Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;10(1):e002479.
doi: 10.1136/bmjdrc-2021-002479.

Effect of the interaction between physical activity and estimated macronutrient intake on HbA1c: population-based cross-sectional and longitudinal studies

Takuma Furukawa  1   2 , Yuichiro Nishida  3 , Megumi Hara  3 , Chisato Shimanoe  4 , Kayoko Koga  3 , Chiharu Iwasaka  3 , Yasuki Higaki  5 , Keitaro Tanaka  3 , Ryoko Nakashima  6 , Hiroaki Ikezaki  6   7 , Asahi Hishida  8 , Takashi Tamura  8 , Yasufumi Kato  8 , Yudai Tamada  8 , Keitaro Matsuo  9   10 , Hidemi Ito  11   12 , Haruo Mikami  13 , Miho Kusakabe  13 , Rie Ibusuki  14 , Keiichi Shibuya  14   15 , Sadao Suzuki  16 , Hiroko Nakagawa-Senda  16 , Etsuko Ozaki  17 , Daisuke Matsui  17 , Kiyonori Kuriki  18 , Yasuyuki Nakamura  19 , Aya Kadota  19 , Kokichi Arisawa  20 , Sakurako Katsuura-Kamano  20 , Kenji Takeuchi  8 , Kenji Wakai  8 ; Japan Multi-Institutional Collaborative Cohort (J-MICC) Study Group
Collaborators, Affiliations

Effect of the interaction between physical activity and estimated macronutrient intake on HbA1c: population-based cross-sectional and longitudinal studies

Takuma Furukawa et al. BMJ Open Diabetes Res Care. 2022 Jan.

Abstract

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.

Keywords: epidemiology; exercise; glycated hemoglobin; nutrients.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the process for selecting study participants. HbA1c, hemoglobin A1c; J-MICC, Japan Multi-Institutional Collaborative Cohort.
See this image and copyright information in PMC

References

    1. Saeedi P, Petersohn I, Salpea P, et al. . Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019;157:107843. 10.1016/j.diabres.2019.107843 - DOI - PubMed
    1. Nyamdorj R, Pitkäniemi J, Tuomilehto J, et al. . Ethnic comparison of the association of undiagnosed diabetes with obesity. Int J Obes 2010;34:332–9. 10.1038/ijo.2009.225 - DOI - PubMed
    1. Heianza Y, Arase Y, Fujihara K, et al. . Longitudinal trajectories of HbA1c and fasting plasma glucose levels during the development of type 2 diabetes: the Toranomon Hospital health management center study 7 (topics 7). Diabetes Care 2012;35:1050–2. 10.2337/dc11-1793 - DOI - PMC - PubMed
    1. Heianza Y, Hara S, Arase Y, et al. . HbA1c 5·7-6·4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS 3): a longitudinal cohort study. Lancet 2011;378:147–55. 10.1016/S0140-6736(11)60472-8 - DOI - PubMed
    1. Wheeler ML, Dunbar SA, Jaacks LM, et al. . Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diabetes Care 2012;35:434–45. 10.2337/dc11-2216 - DOI - PMC - PubMed

Publication types

Substances

LinkOut - more resources