Diet and Physical Activity as Determinants of Continuously Measured Glucose Levels in Persons at High Risk of Type 2 Diabetes

• Published in: Nutrients 2022-01, Vol.14 (2), p.366
• Main Authors: Park, Su Hyun, Yao, Jiali, Chua, Xin Hui, Chandran, Suresh Rama, Gardner, Daphne S L, Khoo, Chin Meng, Müller-Riemenschneider, Falk, Whitton, Clare, van Dam, Rob M
• Format: Article
• Language: English
• Subjects: Accelerometers; Accelerometry - methods; Adult; Behavior; Blood glucose; Blood Glucose - analysis; Blood Glucose Self-Monitoring - methods; Body fat; Carbohydrates; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diet; Diet - methods; Dietary Carbohydrates - administration & dosage; Dietary intake; Dietary Proteins - administration & dosage; Energy Intake; Exercise; Fatty Acids, Unsaturated - administration & dosage; Feeding Behavior; Female; Fluctuations; Glucose; Glucose monitoring; Glucose tolerance; Health risks; Homeostasis; Humans; Hyperglycemia; Insulin; Insulin Resistance; Lifestyles; Male; Middle Aged; Monitoring systems; Physical activity; Polyunsaturated fatty acids; Proteins; Questionnaires; Risk analysis; Risk Factors; Sedentary Behavior; Sensors; Sleep; Young Adult
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14020366

We examined how dietary and physical activity behaviors influence fluctuations in blood glucose levels over a seven-day period in people at high risk for diabetes. Twenty-eight participants underwent a mixed meal tolerance test to assess glucose homeostasis at baseline. Subsequently, they wore an accelerometer to assess movement behaviors, recorded their dietary intakes through a mobile phone application, and wore a flash glucose monitoring device that measured glucose levels every 15 min for seven days. Generalized estimating equation models were used to assess the associations of metabolic and lifestyle risk factors with glycemic variability. Higher BMI, amount of body fat, and selected markers of hyperglycemia and insulin resistance from the meal tolerance test were associated with higher mean glucose levels during the seven days. Moderate- to vigorous-intensity physical activity and polyunsaturated fat intake were independently associated with less variation in glucose levels (CV%). Higher protein and polyunsaturated fatty acid intakes were associated with more time-in-range. In contrast, higher carbohydrate intake was associated with less time-in-range. Our findings suggest that dietary composition (a higher intake of polyunsaturated fat and protein and lower intake of carbohydrates) and moderate-to-vigorous physical activity may reduce fluctuations in glucose levels in persons at high risk of diabetes.