Metabolic syndrome in Korean older adults: Prevalence, determinants, and nursing implications.

BackgroundSufficient physical activity (PA) is a key element for the prevention of non-communicable diseases. Considering leisure time physical activity (LTPA), the purpose of the survey was to provide descriptive data for LTPA, find the proportion of the study population meeting the recommended WHO PA criteria, and to detect the possible relationship between LTPA and overweight.MethodsThe National Physical Activity Survey was carried out in autumn 2015 in the Estonian population (n = 914) aged 15–69 years. For LTPA assessment, the LTPA domain of IPAQ-L interview version was used. LTPA was analysed in regard to fulfilment of the WHO PA recommendations and in association with BMI.ResultsSeventy-three percent of study participants reported any LTPA in the preceding 7 days. 22 % (26 % of men, 20 % of women) met WHO PA recommendations. 50 % of the study participants were considered overweight (48 % of men, 51 % of women) with BMI > 25.0 kg/m2, whereas 20 % of the total study population was obese (BMI ≥ 30.0 kg/m2). Lower adherence to WHO PA recommendations was associated with older age in men, and obesity in both men and women.ConclusionsA strikingly low proportion of people met WHO PA recommendations and a relatively high proportion of overweight people were detected in the study group. Obesity had significant inverse associations with LTPA.

BackgroundPrevious research showed negative associations between physical activity and loneliness in older adults. However, information on associations among middle-aged adults is scarce. In this prognostic factor study, we investigated if starting or stopping to follow the WHO physical activity recommendations was associated with changes in perceived social exclusion and loneliness in this age bracket.MethodsWe used longitudinal representative data of participants aged 40 to 64 years from the German Ageing Survey waves in 2014 and 2017 (analytical sample = 4,264 observations, 54% women). Perceived social exclusion was investigated with the scale from Bude and Lantermann. Loneliness was quantified with the 6-items loneliness scale from De Jong Gierveld. Information from the International Physical Activity Survey items on the time spend in moderate and vigorous physical activity per week was dichotomized. Participants were coded as either following or not following the WHO´s physical activity recommendations of spending at least 150 min of moderate, 75 min of vigorous or an appropriated combination of physical activity per week. We investigated the within (individual) association between starting and stopping to follow WHO´s physical activity recommendations and perceived social exclusion as well as loneliness in asymmetric fixed effects regressions. Analyses were adjusted for age, marital status, employment status, social-network size, general self-efficacy, depressive symptoms, self-rated health, BMI, comorbidities, and physical functioning (SF-36).ResultsStopping to follow the physical activity recommendations from the WHO was associated with perceived social exclusion (ß= 0.09 p = 0.04) but not with loneliness (ß=-0.01, p = 0.71). Starting to follow the WHO physical activity recommendations was neither associated with social exclusion (ß=-0.02, p = 0.54) nor with loneliness (ß=-0.01, p = 0.74) in adjusted asymmetric fixed effects regressions.ConclusionIn middle-aged adults, longitudinal associations were found for physical activity and perceived social exclusion. Perceived social exclusion may be prevented by maintaining at least 150 min of moderate physical activities per week, which is the WHO physical activity recommendation. Future research should investigate moderators and mediators in the association between physical activity and social exclusion as well as loneliness.

