Lifestyle behaviors associated with lower risk of having the metabolic syndrome

doi:10.1016/j.metabol.2004.04.017

Metabolism

Volume 53, Issue 11, November 2004, Pages 1503-1511

https://doi.org/10.1016/j.metabol.2004.04.017 Get rights and content

Abstract

The metabolic syndrome is a cluster of risk factors that predisposes individuals to cardiovascular disease (CVD) and diabetes and is present in almost one fourth of adult Americans. Risk factors involved with the metabolic syndrome can be altered via modifiable lifestyle factors, such as diet, physical activity, and smoking and drinking habits. The objective of this study was to examine the extent to which these modifiable lifestyle behaviors are associated with the risk of having the metabolic syndrome. Data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted between 1988 and 1994, were used to measure the risk of having the metabolic syndrome in healthy adult Americans who follow certain lifestyle behaviors, such as dietary practices, levels of physical activity, smoking and drinking habits. Low physical activity level, high carbohydrate (CHO) intake, and current smoking habits were all significantly associated with an increased risk of having the metabolic syndrome, even after adjusting for other related covariates. Relative to physically inactive subjects, being physically active was associated with lower odds ratio (OR) (0.36, confidence interval [CI] 0.21 to 0.68, P < .01) in overweight men and in normal weight (0.36, CI 0.18 to 0.70, P < .01) and overweight (0.61, CI 0.38 to 0.97, P < .05) women. Although the type of CHO could not be distinguished, relative to a high CHO diet, men having a low or moderate CHO intake had a lower risk of having the metabolic syndrome with respective ORs of 0.41 (CI 0.24 to 0.67, P < .01) and 0.44 (CI 0.25 to 0.77, P < .01); no effect of dietary CHO was observed in women. Moderate alcohol consumption was not significantly related to the risk of having the metabolic syndrome in men, but was associated with a lower OR in women (0.76, CI 0.61 to 0.95, P < .05). Regression models indicate a reduced risk of having the metabolic syndrome when selected low-risk lifestyle factors are present in combination, particularly in subjects with body mass index (BMI) < 30 kg/m². According to our cross-sectional logistic models, the risk of having the metabolic syndrome is substantially lower in individuals who are physically active, nonsmoking, have a relatively low CHO intake and moderate alcohol consumption, and who maintain a BMI in the non-obese range. These observations have potentially important value for public health recommendations.

Section snippets

Subjects

Subjects over the age of 20 years from 4 ethnic groups, non-Hispanic blacks, Mexican Americans, non-Hispanic whites, and others were eligible for inclusion in the study. Among 18,825 eligible subjects, 5,904 subjects were excluded for lack of anthropometric, demographic, socioeconomic, or physical examination information, and 1,480 subjects were excluded due to improper fasting, defined as drinking or eating 6 hours before blood collection. In addition, 202 women who were pregnant or

Subject characteristics

Women in the sample were significantly (P < .001) older (45.6 years; CI, 44.5 to 46.7) than men (43.8 years; CI, 43.0 to 44.6). Men had a significantly higher (P < .05) BMI (26.7 kg/m²; CI, 26.5 to 26.9) than women (26.4 kg/m²; CI, 26.3 to 26.6).

The overall prevalence of the metabolic syndrome was greater (P < .05) in men (23.0%) than in women (21.9%). The prevalence of the metabolic syndrome in men increased from 5.3% in the normal weight group to 21.9% and 58.8% in the overweight and obese

Discussion

The metabolic syndrome, a prevalent within-individual clustering of CVD risk factors, is affected by lifestyle behaviors including physical activity, diet, smoking, and drinking habits.1, 12 In the present study, we developed logistic regression models examining the independent impact of these lifestyle factors on the odds of having the metabolic syndrome within different BMI categories. Our models reveal that the likelihood of being diagnosed with the metabolic syndrome is lower in individuals

