Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

Laura Gallardo-Alfaro^{1

2

3}, Maria Del Mar Bibiloni^{1

2

3}, Catalina M Mascaró^{1

2

3}, Sofía Montemayor^{1

2

3}, Miguel Ruiz-Canela^{1

4}, Jordi Salas-Salvadó^{1

5}, Dolores Corella^{1

6}, Montserrat Fitó^{1

7}, Dora Romaguera^{1

3}, Jesús Vioque^{8

9}, Ángel M Alonso-Gómez^{1

10}, Julia Wärnberg^{1

11}, J Alfredo Martínez^{1

12

13}, Lluís Serra-Majem^{1

14}, Ramon Estruch^{1

15}, José Carlos Fernández-García^{1

16}, José Lapetra^{1

17}, Xavier Pintó^{1

18}, Antonio García Ríos^{1

19}, Aurora Bueno-Cavanillas^{9

20}, José J Gaforio^{9

21}, Pilar Matía-Martín²², Lidia Daimiel²³, Rafael M Micó-Pérez^{24

25}, Josep Vidal²⁶, Clotilde Vázquez^{1

27}, Emilio Ros^{1

28}, Cesar Ignacio Fernandez-Lázaro^{1

4}, Nerea Becerra-Tomás^{1

5}, Ignacio Manuel Gimenez-Alba^{1

6}, María Dolors Zomeño^{1

7}, Jadwiga Konieczna^{1

3}, Laura Compañ-Gabucio^{8

9}, Lucas Tojal-Sierra^{1

10}, Jéssica Pérez-López^{1

11}, M Ángeles Zulet^{1

12}, Tamara Casañas-Quintana^{1

14}, Sara Castro-Barquero^{1

29}, Ana María Gómez-Pérez^{1

16}, José Manuel Santos-Lozano^{1

17}, Ana Galera^{1

18}, F Javier Basterra-Gortari^{1

4

30}, Josep Basora^{1

5}, Carmen Saiz^{1

6}, Karla Alejandra Pérez-Vega^{1

7}, Aina M Galmés-Panadés^{1

3}, Cristina Tercero-Maciá³¹, Carolina Sorto-Sánchez^{1

10}, Carmen Sayón-Orea^{1

4

30}, Jesús García-Gavilán^{1

5}, Júlia Muñoz-Martínez^{1

8}, Josep A Tur^{1

2

3}

Affiliations

¹ CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
² Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain.
³ Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
⁴ Department of Preventive Medicine and Public Health, IdISNA, University of Navarra, 31008 Pamplona, Spain.
⁵ Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain.
⁶ Department of Preventive Medicine, University of Valencia, 46100 Valencia, Spain.
⁷ Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), 08003 Barcelona, Spain.
⁸ Nutritional Epidemiology Unit, Miguel Hernández University, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 46020 Alicante, Spain.
⁹ CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
¹⁰ Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 48013 Vitoria-Gasteiz, Spain.
¹¹ Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, 29071 Málaga, Spain.
¹² Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
¹³ Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
¹⁴ Institute for Biomedical Research, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
¹⁵ Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
¹⁶ Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, 29010 Málaga, Spain.
¹⁷ Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain.
¹⁸ Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
¹⁹ Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain.
²⁰ Department of Preventive Medicine, University of Granada, 18071 Granada, Spain.
²¹ Department of Health Sciences, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaen, 23071 Jaen, Spain.
²² Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
²³ Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
²⁴ CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
²⁵ Network of Researchers REDI Fundación SEMERGEN, 28009 Madrid, Spain.
²⁶ Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
²⁷ Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain.
²⁸ Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain.
²⁹ Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain.
³⁰ Servicio Navarro de Salud, Osasunbidea. 31071 Pamplona, Spain.
³¹ Centro de Salud Raval, 03203 Elche, Spain.

PMID: 32272653
PMCID: PMC7230557
DOI: 10.3390/nu12041013

Randomized Controlled Trial

Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

Laura Gallardo-Alfaro et al. Nutrients. 2020.

. 2020 Apr 7;12(4):1013.

doi: 10.3390/nu12041013.

Authors

Affiliations

¹ CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
² Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain.
³ Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
⁴ Department of Preventive Medicine and Public Health, IdISNA, University of Navarra, 31008 Pamplona, Spain.
⁵ Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain.
⁶ Department of Preventive Medicine, University of Valencia, 46100 Valencia, Spain.
⁷ Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), 08003 Barcelona, Spain.
⁸ Nutritional Epidemiology Unit, Miguel Hernández University, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 46020 Alicante, Spain.
⁹ CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
¹⁰ Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 48013 Vitoria-Gasteiz, Spain.
¹¹ Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, 29071 Málaga, Spain.
¹² Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
¹³ Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
¹⁴ Institute for Biomedical Research, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
¹⁵ Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
¹⁶ Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, 29010 Málaga, Spain.
¹⁷ Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain.
¹⁸ Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
¹⁹ Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain.
²⁰ Department of Preventive Medicine, University of Granada, 18071 Granada, Spain.
²¹ Department of Health Sciences, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaen, 23071 Jaen, Spain.
²² Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
²³ Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
²⁴ CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
²⁵ Network of Researchers REDI Fundación SEMERGEN, 28009 Madrid, Spain.
²⁶ Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
²⁷ Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain.
²⁸ Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain.
²⁹ Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain.
³⁰ Servicio Navarro de Salud, Osasunbidea. 31071 Pamplona, Spain.
³¹ Centro de Salud Raval, 03203 Elche, Spain.

PMID: 32272653
PMCID: PMC7230557
DOI: 10.3390/nu12041013

Abstract

Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55-75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses' Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence.

Keywords: Mediterranean diet; depression risk; metabolic syndrome severity; physical activity; sedentary behaviour.

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Conflict of interest statement

Jordi Salas-Salvadó reports serving on the board of and receiving grant support through his institution from the International Nut and Dried Fruit Council, and Eroski Foundation. Reports serving in the Executive Committee of the Instituto Danone Spain and on the Scientific Committee of the Danone International Institute. He has received research support from Patrimonio Comunal Olivarero, Spain; and Borges S.A., Spain. Reports receiving consulting fees or travel expenses from Danone; Eroski Foundation, Instituto Danone - Spain, and Abbot Laboratories.

Figures

**Figure 1**
Flow-chart of the study participants.

See this image and copyright information in PMC

References

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Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

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Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

Authors

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Abstract

Conflict of interest statement

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