The Mediterranean Lifestyle (MEDLIFE) Index and Metabolic Syndrome in a US Working Population

Abstract

ObjectivesThe Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern rather than individual factors, may be associated with a lower prevalence of metabolic syndrome. The objective was to study the association of a validated MEDLIFE index with metabolic syndrome and its components among a non-Mediterranean working population. MethodsA cross-sectional analysis was conducted at baseline among 249 US career firefighters in Feeding America’s Bravest 2016–2018. The MEDLIFE index consisted of 26 items on food consumption, dietary habits, physical activity, rest, and social interactions that scored 0 or 1 point; scores theoretically could range from 0 to 26 points. Multivariable logistic regression models were used to determine the associations across tertiles of MEDLIFE adherence with metabolic syndrome and its components. Additionally, multivariable linear regressions determined the extent to which each tertile predicted continuous outcomes. ResultsMetabolic syndrome was prevalent among 17.67% of our study population. Participants with higher MEDLIFE adherence (T3: 11–17 points) were 71% less likely to have metabolic syndrome compared to those with lower MEDLIFE adherence (T1: 2–7 points) (OR = 0.29; 95% CI: 0.10 to 0.90, p for trend = 0.04). Furthermore, significant inverse associations were found for T3 versus T1 on abdominal obesity (OR = 0.42; 95% CI: 0.18 to 0.99, p for trend = 0.07) and hypertriglyceridemia (OR = 0.24; 95% CI: 0.09 to 0.63, p for trend = 0.002). Significant inverse associations for continuous outcomes included total-cholesterol, low-density lipoprotein (LDL) cholesterol, and total-c: high-density lipoprotein cholesterol (p for trend < 0.05). ConclusionsHigher adherence to a traditional Mediterranean lifestyle, measured by a comprehensive MEDLIFE index comprised of lifestyle habits beyond dietary intake and physical activity, may be associated with a lower prevalence of metabolic syndrome and a more favorable cardiometabolic profile in a non-Mediterranean working population. Future studies employing the MEDLIFE index are warranted to further study this hypothesis. Funding SourcesUS Department of Homeland Security.