Lifestyle Factors Associated with Metabolic Syndrome Z-Score in US Adolescents

Abstract Objectives Metabolic syndrome (MetS) is a cluster of abnormalities including abdominal obesity that increases risk for diabetes and cardiovascular disease. MetS affects ∼10% of US adolescents, but more may be at risk. The MetS severity z-score (MetS-z) is a continuous measure that may be useful for indicating MetS risk. Preventing at-risk adolescents from developing MetS may be achievable through changes in lifestyle factors such as diet and physical activity. Our objective was to evaluate the relationship of lifestyle-related factors with MetS-z in adolescents. Methods We performed a cross-sectional analysis of adolescents (12 to 19 y) from the National Health and Nutrition Examination Survey (NHANES) 2011–2016. MetS-z was calculated from sex- and race-specific equations developed for adolescents. Sagittal Abdominal Diameter (SAD, representing abdominal visceral fat) was obtained using NHANES standard procedures. Dietary intake was estimated via two 24-hour diet recall interviews and used to calculate the Healthy Eating Index (HEI)-2015 total (range 0–100) and component scores (range 0–10) indicating diet quality. Physical activity (PA, minutes/week of voluntary moderate or vigorous exercise) was reported by participants to trained interviewers and used to determine adherence to national PA guidelines of at least 60 min/day. Multivariable linear regression was used to evaluate the relationship of HEI scores, SAD and physical activity with MetS-z. Results Sample size was 1291 (49% female, 50% white) adolescents. Means (SEM) were: Age, 15.4 y (0.09); BMI z-score, 0.63 (0.04); MetS-z, −0.08 (0.03); SAD, 18.3 cm (0.14); and HEI score, 47.4 (0.46). Median min/week of PA was 178.5, with 30.4% of adolescents meeting PA guidelines. The final model (R2 = 0.53) included age, SAD (β = 0.17, P < 0.0001), HEI score (β = −0.003, P = 0.09), and physical activity (β = −0.005, P = 0.69). Conclusions US adolescents consume a poor-quality diet and less than half meet physical activity guidelines, yet as a group they have a MetS z-score <0, indicating low overall risk. SAD had a significant, positive association with MetS-z. While physical activity and diet were not significant in the model, results suggest the need for improvement of overall diet quality to potentially reduce risk of MetS and related chronic diseases in youth. Funding Sources None.

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Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

Nutrients ◽

10.3390/nu12041013 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1013 ◽

Cited By ~ 2

Author(s):

Laura Gallardo-Alfaro ◽

Maria del Mar Bibiloni ◽

Catalina M. Mascaró ◽

Sofía Montemayor ◽

Miguel Ruiz-Canela ◽

...

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Diet Quality ◽

Dietary Pattern ◽

Severity Score ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Lifestyle Factors ◽

Depression Symptoms ◽

Depression Risk

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.

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Association of diet quality, physical activity, and abdominal obesity with metabolic syndrome z-score in black and white adolescents in the US.

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2021.10.021 ◽

2021 ◽

Author(s):

Suzanne S. Summer ◽

Todd Jenkins ◽

Thomas Inge ◽

Ranjan Deka ◽

Jane C. Khoury

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Abdominal Obesity ◽

Diet Quality ◽

White Adolescents ◽

Z Score ◽

Black And White ◽

The Us ◽

Black And White Adolescents

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The Relationship of Diet Quality with Proportion of Daily Energy Contributed by Sandwiches Varies by Age over Adulthood in Racially and Socioeconomically Diverse Adults

Nutrients ◽

10.3390/nu12092807 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2807

Author(s):

Marie Fanelli Kuczmarski ◽

May A. Beydoun ◽

Nancy Cotugna ◽

Elizabeth Schwenk ◽

Michele K. Evans ◽

...

Keyword(s):

Diet Quality ◽

Healthy Aging ◽

Healthy Eating Index ◽

Racially Diverse ◽

Daily Energy ◽

Study Participants ◽

Relationship Of ◽

The Relationship ◽

Over Time

Sandwiches are considered a staple in diets of United States adults. Previous research with Healthy Aging in Neighborhoods of Diversity across the Life Span study participants revealed that 16% consume a sandwich dietary pattern providing with 44% of their daily energy. Yet, little is known about the effect of sandwiches on diet quality over time. The study objectives were to determine the relationship of energy contributed by sandwiches to diet quality in this socioeconomically and racially diverse sample categorized by age (<50 years and ≥50 years at baseline) and to describe patterns of sandwich consumption over ~12 years. The analyses included a series of linear mixed-effects regression models, with age as the time variable centered at 50 years. In each model, the main outcome was Healthy Eating Index-2010 score with up to three scores, while the main predictor was % total energy from sandwiches (0, >0–20%, >20%) measured concurrently at each visit. Diet quality of older men with income <125% poverty improved over time for those consuming >0–20% and >20% energy from sandwiches compared to young women with incomes >125% poverty who were non-reporters of sandwiches (β ± SE: 10.93 ± 5.27, p = 0.01; 13.11 ± 4.96, p = 0.01, respectively). The three most common sandwich types reported, in descending order, were cold cuts, beef, and poultry.

