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 Furukawa, Takuma
A1 Nishida, Yuichiro
A1 Hara, Megumi
A1 Shimanoe, Chisato
A1 Koga, Kayoko
A1 Iwasaka, Chiharu
A1 Higaki, Yasuki
A1 Tanaka, Keitaro
A1 Nakashima, Ryoko
A1 Ikezaki, Hiroaki
A1 Hishida, Asahi
A1 Tamura, Takashi
A1 Kato, Yasufumi
A1 Tamada, Yudai
A1 Matsuo, Keitaro
A1 Ito, Hidemi
A1 Mikami, Haruo
A1 Kusakabe, Miho
A1 Ibusuki, Rie
A1 Shibuya, Keiichi
A1 Suzuki, Sadao
A1 Nakagawa-Senda, Hiroko
A1 Ozaki, Etsuko
A1 Matsui, Daisuke
A1 Kuriki, Kiyonori
A1 Nakamura, Yasuyuki
A1 Kadota, Aya
A1 Arisawa, Kokichi
A1 Katsuura-Kamano, Sakurako
A1 Takeuchi, Kenji
A1 Wakai, Kenji
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/).