Lifestyle behaviors associated with lower risk of having the metabolic syndrome

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/m(2). 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.