TY - JOUR T1 - Effect of the interaction between physical activity and estimated macronutrient intake on HbA1c: population-based cross-sectional and longitudinal studies JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2021-002479 VL - 10 IS - 1 SP - e002479 AU - Takuma Furukawa AU - Yuichiro Nishida AU - Megumi Hara AU - Chisato Shimanoe AU - Kayoko Koga AU - Chiharu Iwasaka AU - Yasuki Higaki AU - Keitaro Tanaka AU - Ryoko Nakashima AU - Hiroaki Ikezaki AU - Asahi Hishida AU - Takashi Tamura AU - Yasufumi Kato AU - Yudai Tamada AU - Keitaro Matsuo AU - Hidemi Ito AU - Haruo Mikami AU - Miho Kusakabe AU - Rie Ibusuki AU - Keiichi Shibuya AU - Sadao Suzuki AU - Hiroko Nakagawa-Senda AU - Etsuko Ozaki AU - Daisuke Matsui AU - Kiyonori Kuriki AU - Yasuyuki Nakamura AU - Aya Kadota AU - Kokichi Arisawa AU - Sakurako Katsuura-Kamano AU - Kenji Takeuchi AU - Kenji Wakai A2 - , Y1 - 2022/01/01 UR - http://drc.bmj.com/content/10/1/e002479.abstract N2 - Introduction Healthy diet and physical activity (PA) are essential for preventing type 2 diabetes, particularly, a combination of diet and PA. However, reports on interaction between PA and diet, especially from large epidemiological studies, are limited. We investigated the effect of interaction between PA and macronutrient intake on hemoglobin A1c (HbA1c) levels in the general population.Research design and methods We conducted a cross-sectional study of 55 469 men and women without diabetes who participated in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. A self-administered questionnaire ascertained PA and macronutrient intake (carbohydrate, fat, and protein). Multiple linear regression analyses were performed to adjust for confounding variables and examine the interactions. In addition, we conducted a longitudinal study during a 5-year period within a subcohort (n=6881) with accelerometer-assessed PA data.Results Overall, PA had a weak inverse association (β=−0.00033, p=0.049) and carbohydrate intake had a strong positive association (β=0.00393, p<0.001) with HbA1c. We observed a tendency of interactions between PA and carbohydrate or fat intake, but not protein intake, on HbA1c levels after adjusting for age, sex, study area, total energy intake, alcohol consumption, smoking, and medication for hypertension or hypercholesterolemia (Pinteraction=0.054, 0.006, and 0.156, respectively). The inverse associations between PA and HbA1c level were more evident in participants with high-carbohydrate (or low-fat) intake than in participants with low-carbohydrate (or high-fat) intake. Although further adjustment for body mass index slightly attenuated the above interactions (Pinteraction=0.098 for carbohydrate and 0.068 for fat), the associations between PA and HbA1c level in stratified analyses remained unchanged. Similar associations and interactions were reproduced in the longitudinal study.Conclusions The present results suggest that the effect of PA on HbA1c levels is modified by intake of macronutrient composition.Data are available upon reasonable request. Details can be found on the J-MICC Study website (http://www.jmicc.com/). ER -