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.
Highlights
Metabolic syndrome (MetS) is responsible for a 2.5-fold increased cardiovascular mortality, 5-fold increased risk of diabetes, 2-fold higher risk of coronary heart disease and cerebrovascular disease and1.5-fold increase in the risk of all-cause mortality [1].The prevalence of metabolic syndrome (MetS) is a major public health concern
We considered the following food parameters to calculate the Dietary Inflammatory Index (DII): alcohol, carbohydrate, cholesterol, energy, iron, fibre, folic acid, garlic, green/black tea, magnesium, monounsaturated fatty acids (MUFA), omega-3 fatty acids (w-3 FA), omega-6 fatty acids, niacin, onion, protein, polyunsaturated fatty acids (PUFA), riboflavin, saturated fatty acids (SFA), selenium, thiamine, total fat, trans fatty acids (TFA), vitamin A, vitamin B12, vitamin B6, vitamin C, vitamin D, vitamin E, and zinc
The percentage of women and the prevalence of obesity, high blood pressure (BP), hyperglycaemia, low HDL cholesterol and abdominal obesity, and the prescription of antihypertensive agents, anti-cholesterol agents, insulin, oral hypoglycaemic agents, and aspirin or antiplatelet drugs increased with increasing MetS severity, whereas the education level decreased
Summary
The prevalence of MetS is a major public health concern. This data is alarming, given the aging world population being a major contributor to the growing prevalence of MetS. The risk of developing MetS increases with the lack of physical activity (PA), which is an important component of cardiovascular diseases (CVD) development [4,5]. Strong evidence shows that high amounts of sedentary behaviour have been associated with increased risk of several chronic conditions, mortality [6], and higher likelihood of MetS [7]. Diet has a potential role in the prevention and treatment of MetS; higher adherence to the Mediterranean diet (MD) can reduce cardiometabolic risk factors [9] and the prevalence of MetS, and cause reversion of this condition [10]
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