RT Journal Article
SR Electronic
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
FD American Diabetes Association
SP e002479
DO 10.1136/bmjdrc-2021-002479
VO 10
IS 1
A1 Takuma Furukawa
A1 Yuichiro Nishida
A1 Megumi Hara
A1 Chisato Shimanoe
A1 Kayoko Koga
A1 Chiharu Iwasaka
A1 Yasuki Higaki
A1 Keitaro Tanaka
A1 Ryoko Nakashima
A1 Hiroaki Ikezaki
A1 Asahi Hishida
A1 Takashi Tamura
A1 Yasufumi Kato
A1 Yudai Tamada
A1 Keitaro Matsuo
A1 Hidemi Ito
A1 Haruo Mikami
A1 Miho Kusakabe
A1 Rie Ibusuki
A1 Keiichi Shibuya
A1 Sadao Suzuki
A1 Hiroko Nakagawa-Senda
A1 Etsuko Ozaki
A1 Daisuke Matsui
A1 Kiyonori Kuriki
A1 Yasuyuki Nakamura
A1 Aya Kadota
A1 Kokichi Arisawa
A1 Sakurako Katsuura-Kamano
A1 Kenji Takeuchi
A1 Kenji Wakai
A1 ,
YR 2022
UL http://drc.bmj.com/content/10/1/e002479.abstract
AB 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/).