sBackgroundAlthough previous studies have established a close relationship between caloric intake and metabolic syndrome, there is limited research exploring the impact of meal frequency adjusted by caloric intake on metabolic syndrome (MetS).ObjectiveTo evaluate the association of meal frequency and MetS after adjusting for confounding factors including caloric intake in Korean men and women.MethodsWe analyzed the national representative data of a total 12,389 adults (5171 men, 7218 women) from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2012. Subjects were categorized as eating 3 meals/day (MF3) or 2 or fewer meals/day (MF ≤ 2). Daily caloric intake was calculated using CAN-Pro 4.0 (The Korean Nutrition Society, Seoul, Korea).ResultsThe prevalence of components of MetS differed significantly according to meal frequency in both men and women. In an unadjusted analysis, the prevalence of MetS in women was significantly higher in the MF3 group than the MF ≤ 2 group (27.5% vs. 17.8%, P < 0.001), whereas the prevalence of MetS in men did not differ between the MF3 and MF ≤ 2 groups (24.6% vs. 22.7%, P = 0.281). However, after adjusting for age, caloric intake, smoking status, alcohol consumption, physical activity, income, and education level, men in the MF ≤ 2 group had an increased risk of metabolic syndrome compared to men in the MF3 group (OR = 1.37, 95%, CI = 1.12–1.67). On the other hand, meal frequency did not affect the risk of metabolic syndrome in women after adjusting for confounding factors including caloric intake (OR = 1.09, 95%, CI = 0.90–1.31).ConclusionsThis study suggests that lower meal frequency adjusted for caloric intake, physical activity, age, smoking, alcohol, income, and education may be associated with increased risk of MetS in Korean men.

Objectives After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels. Methods The study design was a cross-sectional study at Örebro University Hospital, Sweden. Preoperative and surgical data were retrieved from medical records and questionnaires concerning physical activity (Frändin-Grimby Activity Scale, the Physical activity Likert-scale Haskell, Patient-Specific Functional Scale, and Exercise Self-efficacy Scale) were completed six months after surgery. Data were collected on pain, dyspnea, general health status and kinesiophobia i.e. fear of movement, using the Tampa Scale of Kinesiophobia Heart. Results In total, 71 patients (68 ± 11 years, males 82%) participated in this study. Most patients (76%) reported a light to moderate activity level (Frändin-Grimby levels 3-4) six months after cardiac surgery. In total, 42% of the patients adhered to the WHO’s physical activity recommendations (150 min/week). Pain and dyspnea were low. Patients with lower activity levels exhibited significantly higher levels of fear of movement (p =.025). Conclusions The majority of patients reported engaging in light to moderate activity levels six months after cardiac surgery. Despite this, less than half of the patients met the WHO's physical activity recommendations. Potential barriers to physical activity such as pain, dyspnea and fear of movement were reported to be low.

Daily adherence to WHO recommended physical activity guidelines has multiple health benefits in children and adolescents. Limited data from low and middle-income countries are available regarding adherence to WHO physical activity recommendations. This study aims to objectively measure physical activity intensities and explore associations with sociodemographic and anthropometric factors related to nonadherence to the WHO minimum physical activity recommendations. Two cross-sectional studies were conducted between 2014 and 2019 in two distinct populations of Ecuador in terms of poverty and residency (Cuenca: 66% live in urban areas, and 38.2% have unsatisfied basic needs; Quininde, 76.4% live in rural areas and 91% have unsatisfied basic needs). Waist-worn accelerometers were used to measure daily physical activity, standardized questionnaires were used to assess sociodemographic variables (age, sex, ethnicity, and socioeconomic status), and anthropometric (weight, height, waist circumference) measurements were taken. Multivariable regression was used to assess the relationship between sociodemographic and anthropometric factors with physical activity in each study population. The study involved 650 participants in Cuenca, with a mean age of 9.1 years (SD 2.9), and 985 children and adolescents in Quinindé, with a mean age of 8.3 years (SD 0.4). In both settings, boys were more likely than girls (Cuenca: adj. OR 3.09, 95% CI 2.17–4.39; Quinindé adj. OR 5.63, 95% CI 4.03–7.85) to achieve the WHO physical activity guidelines. More affluent participants were much less likely to meet this recommendation than their poorer counterparts in both settings. In Cuenca, a higher waist circumference was inversely associated with meeting WHO daily physical activity recommendation (adj. OR 0.96, 95% CI 0.94–0.98), whereas in Quinindé, adherence to WHO guidelines was more likely in non-Mestizo than Mestizo children (adj. OR 1.45, 95% CI 1.02–2.07). The findings suggest that anthropometric differences and sociodemographic disparities influence the attainment of WHO physical activity recommendations in Ecuadorian children.

