TY - JOUR
T1 - Effect of the interaction between physical activity and estimated macronutrient intake on HbA1c
T2 - population-based cross-sectional and longitudinal studies
AU - Furukawa, Takuma
AU - Nishida, Yuichiro
AU - Hara, Megumi
AU - Shimanoe, Chisato
AU - Koga, Kayoko
AU - Iwasaka, Chiharu
AU - Higaki, Yasuki
AU - Tanaka, Keitaro
AU - Nakashima, Ryoko
AU - Ikezaki, Hiroaki
AU - Hishida, Asahi
AU - Tamura, Takashi
AU - Kato, Yasufumi
AU - Tamada, Yudai
AU - Matsuo, Keitaro
AU - Ito, Hidemi
AU - Mikami, Haruo
AU - Kusakabe, Miho
AU - Ibusuki, Rie
AU - Shibuya, Keiichi
AU - Suzuki, Sadao
AU - Nakagawa-Senda, Hiroko
AU - Ozaki, Etsuko
AU - Matsui, Daisuke
AU - Kuriki, Kiyonori
AU - Nakamura, Yasuyuki
AU - Kadota, Aya
AU - Arisawa, Kokichi
AU - Katsuura-Kamano, Sakurako
AU - Takeuchi, Kenji
AU - Wakai, Kenji
N1 - Funding Information:
Funding This study was supported by Grants-in-Aid for Scientific Research for Priority Areas of Cancer (No. 17015018) and Innovative Areas (No. 221S0001) and by JSPS KAKENHI Grants (Nos. 16H06277 (CoBiA) and 21K06645) from the Japanese Ministry of Education, Culture, Sports, Science and Technology.
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/1/3
Y1 - 2022/1/3
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 (P interaction =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 (P interaction =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.
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 (P interaction =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 (P interaction =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.
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U2 - 10.1136/bmjdrc-2021-002479
DO - 10.1136/bmjdrc-2021-002479
M3 - Article
C2 - 34980592
AN - SCOPUS:85122849814
SN - 2052-4897
VL - 10
JO - BMJ Open Diabetes Research and Care
JF - BMJ Open Diabetes Research and Care
IS - 1
M1 - e002479
ER -
