Furukawa, Takuma Saga University
Nishida, Yuichiro Saga University
Hara, Megumi Saga University
Shimanoe, Chisato Saga University
Koga, Kayoko Saga University
Iwasaka, Chiharu Saga University
Higaki, Yasuki Fukuoka University
Tanaka, Keitaro Saga University
Nakashima, Ryoko Kyushu University
Ikezaki, Hiroaki Kyushu University
Hishida, Asahi Nagoya University
Tamura, Takashi Nagoya University
Kato, Yasufumi Nagoya University
Tamada, Yudai Nagoya University
Matsuo, Keitaro Aichi Cancer Center Research Institute|Nagoya University
Ito, Hidemi Aichi Cancer Center Research Institute|Nagoya University
Mikami, Haruo Chiba Cancer Center Research Institute
Kusakabe, Miho Chiba Cancer Center Research Institute
Ibusuki, Rie Kagoshima University
Shibuya, Keiichi Kagoshima University
Suzuki, Sadao Nagoya City University
Nakagawa-Senda, Hiroko Nagoya City University
Ozaki, Etsuko Kyoto Prefectural University of Medicine
Matsui, Daisuke Kyoto Prefectural University of Medicine
Kuriki, Kiyonori University of Shizuoka
Nakamura, Yasuyuki Shiga University of Medical Science
Kadota, Aya Shiga University of Medical Science
Takeuchi, Kenji Nagoya University
Wakai, Kenji Nagoya University
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.
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.
The present results suggest that the effect of PA on HbA1c levels is modified by intake of macronutrient composition.
BMJ Open Diabetes Research & Care
BMJ Publishing Group
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