Design and preliminary results of a metropolitan lifestyle intervention program for people with metabolic syndrome in South Korea

Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome

BACKGROUND

Metabolic syndrome has a high global prevalence, affecting 26% of South Koreans. Lifestyle modifications have shown benefits in studies involving health behavior enhancement, specifically through workplace eating and exercise interventions. However, workplace interventions focusing on health behaviors have been inadequately explored.

OBJECTIVES

This study examined factors affecting health promotion behaviors of workers at high risk of metabolic syndrome by applying Theory of Planned Behavior constructs (attitude, subjective norm, perceived behavioral control, and intention).

METHODS

This correlational cross-sectional study collected survey data from 164 hotel workers in South Korea. The study applied factor analysis and structural equation modeling for the data analysis.

RESULTS

Analysis revealed five health promotion behaviors: exercise, making healthy food choices, avoiding fatty foods, eating a nutritious and balanced diet, and eating regular moderate meals. Participants were grouped as total participants, those with one risk factor and those with two risk factors. In the total group, four behaviors were influenced by perceived behavioral control: exercise, making healthy food choices, eating a nutritious and balanced diet, and eating regular moderate meals. In the one risk factor group, intention and attitude influenced the eating regular moderate meals behavior, and two other behaviors were influenced by perceived behavioral control: exercise and eating a nutritious and balanced diet; in the two risk factors group, only perceived behavioral control directly affected exercise.

DISCUSSION

Perceived behavioral control was a key predictor of health behaviors, and theory constructs partially explained behaviors. Perceived behavioral control influenced four behaviors and influenced exercise in all three groups. Also, theory constructs showed a greater effect on behaviors in the one risk factor group than in the two risk factor group, indicating that participants with one risk factor more effectively managed their behaviors on their own and with health care providers' support. Occupational health providers should conduct early assessments of workers showing metabolic syndrome risk factors to identify their particular risks, intention, and behaviors. As the number of risk factors affects behaviors and perceived behavioral control primarily influences exercise, these findings should be incorporated in metabolic syndrome interventions.

Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program

BACKGROUND/OBJECTIVES

The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants.

SUBJECTS/METHODS

Data of 54,385 participants aged 20–64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1–2; healthy group, none). Adherence to dietary guidelines was determined from the number of “yes” responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines.

RESULTS

In the MetS group, MetS prevalence decreased after the SMESY program (men, −41.9%p; women, −48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by −44.1%p for men and −49.5%p for women, whereas the prevalence in those with negative changes decreased by −38.1%p for men and −48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61–0.80 for men; OR, 0.88; 95% CI, 0.79–0.99 for women).

CONCLUSIONS

The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

Alcohol consumption frequency or alcohol intake per drinking session: Which has a larger impact on the metabolic syndrome and its components?

OBJECTIVES

This study investigated the relationship between drinking behavior (alcohol consumption frequency, average alcohol intake per drinking session) and the prevalence of metabolic syndrome (MetS) and its components (central obesity, raised triglycerides, decreased HDL cholesterol, raised blood pressure, raised fasting plasma glucose) in Korean men and women above the age of 20.

METHODS

Our study employed data from the Korea National Health and Nutritional Examination Survey (KNHANES) for the years 2007-2013. The study population consisted of a total of 16,507 Korean males and 22,548 females; 30.0% (n = 4908) of all males and 29.8% (n = 6663) of all females were diagnosed with metabolic syndrome.

RESULTS

Relative to abstaining males, males who consumed alcohol more than 2-3 times per week (OR: 1.32, 95% CI: 1.04-1.66), as well as those who consumed more than 10 drinks per drinking session (OR: 1.71, 95% CI 1.41-2.08) had greatly increased odds risk of MetS. Alcohol consumption frequency was not associated with increased odds risk of MetS for females, however. Relative to abstaining females, females who consumed just 3-4 drinks per session had a 17% increased odds risk of MetS (OR: 1.17, 95% CI: 1.02-1.35). Females consuming more than 10 drinks per drinking session (OR: 1.91, 95% CI 1.44-2.52) were likely to have a 91% increase in odds risk of MetS. For males, alcohol consumption frequency was associated with high blood pressure and high fasting plasma glucose levels, while average alcohol intake per drinking session was associated with central obesity, high triglyceride levels, high blood pressure, and high fasting plasma glucose. For females, alcohol intake per session was associated with central obesity, high triglycerides, raised blood pressure, and high fasting plasma glucose.