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Citation Excerpt :
The National Health and Nutrition Survey in Japan in 2017 reported that 1 in 4 men and 1 in 8 women had metabolic syndrome [4]. Lifestyle factors, such as physical activity, smoking status, and diet, were associated with metabolic syndrome [5,6]. With regard to eating behaviors, eating speed has been reported to be associated with an increased risk of obesity [7].
Evidence from prospective studies on the association between eating speed and metabolic syndrome is limited. We prospectively investigated the association between eating speed and metabolic syndrome in a Japanese working population.
Participants were 1018 workers (ages 19–68 y) without metabolic syndrome at baseline who completed both baseline and 3-y follow-up surveys. Eating speed was self-reported and categorized as slow, medium, or fast. Metabolic syndrome was defined using criteria recommended in a joint interim statement from several international societies. A multiple logistic regression was used to estimate the odds ratio of metabolic syndrome according to eating speed with adjustment for covariates, including total energy intake.
At the 3-y follow-up, 67 workers (6.6%) were newly identified as having metabolic syndrome. Fast eating speed was significantly associated with increased odds of developing metabolic syndrome, with multivariable-adjusted odds ratios for eating fast of 2.13 (95% confidence intervals, 1.23–3.68) compared with medium eating speed with an adjustment for covariates, including total energy intake. The association remained statistically significant after an additional adjustment for body mass index (BMI) and BMI change between baseline and follow-up surveys (odds ratio: 1.95; 95% confidence interval, 1.06–3.56).
Fast eating speed was associated with an increased likelihood of developing metabolic syndrome independently of total energy intake, BMI at baseline, and BMI change during the follow-up period.
Gender differences in the impact of metabolic syndrome components on mortality in older people: A systematic review and meta-analysis
2020, Nutrition, Metabolism and Cardiovascular Diseases
The influence of metabolic syndrome (MetS) on mortality may be influenced by age- and gender-related changes affecting the impact of individual MetS components. We investigated gender differences in the association between MetS components and mortality in community-dwelling older adults.
Prospective studies were identified through a systematic literature review up to June 2019. Random-effect meta-analyses were run to estimate the pooled relative risk (RR) and 95% confidence intervals (95% CI) of all-cause and cardiovascular (CV) mortality associated with the presence of MetS components (abdominal obesity, high triglycerides, low HDL cholesterol, high fasting glycemia, and high blood pressure) in older men and women. Meta-analyses considering all-cause (103,859 individuals, 48,830 men, 55,029 women; 10 studies) and CV mortality (94,965 individuals, 44,699 men, 50,266 women; 8 studies) did not reveal any significant association for abdominal obesity and high triglycerides in either gender. Low HDL was associated with increased all-cause (RR = 1.16, 95% CI: 1.02–1.32) and CV mortality (RR = 1.34, 95% CI: 1.03–1.74) among women, while weaker results were found for men. High fasting glycemia was associated with higher all-cause mortality in older women (RR = 1.35, 95% CI: 1.22–1.50) more than in older men (RR = 1.21, 95% CI: 1.13–1.30), and CV mortality only in the former (RR = 1.36, 95% CI: 1.04–1.78). Elevated blood pressure was associated with increased all-cause mortality (RR = 1.16, 95% CI: 1.03–1.32) and showed marginal significant results for CV death only among women.
The impact of MetS components on mortality in older people present some gender differences, with low HDL cholesterol, hyperglycemia, and elevated blood pressure being more strongly associated to all-cause and CV mortality in women.

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^☆: Supported by Grant No. DK PO1-42618 from the National Institutes of Health, an unrestricted grant from Pfizer Pharmaceutical (to S.Z.), and fellowship funding from Bristol Myers Squibb-Mead Johnson and the Canadian Institutes of Health Research (to M-P.St-O.).

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Lifestyle behaviors associated with lower risk of having the metabolic syndrome☆

Abstract

Section snippets

Subjects

Subject characteristics

Discussion

Lancet

Ann Epidemiol

Am J Cardiol

Prev Med

Metabolism

Metabolism

Am J Clin Nutr

Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

JAMA

The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men

JAMA

Abdominal adiposity and coronary heart disease in women

JAMA

Prevalence of the metabolic syndrome among US adultsFindings from the Third National Health and Nutrition Examination Survey

JAMA

Social class, health behaviors, and mortality among men and women in eastern Finland

BMJ

Social inequality in coronary risk: Central obesity and the metabolic syndrome. Evidence from the Whitehall II Study

Diabetologia

Diet, lifestyle, and the risk of type 2 diabetes mellitus in women

N Engl J Med

Food patterns and components of the metabolic syndrome in men and womenA cross-sectional study within the Malmö Diet and Cancer Cohort

Am J Epidemiol

Dietary carbohydrates, physical inactivity, obesity, and the “metabolic syndrome” as predictors of coronary heart disease

Curr Opin Lipidol

The metabolic syndrome: Prevalence and associated risk factors: Findings in the US population from The Third National Health and Nutrition Examination Survey, 1988–1994

Arch Intern Med

Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–1994

Vital Health Stat

Healthy People 2010

With understanding and improving health and objectives for improving health

Nutrition and Your Health

Analysis of Health Surveys—Wiley Series in Probability and Statistics

Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men

Med Sci Sports Exerc

Physical activity and the metabolic syndrome in a tri-ethnic sample of women

Obes Res

Low levels of leisure-time physical activity and cardiorepiratory fitness predict development of the metabolic syndrome

Diabetes Care