Cardiovascular disease is a leading cause of mortality globally and in South Korea. The American Heart Association (AHA) developed Life's Essential 8 (LE8) to evaluate cardiovascular health (CVH) through 8 metrics. However, LE8 has not been studied in the Korean population. This study aims to assess CVH in Korean adults using LE8 metrics and Korea National Health and Nutrition Examination Survey (KNHANES) data. This cross-sectional study analyzed 35,117 adults from KNHANES (2014-2021). CVH scores were calculated across 8 metrics (diet, physical activity [PA], nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure) and classified as high (80-100), moderate (50-79), or low (0-49). Demographic, socioeconomic, and clinical characteristics were compared across categories. Among 35,117 participants (weighted population: 30,544,496; 51.6% women), the mean CVH score was 63.1±0.1, with women scoring higher than men (66.9 vs. 59.1; p<0.001). Only 12.3% achieved high CVH, while 17.7% were classified as low. Diet and PA had the lowest scores, while sleep and blood glucose scored highest. Women demonstrated higher scores than men except in PA. Low CVH was associated with older age (≥65 years: 19.5% low vs. 4.4% in 19-39 years), lower socioeconomic status (68.2% low vs. 31.8% high education), and chronic diseases (e.g., hypertension, diabetes). This first application of AHA's LE8 metrics to Korean adults revealed suboptimal CVH with significant disparities by age, gender, socioeconomic status, and chronic diseases, emphasizing the need for targeted interventions.

Objectives: To evaluate gender specific characteristics in the prevalence of metabolic syndrome (MetS) and abnormalities in Korean population using the 2009 Joint Interim Statement of the International Diabetes Federation. Methods: We performed a secondary analysis of data based on the 2012 Korea National Health and Nutrition Examination Survey (KNHANES). MetS prevalence was calculated for 5,935 Korean adults (≥ 20 years of age) by sex and age group. Incidence rates of five MetS risk factors were also assessed. Results: The prevalence of MetS among Koreans was 21.7% (22.9% for men, 20.6% for women). Elderly women after menopause had the highest prevalence of MetS and all five risk factors. Young and middle-aged men had higher prevalence and risk factors of MetS than similarly-aged women, but the rate of MetS in women surged significantly from age 50 and surpassed that of men thereafter. Women had a higher prevalence of low HDL cholesterol than men in all age groups. Of the five MetS risk factors, the prevalence of hypertension was highest (36.0%). About one-third of Korean have hypertension as a main risk factor. Conclusion: We observed a mounting gender disparity with age due to an increase in the prevalence of metabolic abnormalities in female. Preventive strategies including lifestyle interventions and health education about MetS need to be implemented pre-menopausal women and middle-aged men. Therapeutic strategies including drug intervention should be employed for elderly women. In 2012, more than one-fifth of Korean have MetS. These results indicate that MetS is an imperative public health issue that needs to be managed at the national level. Reducing the rates of hypertension and dyslipidemia will be critical to controlling MetS. This study provides not only the latest information but also target population and high risk factors for controlling MetS.

