Low Muscular Strength, Weight Status, and Metabolic Syndrome in Adolescents: National Health and Nutrition Examination Survey 2011–2014

Purpose: To investigate the association between muscular strength and metabolic syndrome (MetS), with a specific focus on the role of weight status, using a nationally representative sample of US youth. Methods: The analysis included 409 boys and 415 girls from the 2011 to 2014 National Health and Nutrition Examination Survey between 12 and 18 years of age. The prevalence of MetS was defined using age- and sex-specific criteria for abdominal obesity, elevated triglycerides, blood pressure, fasting glucose, and low high-density lipoprotein (HDL) cholesterol. Strength was assessed via handgrip dynamometer and expressed as age- and sex-specific z scores of relative strength. Low strength was defined as a relative strength below the 25th percentile. Analyses controlled for age, sex, race/ethnicity, physical activity, and weight status. Results: The sample prevalence of MetS was approximately 5.3%. However, MetS prevalence was 18.5% in overweight/obese youth with low strength. The adjusted odds of MetS were 3.1 (95% confidence interval, 1.5–6.3, P < .001) times higher for overweight/obese youth with low strength versus sufficient strength. Conclusion: Muscular strength is predictive of adolescent MetS, specifically in those with unhealthy weight status. Approximately one in 5 overweight/obese youth with low strength had MetS. These findings highlight the relevance of muscular strength in youth cardiometabolic morbidities.