The U.S. National Health and Nutrition Examination Survey (NHANES) physical activity monitor datasets for 2011-12 and 2013-14 were released in late 2020. To date, there has been limited interpretation of these nationally representative wrist-worn accelerometer data (summarized and reported in Monitor Independent Movement Summary [MIMS] units) and their relationships with health-related outcomes. This study examined the associations between free-living DailyMIMS (volume), Peak 1MIMS and Peak 30MIMS (intensity), and risk of Metabolic Syndrome (MetS). Data from adults (N=3787; 18-80+ years) in the 2011-12 and 2013-14 NHANES cycles with health examination and accelerometry data were included. Accelerometer data were processed into Peak 1MIMS and Peak 30MIMS (MIMS/min), and DailyMIMS (MIMS/day). Design-based generalized linear and logistic regressions, and a sample-weighted decision tree, were used to examine associations between MIMS variables and MetS risk factors. Lower Peak 1MIMS, Peak 30MIMS, and DailyMIMS were observed for every one-unit increase in the number of risk factors -3.9 [95% CI: -4.3, -3.4] and -2.3 [-2.6, -2.1] MIMS/min, (-672.1 [-772.7, -571.5] MIMS/day, respectively, all p< 0.001). The Decision Tree classified individuals ≥ 46.5 years with a DailyMIMS ≥ 12 245 MIMS/day and a Peak 30MIMS < 45.1 MIMS/min as having MetS (≥ 3 risk factors). Individuals < 46.5 years with a Peak 1MIMS ≥ 62.9 MIMS/min were classified with 0 risk factors. Higher DailyMIMS and PeakMIMS were associated with an absence of MetS risk factors, with a progressive decline as the number of risk factors increased. These findings may be considered as preliminary benchmarks for DailyMIMS and PeakMIMS associated with cardiometabolic risk.
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