Background: Driving adolescents to more correct food habits and physical activity is crucial to promoting health and avoiding the increase in morbidity and mortality in adulthood. Literature has focused on these behaviors in the adult population, while studies on adolescents are more limited. This study aims to explore the level of knowledge, attitudes, and behaviors regarding nutrition and physical activity to acquire insight into adolescents and identify the associated predictors. Methods: A cross-sectional study was conducted among adolescents aged 10 to 19 years from public middle and high schools randomly selected in the Campania Region, Southern Italy. A self-administered questionnaire, including closed and open-ended questions, assessed socio-demographic and health-related characteristics, dietary habits, physical activity, and sources of health information. Results: Regarding socio-demographic and health-related characteristics, among 1433 adolescents who completed the survey, the mean age was 15.2 years, 50.5% were boys, 16.8% reported having a non-communicable disease, and 18% were overweight or obese. Multivariate analysis showed that older age, male gender, daily breakfast with at least one parent, higher self-rated knowledge on nutrition, awareness of fruit and vegetables consumption recommendations, correct dietary attitudes (daily breakfast, consumption of fruit and vegetables at least once a day, of legumes at least twice a week, and of carbonated sugary drinks less than once a day), the need for additional dietary information, meeting WHO physical activity recommendations, and less than two hours of daily screen time are determinants of a high quality diet score. Conversely, living with a single family member and current smoking were negatively associated with high quality diet. Older age, male gender, risk of alcohol abuse, higher quality diet, and lower mobile phone use are associated with meeting WHO physical activity recommendations. Since we investigated risky behaviors, potential limitations of this study could include social desirability and recall bias. Conclusions: Many adolescents lead unhealthy lifestyles, but younger adolescents and girls appear to be at higher risk of unhealthy behaviors. Targeted initiatives promoting regular physical activity and balanced diets in schools, involving parents and teachers in a collaborative plan, are essential to improving adolescents’ health and well-being.

BackgroundTailored recommendations for patients after percutaneous coronary interventions (PCI) need physical activity (PA) to be objectively measured and assessed for adherence to guidelines. The recent WHO guidelines removed the daily recommended bout duration, while the potential impact of this change on patients after PCI remains unclear.AimWe evaluated prevalence estimates of adherence to PA recommendations among patients after PCI across the 2010 [≥30 min moderate- to vigorous-intensity PA (MVPA) at ≥ 10-min bout duration] and 2020 WHO guidelines (≥30 min of MVPA of any bout duration), as well as 7,500 and 10,000 steps.MethodsWe conducted an observational longitudinal single-center study with patients after PCI for chronic or acute coronary syndrome (ACS); maximal age 80 years. Wrist-worn accelerometers recorded participants’ PA data from the evening of hospital discharge over the next 18 days.ResultsWe analyzed data from 282 participants with sufficient minimum wear time (7 days of ≥12 h), including 45 (16%) women; and 249 (88%) with ACS. Median wear time was 18 (17, 18) days. Median participant age was 62 (55, 69) years. Fifty-two participants (18.4%) fulfilled 2010 WHO guidelines and 226 (80.1%) fulfilled the 2020 WHO guidelines. Further, 209 (74.1%) participants achieved ≥7,500 steps/day and 155 (55.0%) performed ≥10,000 steps/day.ConclusionAmong participants after PCI, most MVPA was accumulated in bouts <10 min, leading to a fourfold discrepancy between participants fulfilling the 2010 and 2020 WHO PA recommendations. The number of steps/day may be a valid proxy to recent WHO PA recommendations as it is not dependent on the bout-length definition.Clinical trial registration[ClinicalTrials.gov], identifier [NCT04663373].

[Purpose] This study analyzed data from the 7th Korean National Health and Nutrition Examination Survey (2016‒2018) to compare the differences in energy intake and physical activity (PA) levels in middle-aged Korean men aged 40-59 years according to household type and the presence of metabolic syndrome (MetS).[Methods] Data from 2,266 young adults (aged >39 years and <60 years) were obtained from the KNHANES. We analyzed the differences in energy intake and PA levels according to household type and MetS. The presence or absence of MetS was determined by measuring waist circumference, blood pressure, fasting blood glucose, triglyceride, and HDL-C levels.[Results] Regarding total nutritional intake, no relationship with MetS was observed regardless of household type (interaction between MetS and household type: p = 0.875). No differences in total PA were observed between multiple- and single-person households (interaction between MetS and household type: p = 0.122). The relationship between MetS and MetS components according to nutritional intake showed that participants with a higher energy intake had a 27% lower prevalence of low high-density lipoprotein cholesterol (HDL-C) (p < 0.05) and a 36% higher prevalence of high blood pressure (p < 0.01). The relationship between MetS and MetS components according to the PA level showed significantly reduced prevalence of MetS by approximately 39%, 35%, and 43% (p < 0.01, 0.01, and 0.001) in subjects who were somewhat active, active, and very active, respectively, compared to inactivity.[Conclusion] Middle-aged men showed no difference in nutritional intake and PA between multiple- and single-person households. However, the risk of MetS was significantly higher in participants with approximately 1.5 times the energy intake compared to the group with the lowest energy intake. Moreover, higher levels of PA had a marked positive effect on the risk factors and prevalence of MetS. Therefore, we suggest that reducing the total energy intake and increasing total PA are important for preventing MetS in middle-aged men regardless of household type.

