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Open AccessArticle

Diet, Secondhand Smoke, and Glycated Hemoglobin (HbA1c) Levels among Singapore Chinese Adults

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Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
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The UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 15232, USA
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Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
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Ramboll U.S. Corporation, 28 Amity Street Suite 2A, Amherst, MA 01002, USA
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Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria 3086, Australia
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Baker Institute for Heart and Diabetes, Melbourne, Victoria 3004, Australia
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Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
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Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
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Department of Biochemistry, Molecular Biology and BioPhysics, University of Minnesota, Minneapolis, MN 55455, USA
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Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
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Saw Swee School of Public Health, National University of Singapore, Singapore 117549, Singapore
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(24), 5148; https://doi.org/10.3390/ijerph16245148
Received: 12 November 2019 / Revised: 8 December 2019 / Accepted: 10 December 2019 / Published: 17 December 2019
The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 years), intakes of omega-3 polyunsaturated fatty acids, vitamin C, vitamin E and fiber were estimated using a modified food frequency questionnaire. At follow-up (age 64 ± 9 years), HbA1c and cotinine were measured. A product term between cotinine (above or below the median value) and each nutrient (high or low intake) was included in separate linear regression models with HbA1c as the outcome. HbA1c among those with high cotinine and low omega-3 polyunsaturated fatty acids intakes were higher than would be expected due to the individual effects alone (p-for-interaction = 0.05). Among those with lower intakes of omega-3 polyunsaturated fatty acids, high cotinine levels were associated with 0.54% higher HbA1c levels (95% confidence interval [CI]: 0.02, 1.06). Conversely, among those with higher intakes of omega-3 polyunsaturated fatty acids, HbA1c differ not differ by exposure (−0.09%; 95% CI: −0.45, 0.30). No evidence of interaction was observed for other nutrients. Diets high in omega-3 polyunsaturated fatty acids may ameliorate secondhand smoke-induced increases in HbA1c. View Full-Text
Keywords: diet; antioxidants; omega-3 polyunsaturated fatty acids; cotinine; HbA1c; interaction diet; antioxidants; omega-3 polyunsaturated fatty acids; cotinine; HbA1c; interaction
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Moore, B.F.; Butler, L.M.; Bachand, A.M.; Salim, A.; Reynolds, S.J.; Wang, R.; Nelson, T.L.; Peel, J.L.; Murphy, S.E.; Koh, W.-P.; Yuan, J.-M.; Clark, M.L. Diet, Secondhand Smoke, and Glycated Hemoglobin (HbA1c) Levels among Singapore Chinese Adults. Int. J. Environ. Res. Public Health 2019, 16, 5148.

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