Abstract
The associations of nutrition factors and physical activities with adult diabetes are inconsistent; while most of these factors are inter correlated. The aims of this study are to overcome the disturbance of the multicollinearity of the risk factors and examine the associations of these factors with diabetes using the principal component analysis (PCA) and regression analysis with principal component scores (PCS). Totally, 659 adults with diabetes and 2827 non-diabetic were selected from the 2012 Health Information National Trends Survey (HINTS 4, Cycle 2). PCA was utilized to deal with multicollinearity of the risk factors. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors and PCS with diabetes. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The first 3 PCs for nutrition factors and physical activities could explain 70% variances. The first principal component (PC1) is a measure of nutrition factors (fruit and vegetables consumption), PC2 is a measure for physical activities (moderate exercise and strength training), and PC3 is about calorie information use and soda use. Weighted multiple logistic regression showed that African Americans, middle aged adults (45-64 years), elderly (65+), never married, and with lower education were associated with increased odds of diabetes. After adjusting for others factors, the PC1 showed marginal association with diabetes (OR=0.84, 95% CI=0.70-1.01); while PC2 and PC3 revealed significant associations with diabetes (OR=0.73, 95% CI=0.61-0.86 and OR=0.85, 95% CI=0.74-0.99, respectively). In conclusion, PCA can be used to reduce the indicators in complex survey data. The first 3 PCs of nutrition factors and physical activities were associated with diabetes. Promotion of health food and physical activities should be encouraged to help decrease the prevalence of diabetes.
Highlights
There were 284.6 million of people with diabetes in 2010 and it was predicted to be 438.4 million in 2025 [1]
It was found that vegetable but not fruit consumption reduced the risk of type 2 diabetes in Chinese women [18]; while another study showed that fruit or vegetables separately were not associated with diabetes, only green leafy vegetable intake was inversely associated with diabetes [19]
The PC1 is a measure of nutrition factors, the PC2 is a factor for physical activity, and the PC3 is a measure of calorie information use and soda use
Summary
There were 284.6 million of people with diabetes in 2010 and it was predicted to be 438.4 million in 2025 [1]. A metaanalysis showed that increasing the amount of green leafy vegetables in an individual’s diet could help to reduce the risk of type 2 diabetes [16]. A recent study revealed that fruit and vegetable intake was not related to incidence of type 2 diabetes in older subjects [20]. Previous study has suggested a correlation between drinking diet soda and glucose control in adults with diabetes [25]; while reduced sugar intake showed improvements in key risk factors for type 2 diabetes [26]. A more recent study showed that consumptions of soft drinks, sweetened-milk beverages and energy from total sweet beverages were associated with increasing risk of type 2 diabetes [28]
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