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Background Healthy diet and physical activity (PA) are considered important for prevention and treatment of diabetes, particularly as diet and PA combined. However, reports on the interaction between PA and diet are limited, especially from large epidemiological study. Methods The present cross-sectional study used data collected from 55,469 participants in non-diabetes general population who completed the baseline survey on the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. Multiple linear regression was used to adjust for confounding variables and to examine interactions between PA and macronutrient (carbohydrate, fat and protein) intake on HbA1c. Result The significant interactions between PA and carbohydrate intake or fat intake, but not protein intake, on HbA1c were observed after adjustment for confounding variables (P interaction = 0.021, 0.004 and 0.164, respectively). The inverse associations between PA and HbA1c were more evident in the participants with high-carbohydrate/low-fat intake compared to those with low-carbohydrate/high-fat intake. Although further adjustment for body mass index (BMI) slightly weakened interactions between PA and carbohydrate/fat intake on HbA1c (P interaction = 0.063 and 0.059, respectively), the associations between PA and HbA1c in the stratified analysis remained. Conclusion The present study found the interaction between PA and carbohydrate/fat intake on HbA1c. This finding suggests that the effect of PA on blood glucose control is modified by intake of macronutrient composition. Key messages Interaction between PA and macronutrient intake is likely to play an important role in the control of glucose control.

305Interaction between physical activity and nutritional intake on HbA1c in Japanese general population