Lifestyle and Health-Related Quality of Life Relationships Concerning Metabolic Disease Phenotypes on the Nutrimdea Online Cohort

Abstract

Obesity, diabetes and cardiovascular events are non-communicable diseases (NCDs) directly related to lifestyle and life quality. Rises on NCDs rates are leading to increases in early deaths concerning metabolic morbidities. Health-related quality of life (HRQoL) has been described as a subjective perception about the influence of health and personal features on human well-being. This study aimed to characterize phenotypic and lifestyle roles on the occurrence of metabolic diseases and determine the potential mutual interactions and with HRQoL. Data from an online adult population (NUTRiMDEA study, n = 17,332) were used to estimate an adapted Obesogenic Score (ObS), while logistic regression analyses were fitted in order to examine relevant factors related to the prevalence of different metabolic diseases including HRQoL. Sex and age showed significant differences depending on lifestyle and metabolic health (p < 0.05). Adherence to the Mediterranean diet and physical activity showed a mutual interaction concerning ObS (p < 0.001), as well with metabolic health (p = 0.044). Furthermore, metabolic diseases showed own features related to sociodemographic and lifestyle characteristics in this population. Metabolic syndrome components may be differently influenced by diverse lifestyle or socioeconomic factors which in turn affect the perceived HRQoL. These outcomes should be taken into account individually for a precision medicine and public health purposes.

Keywords: Mediterranean diet; health-related quality of life; metabolic health and disease; online data collection; physical activity.

Figure 1

Flow diagram of the NUTRiMDEA Study. The implausible values were outliers which were calculated using boxplots. For weight, the lower limit was set at 19 Kg and the upper limit at 110 Kg. For height, the lower limit was 142 cm and the upper limit 193 cm. For pant size, the lower limit was 28 and the upper limit was 54. For BMI, the lower limit was 13.22 Kg/m² and the upper limit was 34.67 Kg/m². For light PA, the upper limit was from 900 min/week. The upper limit of moderate PA was set at 550 min/week and 600 min/week for PA intense. For total METs, the upper limit was 7194 METs-min/week.

Figure 2

Characteristics of different diseases (obesity, diabetes, HBP and dyslipidemia). (I) Prevalence of family disease (%). (II) BMI (Kg/m²). (III) HRQoL score PCS12 and MCS12 (0–100 points). (IV) MDS14 (0–14 points). (V) Prevalence of sedentarism (%). (VI) Physical Activity (METs-min/week). (VII) Obesogenic Score (0–3 points). Family disease (%) refers to the same disease in each column. The statistics used to compare mean differences in Family disease (%) and sedentarism (%) were the chi-square test while one way analysis of variance (ANOVA) with sidak post-hoc test was performed for the rest (PCS12, MCS12, Obesogenic Score, MDS14, BMI and PA). Threshold significance was set at p < 0.05. * p < 0.05. ^abcd means with different superscripts are statistically different.

Figure 3

The interaction of healthy status or presence of metabolic diseases and dichotomized Mediterranean diet Score (MDS14) into high and low, in relation to total physical activity (METs-min/week) (mean ± SE). D × H means interaction between Mediterranean diet Score (MDS14) and metabolic Health/disease. Threshold significance was set at p < 0.05. p-values for two-way analysis of variance (ANOVA) with sidak post-hoc test between groups. Adjusted by type of survey, HRQoL, age, sex, family disease, sedentarism and mean meals per day. Different letters ‘abcd’ indicate statistically differences. Thus, significant differences were observed within the high Mediterranean diet group between health and ≥2 metabolic diseases