Change in physical activity, food choices and hemoglobin A1c among American Indians and Alaska Natives with type 2 diabetes

•At baseline, physically active participants with higher healthy food scores had lower HbA1c levels than non-active participants.•Over the three-year period, women who increased physical activity and/or healthy food consumption had slightly decreased HbA1c.•Changes in physical activity and HbA1c differed by gender.