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Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa100 ◽

2020 ◽

Author(s):

Lauren Covington ◽

Bridget Armstrong ◽

Angela C B Trude ◽

Maureen M Black

Keyword(s):

Physical Activity ◽

Diet Quality ◽

Low Income ◽

Sleep Onset ◽

Healthy Eating Index ◽

Future Research ◽

Z Score ◽

Household Poverty ◽

Z Scores ◽

Low Income Families

Abstract Background Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families. Purpose To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight. Methods Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers’ weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score. Results Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score. Conclusions Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities. Trial registration number NCT02615158.

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The relationship of physical activity with dietary cancer-protective nutrients and cancer-related biological and lifestyle factors

European Journal of Cancer Prevention ◽

10.1097/00008469-200308000-00016 ◽

2003 ◽

Vol 12 (4) ◽

pp. 339-346 ◽

Cited By ~ 7

Author(s):

H Schröder ◽

R Elosua ◽

J Marrugat

Keyword(s):

Physical Activity ◽

Lifestyle Factors ◽

Relationship Of ◽

The Relationship

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Investigating the Relationship of Body Mass Index, Diet Quality, and Physical Activity Level between Fathers and Their Preschool-Aged Children

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2014.12.003 ◽

2015 ◽

Vol 115 (6) ◽

pp. 919-926 ◽

Cited By ~ 34

Author(s):

Rachel L. Vollmer ◽

Kari Adamsons ◽

Amy Gorin ◽

Jaime S. Foster ◽

Amy R. Mobley

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Body Mass ◽

Diet Quality ◽

Physical Activity Level ◽

Activity Level ◽

Relationship Of ◽

The Relationship ◽

Preschool Aged Children

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Diet Quality, Physical Activity, and Weight Changes and Their Association With 6-Year Risk of Metabolic Syndrome in Mexican Adults

American Journal of Lifestyle Medicine ◽

10.1177/15598276211017488 ◽

2021 ◽

pp. 155982762110174

Author(s):

Marcela Perez-Rodriguez ◽

Juan Osvaldo Talavera ◽

Jorge Salmeron

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Diet Quality ◽

Weight Change ◽

Lower Risk ◽

Health Workers ◽

Lifestyle Factors ◽

Weight Changes ◽

Study Results

Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period.

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Cross-sectional Relationships between Alternate Healthy Eating Index (AHEI) with General and Abdominal Obesity and Blood Pressure in Iranian Hospital Employees

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666210810144259 ◽

2021 ◽

Vol 21 ◽

Author(s):

Shahrzad Mirashrafi ◽

Marzieh Kafeshani ◽

Akbar Hassanzadeh ◽

Mohammad Hassan Entezari

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Healthy Eating ◽

Diet Quality ◽

Healthy Eating Index ◽

Cross Sectional ◽

Hospital Employees ◽

The Mean ◽

The Relationship

Background and Aims: Due to the increasing prevalence of obesity and related disorders, there is an urgent need to examine the relationship between diet quality and public health. The Alternative Healthy Eating Index (AHEI) is one of the indices that is used to assess diet quality. Therefore, we investigated the relationship between AHEI and anthropometric measurements and blood pressure. Methods: In this cross-sectional study, 127 male and female hospital employees were examined. The AHEI was calculated by a 168 items Food Frequency Questionnaire. Body weight, height, Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR) and blood pressure were measured by skilled nutritionists. Physical activity level was also obtained by International Physical Activity Questionnaire (IPAQ). Results : The mean total AHEI score in participants was reported as 47.1±6.9 (min=31.9, max=60.3). The mean differences of total AHEI score across the obese/non-obese employees were not statistically significant (P>0.05). Furthermore, there was no significant correlation between total AHEI score and BMI (r=0.019), WC (r=0.022), WHR (r=-0.102), systolic (r=-0.133) and diastolic blood pressure (r=-0.040) (P>0.05). The score of nuts and soybeans was inversely related to the WHR (P=0.008) and systolic blood pressure (P=0.030). Cereal fiber score had a negative relationship with BMI (P=0.02), WC (P=0.03), WHR (P=0.004) and systolic (P<0.001) and diastolic blood pressure (P=0.012). Conclusion: Consumption of nuts and soybeans -one serving per day- can be associated with WHR and systolic blood pressure reduction. More studies with a larger scale are needed to examine diet quality.

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