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

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.

Automated summary

We investigated the impact of dietary and physical activity behaviors on blood glucose fluctuations in individuals at high risk for diabetes. The study found that higher BMI, body fat, and markers of hyperglycemia and insulin resistance were linked to higher mean glucose levels over the seven-day period. However, engaging in moderate-to-vigorous physical activity and consuming polyunsaturated fats were associated with less variation in glucose levels, while higher protein and polyunsaturated fat intake were associated with more time-in-range. On the other hand, higher carbohydrate intake was associated with less time-in-range. These findings suggest that a diet high in polyunsaturated fat and protein, along with regular moderate-to-vigorous physical activity, may help reduce glucose fluctuations in individuals at high risk for diabetes.