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Association between glycated hemoglobin and diet and other lifestyle factors in a nondiabetic population: cross-sectional evaluation of data from the Potsdam cohort of the European Prospective Investigation into Cancer and Nutrition Study^1,2,3

¹ From the German Institute of Human Nutrition, the Department of Epidemiology, Potsdam-Rehbrücke, Germany; Unilever Research Vlaardingen, Vlaardingen, Netherlands; and the Institute of Clinical Chemistry, the Department of Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany.

Background: Glycation reactions of proteins and other compounds, depending on blood glucose concentrations, have a detrimental effect on health.

Objective: The association of diet and other lifestyle factors with glycated hemoglobin (Hb A_1c) values was examined in a nondiabetic population.

Design: This was a cross-sectional study of 1773 middle-aged men and women. Mean Hb A_1c values were calculated for categories of diet and lifestyle factors, and odds ratios (ORs) for the highest versus lowest tertiles of Hb A_1c were determined and compared.

Results: The OR of being in the highest Hb A_1c tertile compared with the lowest increased with greater age [age 40–44 y compared with >60 y: men (OR: 2.86; 95% CI: 1.60, 5.20) and women: (6.11; 3.15, 12.30)] and greater obesity [body mass index (in kg/m²) >25 and waist-hip ratio >1.0 in men and >0.8 in women): men (2.80; 1.48, 5.45) and women (1.73; 1.15, 2.61)]. High energy and energy-adjusted saturated fat intakes were associated with increased risk of being in the highest tertile of Hb A_1c [highest compared with lowest quintile: (1.53; 1.04, 2.26; P for trend = 0.013) and (1.98; 1.33, 2.95; P for trend = 0.003), respectively]. No significant associations were observed for intakes of carbohydrates, protein, dietary fiber, or ß-carotene; however, some of the associations were nearly significant. Alcohol, vitamin C, and vitamin E intakes were inversely related to risk [highest compared with lowest quintile: (0.56; 0.38, 0.83; P for trend = 0.001), (0.50; 0.33, 0.74; P for trend = 0.003), and (0.65; 0.43, 0.96; P for trend = 0.036), respectively].

Conclusion: Hb A_1c values might be modifiable by diet and other lifestyle factors.

Key Words: Hb A_1c • glycated hemoglobin • diet • type 2 diabetes • risk factor • vitamin C • saturated fat • alcohol • European Prospective Investigation into Cancer and Nutrition Study • Potsdam • EPIC Study

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