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Multicenter Study
. 2016 Mar;137(3):e20153177.
doi: 10.1542/peds.2015-3177. Epub 2016 Feb 9.

Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

Arthur M Lee  1 , Matthew J Gurka  2 , Mark D DeBoer  3
Affiliations
Multicenter Study

Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

Arthur M Lee et al. Pediatrics. 2016 Mar.

Erratum in

Abstract

Background and objectives: Childhood metabolic syndrome (MetS) is a risk factor for adverse outcomes later in life. Our goal was to identify temporal trends among US adolescents in the severity of MetS, its individual components, and factors related to diet and physical activity.

Methods: We analyzed 5117 participants aged 12 to 19 from NHANES. We used regression analysis of individual waves of data, 1999 to 2012. MetS severity was calculated using a gender- and race/ethnicity-specific MetS severity z score.

Results: There was a linear trend of decreasing MetS severity in US adolescents from 1999 to 2012 (P = .030). This occurred despite a trend of increasing BMI z score (P = .005); instead, the decrease in MetS severity appeared to be due to trends in increasing high-density lipoprotein (HDL; P < .0001) and decreasing triglyceride (P = .0001) levels. In considering lifestyle factors, there was no change in physical activity over the time period. Regarding dietary patterns, total calorie consumption and carbohydrate consumption were positively associated with triglyceride levels and negatively associated with HDL levels, whereas unsaturated fat consumption exhibited the opposite associations. Consistent with these associations, there was a trend of decreasing total calorie consumption (P < .0001), decreasing carbohydrate consumption (P < .0001), and increasing unsaturated fat consumption (P = .002).

Conclusions: The healthier trend of declining MetS severity in adolescents appeared to be due to favorable increases in HDL and decreases in fasting triglyceride measurements. These were in turn associated with favorable changes in dietary patterns among US adolescents. Future studies should investigate the causality of dietary differences on changes in MetS severity in adolescents.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Trends in prevalence and measurements of MetS and its components versus time. Individual means and 95% confidence interval bars are shown for each sampling period. Regression lines are shown with 95% confidence bands shaded. P values are reported for nonzero trends. For prevalence values, slope is reported as change in percentage per sampling period. For measurements, slope is reported as change in measurement unit per sampling period. There were significant decreasing trends of low HDL and hypertriglyceridemia prevalence. There were significant decreasing trends in MetS z score and fasting plasma triglycerides. There were significant increasing trends in BMI z score and HDL.
FIGURE 2
FIGURE 2
Trends in dietary factors. Individual means and 95% confidence interval bars are shown for each sampling period. Regression lines are shown with 95% confidence bands shaded. P values are reported for nonzero trends. For total calorie consumption, slope is reported as change in calories consumed per sampling period. For carbohydrate and unsaturated fat intake, slope is reported as change in percentage per sampling period. There were significant decreasing trends in total calorie consumption and percentage of calories accounted for by carbohydrates. There was a significant increasing trend in percentage of calories accounted for by unsaturated fats.
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