Poor Eating Behaviors Related to the Progression of Prediabetes in a Japanese Population: An Open Cohort Study

This study aimed to examine lifestyle factors associated with the change in glucose categories among individuals without diabetes. We analyzed cohort data of medical check-ups at baseline between April 2008 and December 2012. The primary and secondary outcomes were the change in glucose categories from normoglycemia (glycated hemoglobin (HbA1c) < 5.7% and fasting plasma glucose (FPG) < 5.6 mmol/L) to prediabetes (HbA1c 5.7–6.4% or FPG 5.6–6.9 mmol/L) and from prediabetes to normoglycemia. During a mean follow-up of 2.4 years, 7083 of 57,018 individuals with normoglycemia developed prediabetes, whereas 4629 of 9926 individuals with prediabetes returned to normoglycemia. Factors associated with progression to prediabetes were baseline BMI (hazard ratio [95% confidence interval]: 1.08 [1.07–1.09]), change in BMI during follow-up (1.05 [1.03–1.07]), late dinner/snacking (1.16 [1.10–1.22]), skipping breakfast (1.12 [1.06–1.18]), and heavy alcohol consumption (1.33 [1.24–1.42]). Factors associated with return to normoglycemia from prediabetes were baseline BMI (0.94 [0.93–0.95]) and change in BMI during follow-up (0.95 [0.93–0.97]). In conclusion, poor eating behaviors, such as skipping breakfast, late dinner/snacking, and heavy alcohol consumption, were associated with the progression from normoglycemia to prediabetes.