BackgroundPrevious studies have suggested that blood Cd, Pb exposure, and physical activity levels may influence the development of hypertension. This study aimed to investigate the relationship between blood Cd, Pb levels, and hypertension by the level of physical activity in Korean adults using The Korea National Health and Nutrition Examination Survey (KNHANES).MethodsWe used data from the KNHANES (2008–2013), a nationally representative, cross-sectional, population-based study. We included 8,510 participants who had records of blood Cd, Pb and, blood pressure measurements. Multiple logistic regression was used to examine the association between blood Cd and Pb exposure and the development of hypertension, as well as the modifying effects of physical activity levels. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S).ResultsFollowing covariates adjustments, we found significant associations of blood Cd and Pb with higher hypertension prevalence. This association was more apparent in low physical activity while blood Cd and Pb concentrations were not significantly associated with hypertension in participants with more activity. Additionally, there was a significant interaction between blood Cd and physical activity on hypertension risk (RERI = 0.17, 95% CI: -0.36–0.7; AP = 0.12, 95% CI: -0.28–0.52; S = 1.75, 95% CI:1.36–2.14).ConclusionsOur results suggest that low physical activity may substantially amplify the adverse effects of blood Pb and Cd exposure on hypertension risk. However, interactions were only found for Cd. Further studies are needed to confirm these findings.

Introduction. Regular physical activity is a recognized method of non-pharmacological prevention many chronic diseases. The aim of this study was to evaluate the prevalence of physical activity and abdominal obesity in 631 randomly selected men from Warmia and Masuria region in Poland. Material and methods. 631 men from the Warmia and Mazury region in age of 19–82 years (47.2 } 13.7 years) were examined between Dec 2014 and Dec 2016. Participants completed standardized questionnaire. Anthropometric measurements were performed. BP was measured. In serum of 398 participants glucose and lipidogram were measured. Analyses were performed separately for three groups depending on time of physical activity in week: ACT+ (meet WHO physical activity recommendations ≥ 150 min/week), ACT+/- (do not meet WHO recommendations &lt; 150 min/week and ≥ 50 min/week) and ACT — (do sport occasionally or never). Two groups were performed depending on the BP: AHT+ (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or antihypertensive therapy) and AHT — (BP values &lt; 140/90 mmHg and no antihypertensive therapy). Results. ACT-, ACT+/- and ACT+ accounted respectively for 53%, 24% and 23%, AHT+ for 55.6% and men with waist circumference ≥ 94 cm for 63.9% of studied population. In ACT- increased BP was measured more frequently in comparison with ACT+. In ACT+ waist circumference, DBP and HR were lower and PP was higher in comparison to ACT-. Laboratory tests results did not differ between all three groups of respondents. It was observed that group of participants with waist circumference &lt; 94 cm had lower values of blood pressure parameters in comparison to participants with waist circumference ≥ 94 cm. Conclusions. Only 1 out of 4 men in Warmia and Masuria region in Poland meets the WHO physical activity recommendations, 64% of them have abdominal obesity and more than a half had measured increased values of arterial blood pressure. These findings reveal increased risk o

