We evaluated whether the associations between birth weight and type 2 diabetes differed by adulthood lifestyle by using multiplicative and additive interaction analyses.24 25 26 We tested the multiplicative interaction by comparing the 2 log likelihood of the multivariate adjusted models with and without the cross product interaction term.24To access the additive interaction between birth weight and unhealthy lifestyle on risk of type 2 diabetes, we considered birth weight and count of unhealthy lifestyle factors as two continuous variables. We assessed the relative excess risk due to interaction as an index of additive interaction.26 27 We further examined the decomposition of the joint effect that is, the proportions attributable to birth weight alone, to unhealthy lifestyle alone, and to their interaction.26 27We also calculated the hypothetical population attributable risk, an estimation of the percentage of incident type 2 diabetes in the study population that theoretically would not have occurred if all people had been in the low risk category, combining a healthy birth weight and a healthy lifestyle, assuming a causal relation. To allow valid calculation of population attributable risk, we used pooled logistic regression models with age and time period included in the model.

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