Yao Jiali, Brugger Victoria K, Edney Sarah M, Tai E-Shyong, Sim Xueling, Müller-Riemenschneider Falk, van Dam Rob M
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Int J Behav Nutr Phys Act. 2024 Dec 18;21(1):142. doi: 10.1186/s12966-024-01693-5.
It remains unclear what lifestyle behaviors are optimal for controlling postprandial glucose responses under real-world circumstances in persons without diabetes. We aimed to assess associations of diet, physical activity, and sleep with postprandial glucose responses in Asian adults without diabetes under free-living conditions.
We conducted an observational study collecting intensive longitudinal data using smartphone-based ecological momentary assessments, accelerometers, and continuous glucose monitors over nine free-living days in Singaporean men and women aged 21-69 years without diabetes. The outcome was the 2-h postprandial glucose incremental area under the curve (mmol/l*min). Associations were estimated using linear mixed-effect models.
The analyses included 11,333 meals in 789 participants. Greater variations in glucose and lifestyle measures were observed within individuals than between individuals. Higher consumption of carbohydrate-rich and deep-fried foods and lower consumption of protein-rich foods were significantly associated with higher postprandial glucose levels (incremental area under the curve). The strongest association was observed for including refined grains (46.2 [95% CI: 40.3, 52.1]) in meals. Longer postprandial light-intensity physical activity (-24.7 [(-39.5, -9.9] per h) and moderate-to-vigorous-intensity physical activity (-58.0 [-73.8, -42.3]) were associated with substantially lower postprandial glucose levels. Longer daily light-intensity physical activity (-7.5 [-10.7, -4.2]) and sleep duration (-2.7 [-4.4, -1.0]) were also associated with lower postprandial glucose levels. Furthermore, postprandial glucose levels were the lowest in the morning and the highest in the afternoon. The results were largely consistent for males and females and for participants with and without prediabetes.
Consuming less refined grains and more protein-rich foods, getting more physical activity (particularly during the postprandial period), and having a longer sleep duration were associated with lower postprandial glucose levels in Asian adults without diabetes. Our findings support multi-component lifestyle modifications for postprandial glucose control and highlight the importance of the timing of eating and physical activity.
在现实生活中，对于无糖尿病者而言，何种生活方式行为最有利于控制餐后血糖反应尚不清楚。我们旨在评估在自由生活条件下，饮食、身体活动和睡眠与无糖尿病的亚洲成年人餐后血糖反应之间的关联。
我们进行了一项观察性研究，在9个自由生活日期间，使用基于智能手机的生态瞬时评估、加速度计和连续血糖监测仪，收集了新加坡21 - 69岁无糖尿病的男性和女性的密集纵向数据。观察指标为餐后2小时血糖曲线下增量面积（mmol/l*min）。使用线性混合效应模型估计关联。
分析纳入了789名参与者的11333次进餐。个体内血糖和生活方式指标的变化大于个体间的变化。富含碳水化合物和油炸食品的摄入量较高以及富含蛋白质食品的摄入量较低，与较高的餐后血糖水平（曲线下增量面积）显著相关。进餐时摄入精制谷物（46.2 [95%置信区间：40.3, 52.1]）的关联最为显著。餐后较长时间的轻度身体活动（每小时 - 24.7 [(-39.5, -9.9)]）和中度至剧烈强度身体活动（-58.0 [-73.8, -42.3]）与餐后血糖水平显著降低相关。每日较长时间的轻度身体活动（-7.5 [-10.7, -4.2]）和睡眠时间（-2.7 [-4.4, -1.0]）也与较低的餐后血糖水平相关。此外，餐后血糖水平在早晨最低，下午最高。男性和女性以及有和无糖尿病前期的参与者的结果基本一致。
在无糖尿病的亚洲成年人中，较少摄入精制谷物和较多摄入富含蛋白质的食物、增加身体活动（尤其是餐后期间）以及延长睡眠时间与较低的餐后血糖水平相关。我们的研究结果支持通过多方面生活方式改变来控制餐后血糖，并强调饮食和身体活动时间的重要性。
