , characterized by olive oil , salad vegetables , and legumes and by avoidance of sweet bakery items , margarine , and tea , was associated with country of birth but not with diabetes . Factor 2 , characterized by salad and cooked vegetables , was inversely associated with diabetes . Factor 3 , characterized by meats and fatty foods , was associated with increased diabetes risk . A range of fruits loaded strongly on factor 4 , which showed little association with diabetes . Avoidance of a dietary pattern including meats and fatty foods , as well as adherence to a pattern including salad and cooked vegetables , is recommended BACKGROUND Epidemiologic studies suggest that greater consumption of fruit and vegetables may decrease the risk of diabetes mellitus , but the evidence is limited and inconclusive . Plasma vitamin C level is a good biomarker of fruit and vegetable intake , but , to our knowledge , no prospect i ve studies have examined its association with diabetes risk . This study aims to examine whether fruit and vegetable intake and plasma vitamin C level are associated with the risk of incident type 2 diabetes . METHODS We administered a semiquantitative food frequency question naire to men and women from a population -based prospect i ve cohort ( European Prospect i ve Investigation of Cancer-Norfolk ) study who were aged 40 to 75 years at baseline ( 1993 - 1997 ) when plasma vitamin C level was determined and habitual intake of fruit and vegetables was assessed . During 12 years of follow-up between February 1993 and the end of December 2005 , 735 clinical ly incident cases of diabetes were identified among 21 831 healthy individuals . We report the odds ratios of diabetes associated with sex-specific quintiles of fruit and vegetable intake and of plasma vitamin C levels . RESULTS A strong inverse association was found between plasma vitamin C level and diabetes risk . The odds ratio of diabetes in the top quintile of plasma vitamin C was 0.38 ( 95 % confidence interval , 0.28 - 0.52 ) in 
    Output:
    
The summary estimates showed no significant benefits of increasing the consumption of vegetables , fruit , or fruit and vegetables combined .