Longitudinal Association Between the Consumption of Vegetables, Fruits, and Red Meat and Diabetes Disease Burden: An Analysis of Multiple Global Datasets

Background: Dietary factors, such as vegetable, fruit, and red meat consumption, have varying effects on the disease burden of diabetes, the world's third leading health concern. This study aims to evaluate the global impact of vegetable/fruit/red meat consumption on disease burdens. Methods: Diabetes disease burden, vegetable/fruit/red meat consumption, and covariates data were obtained from the Global Burden of Disease Study (GBD) 2021, Food and Agriculture Organization (FAO), and WHO, respectively, and matched by country/region and year. Global vector maps assessed the status of diabetes disease burden and the consumption of three dietary factors in 2021, and their trends from 2010 to 2021 were illustrated through local regression curves. Generalized additive mixed models (GAMMs) were used to analyze relationships, with weights assigned based on log-transformed values relative to the mean population of each country. Results: A comprehensive dataset spanning 2010-2021, encompassing 175 countries/regions, was successfully matched and utilized in the analysis. In 2021, Oceania had the highest diabetes burden, whereas East Asia had a lower one. Globally, the disease burden increased from 2010 to 2021, accompanied by rising per capita vegetable and fruit consumption but declining red meat consumption. Vegetable consumption was inversely correlated with the age-standardized incidence rate (ASIR) and exhibited a "J-shaped" curve with the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year (DALY) rate (ASDR) (nadir at approximately 80 kcal/capita/day (kcal/cap/day). Fruit consumption had a "U-shaped" relationship with ASDR (nadir at approximately 100 kcal/cap/day). Red meat consumption was negatively correlated to ASIR and had a "U-shaped" relationship with ASMR and ASDR (nadir at 200 kcal/cap/day). Conclusions: The global diabetes disease burden is heavy, and dietary consumption varies widely. Vegetable-related risks differ between diabetics and non-diabetics. Proper fruit consumption decreases ASDR. Moderate red meat increases can reduce the disease burden, but excessive consumption increases ASMR and ASDR.