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

Moore, Brianna F. and Butler, Lesley M. and Bachand, Annette M. and Salim, Agus and Reynolds, Stephen J. and Wang, Renwei and Nelson, Tracy L. and Peel, Jennifer L. and Murphy, Sharon E. and Koh, Woon-Puay and Yuan, Jian-Min and Clark, Maggie L. (2019) Diet, Secondhand Smoke, and Glycated Hemoglobin (HbA1c) Levels among Singapore Chinese Adults. International Journal of Environmental Research and Public Health, 16 (24). p. 5148. ISSN 1660-4601

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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.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Moore, Brianna F.
Butler, Lesley M.
Bachand, Annette M.
Salim, Agus
Reynolds, Stephen J.
Wang, Renweirew59@pitt.edurew59
Nelson, Tracy L.
Peel, Jennifer L.
Murphy, Sharon E.
Koh, Woon-Puay
Yuan, Jian-Minyuanj@upmc.eduyuanj
Clark, Maggie L.
Centers: Other Centers, Institutes, Offices, or Units > Hillman Cancer Center
Date: 17 December 2019
Date Type: Publication
Journal or Publication Title: International Journal of Environmental Research and Public Health
Volume: 16
Number: 24
Publisher: MDPI AG
Page Range: p. 5148
DOI or Unique Handle: 10.3390/ijerph16245148
Schools and Programs: School of Public Health > Epidemiology
Refereed: Yes
Uncontrolled Keywords: diet; antioxidants; omega-3 polyunsaturated fatty acids; cotinine; HbA1c; interaction
ISSN: 1660-4601
Official URL:
Funders: American Heart Association Beginning Grant-in-Aid, National Health and Medical Research Council, U.S. National Institutes of Health
Article Type: Research Article
Date Deposited: 06 Jun 2022 15:35
Last Modified: 06 Jun 2022 15:35


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