Few studies have examined overall patterns of eating alone in relation to the risk of metabolic syndrome (MetS) in Korean populations. The present study aimed to examine the relationship between patterns of eating alone and the risk of MetS in Korean adults. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) for 2013–2015 were used, with 8988 Korean adult participants, including 3624 men and 5364 women, aged 18 to 64 years. Patterns of eating alone were categorized into eight groups based on the total frequency of eating alone on a daily basis in the past one year: (1) three times for breakfast, lunch, and dinner; (2) twice for breakfast and dinner; (3) twice for lunch and dinner; (4) twice for breakfast and lunch; (5) once for breakfast only; (6) once for lunch only; (7) once for dinner only; and (8) never eating alone. The presence of MetS has been defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF). Multivariable logistic regression analyses were performed to assess the association between patterns of eating alone versus the risk of MetS after controlling for age, income, occupation, number of family members, generation types, marital status, smoking status, and physical activity. The prevalence of MetS was the highest in men and women aged 40–64 who had breakfast, lunch, and dinner alone (50.1% and 36.8%, respectively). Men who had dinner alone or lunch and dinner alone compared with those who eat with others had a significantly higher risk of MetS, with adjusted odds ratios (AOR) of 1.51, and a 95% confidence interval (CI) of 1.06–2.16; and an AOR of 1.54, with a 95% CI of 1.05–2.25, respectively. Women who had breakfast alone compared with those who ate with others had a significantly lower risk of MetS (AOR 0.70, 95% CI 0.53–0.94). In conclusion, patterns of eating alone are differentially associated with the risk of MetS in a representative sample of Korean adults. Future studies are warranted to identify dietary patterns across the different eating alone patterns in relation to various health outcomes in Korean adult populations.

Background: Metabolic syndrome (MetS), characterized by the co-occurrence of obesity, hypertension, hyperglycemia, and dyslipidemia, substantially increases the risk of cardiovascular disease and type 2 diabetes. In South Korea, the prevalence of MetS is steadily increasing. While physical activity is known to mitigate this risk, recent evidence suggests that the timing of activity, not just its volume, may also be important. Methods: We analyzed accelerometer data from Korean adults who participated in the 2014–2016 Korea National Health and Nutrition Examination Survey (KNHANES). Functional principal component analysis (FPCA) was applied to minute-level physical activity trajectories to extract key temporal patterns. Logistic regression models assessed associations between the resulting principal component (PC) scores and MetS, adjusting for demographic, behavioral, and occupational factors, as well as total moderate-to-vigorous physical activity (MVPA). Results: Among the four extracted components, the third principal component (PC3)—reflecting higher morning and evening activity with reduced afternoon variability—was significantly associated with increased risk of MetS in the fully adjusted model (adjusted OR = 1.117; 95% CI: 1.003–1.244). Conclusions: These findings suggest that temporal patterns of physical activity, particularly reduced variability in the afternoon, may be linked to adverse metabolic outcomes. Beyond overall activity volume, the timing and distribution of daily physical activity should be considered in metabolic health research and interventions.

It is well known that dyslipidemia is a major risk factor for coronary heart disease and stroke, which are currently the leading causes of death in Korea. Dyslipidemia refers to the abnormal amount or imbalance of lipids in the blood, and its clinically important types include elevated total cholesterol, elevated triglycerides, elevated low density lipoprotein-cholesterol (LDL-C), and decreased high density lipoprotein-cholesterol (HDL-C) levels. Among the major types of blood cholesterol, LDL-C is the most extensively studied in association with the risk of cardiovascular disease. ] Over the last few decades, obesity has become more prevalent in Korea due to increasing consumption of high-fat diets and decreasing physical activity, 6) and has raised concerns about dyslipidemia. The Korea National Health and Nutrition Examination Survey (KNHANES) measured blood levels of total cholesterol, triglycerides, and HDL-C in national representative samples since 1998.