Lifestyle modification –healthy diet and physical activity– can help prevent or delay type 2 diabetes in adults with prediabetes (preDM) . However, 84% of US adults with preDM are unaware they have it. Whether preDM status awareness is associated with leisure-time physical activity (LTPA) levels and dietary intake is unknown. Using data from US adults without DM ≥18 y from the National Health and Nutrition Examination Surveys 2013-2018, we classified preDM as ‘aware’ (self-report of preDM and 5.7%≤A1c<6.5%, n=456) , ‘unaware’ (no self-report; 5.7%≤A1c<6.5%, n=2,223) , and ‘normoglycemic’ (A1c<5.7% but self-reported as preDM, n=191) . We calculated means or medians for LTPA (self-reported minutes of moderate to vigorous physical activity per week) , dietary intake (total calories, fruit, vegetables, whole grains, added sugars, processed meat, unprocessed red meat from one day of 24-h recall data) , and the Healthy Eating Index (HEI) 2015, a marker of overall healthy diet (higher score indicates healthier diet) . Of adults with or reporting preDM, 77.9% were unaware (mean age [years]: 51.2 [standard error, 0.5]; 44.6% [1.4] female; mean BMI: 30.3 kg/m2[0.2]) , 14.3% were aware (mean age: 57.4 [0.9]; 56.5% [2.6] female; mean BMI: 31.8 kg/m2 [0.5]) , and 7.8% were normoglycemic (mean age: 43.6 [1.4]; 71.1% [3.7] female; mean BMI: 30.6 kg/m2 [0.6]) . PreDM-aware and normoglycemic adults consumed less calories (p=0.002) , added sugars (p<0.001) , and unprocessed red meat (p<0.001) than preDM-unaware adults. PreDM-aware and preDM-unaware adults consumed more processed meat than normoglycemic adults (p=0.002) . HEI scores and fruit, vegetables, and whole grains intake were low overall and across groups (all p>0.05) . Mean LTPA levels did not significantly vary across the 3 groups (p=0.22) . Overall, preDM awareness is associated with lower added sugars, red meat, and total overall calories intake, suggesting that efforts to increase awareness may lead to healthier eating among those with preDM.


K.R.Siegel: None. M.E.Pavkov: None. S.R.Benoit: None. G.Imperatore: None. K.M.Bullard: None.

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