Joint associations of fresh fruit intake and physical activity with glycaemic control among adult patients with diabetes: a cross-sectional study

OBJECTIVE: To investigate the joint associations of fresh fruit intake and physical activity with glycaemic control in adult patients with diabetes mellitus (DM). DESIGN: It was an observational study involving adult patients with DM through a face-to-face questionnaire survey, physical measurements and laboratory examinations. Data were analysed by introducing a generalised linear mixed model, and a significant difference was set at p<0.05. SETTING: Nanjing, Jiangsu, China. PARTICIPANTS: A total of 5663 adult patients with DM from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance were recruited. RESULTS: Based on the food frequency questionnaire, fresh fruit intake was classified as ‘not eat’, ‘1~99 g/day’ and ‘≥100 g/day’. Physical activity level was calculated based on the data of Global Physical Activity Questionnaire and classified into insufficient physical activity (<600 MET-min/week) and sufficient physical activity (≥600 MET-min/week). The likelihood of glycaemic control in adult patients with DM with fresh fruit intake ≥100 g/day was 37.8% (OR: 1.378; 95% CI: 1.209 to 1.571) higher than those with fresh fruit intake <100 g/day, which was 26% (OR: 1.260; 95% CI: 1.124 to 1.412) higher in adult patients with DM with sufficient physical activity than those with insufficient physical activity. Adult patients with DM with fresh fruit intake ≥100 g/day and sufficient physical activity presented the greatest likelihood of glycaemic control (OR: 1.758; 95% CI: 1.471 to 2.102) compared with those with both fresh fruit intake <100 g/day and insufficient physical activity. CONCLUSIONS: Fresh fruit intake ≥100 g/day combined with sufficient physical activity is associated with a significantly higher likelihood of glycaemic control in adult patients with DM.