CONCLUSIONS

Frequent alcohol consumption and high alcohol intake per drinking session were associated with higher prevalence of MetS and its components for Korean men; alcohol intake per drinking session only was associated with higher prevalence of MetS and its components for Korean women.

Trends in the prevalence of metabolic syndrome and its components in South Korea: Findings from the Korean National Health Insurance Service Database (2009-2013)

Background

The prevalence of metabolic syndrome has markedly increased worldwide. However, studies in the United States show that it has remained stable or slightly declined in recent years. Whether this applies to other countries is presently unclear.

Objectives

We examined the trends in the prevalence of metabolic syndrome and its components in Korea.

Methods

The prevalence of metabolic syndrome and its components was estimated in adults aged >30 years from the Korean National Health Insurance Service data from 2009 to 2013. The revised National Cholesterol Education Program criteria were used to define metabolic syndrome.

Results

Approximately 10 million individuals were analyzed annually. The age-adjusted prevalence of metabolic syndrome increased from 28.84% to 30.52%, and the increasing trend was more prominent in men. Prevalence of hypertriglyceridemia, low HDL-cholesterol, and impaired fasting plasma glucose significantly increased. However, the prevalence of hypertension decreased in both genders. The prevalence of abdominal obesity decreased in women over 50 years-of-age but significantly increased in young women and men (<50 years).

Conclusions

The prevalence of metabolic syndrome is still increasing in Korea. Trends in each component of metabolic syndrome are disparate according to the gender, or age groups. Notably, abdominal obesity among young adults increased significantly; thus, interventional strategies should be implemented particularly for this age group.

Office Workers' Risk of Metabolic Syndrome-Related Indicators: A 10-Year Cohort Study

The purpose of the study is to assess the relationship between the prevalence of metabolic syndrome-related risk factors and work tenure among office workers. A 10-year cohort analysis was conducted using employees' health examinations given to new employees within 1 or 2 years of joining the firm and every 5 years thereafter. Age-adjusted odds ratios (95% confidence interval [CI], p < .05) were calculated based on a contrast test with general estimating equations. Specifically, the age-adjusted odds ratios and CIs of those with 20 ± 1 years of work, compared with those with 1 to 2 years of work, were as follows: triglycerides (≥150 mg/dl) 3.01 (2.11, 4.28), waist circumference (male ≥90 cm) 2.70 (1.63, 4.45), and fasting glucose (≥100 mg/dl) 2.67 (1.78, 4.01). The findings of the relationship between metabolic syndrome risk and work tenure as well as the baseline health data of new employees provide a foundation for developing a workplace health management system.

The Seoul Metropolitan Lifestyle Intervention Program and Metabolic Syndrome Risk: A Retrospective Database Study

Since 2011, the Seoul Metabolic Syndrome Management (SMESY) program has been employed as a community-wide, lifestyle modification intervention in Seoul, Korea. We aimed to determine if the SMESY intervention would be significantly associated with improvements in metabolic syndrome (MetS) risk factors. This retrospective database study included data from 25,449 participants aged 30–64 years between 1 January 2013 and 30 June 2013. In the SMESY program, 3 risk-stratified groups by the number of MetS factors were followed for 12 months with different intensity and timeframe of intervention. Among the high-(n = 7116) and moderate-risk groups (n = 14,762), all MetS factors (except triglycerides among the moderate-risk group) as well as MetS z-scores significantly improved over 12 months (all p < 0.05). Among the low-risk group (n = 3571), all factors aggravated significantly over 12 months (all p < 0.05). We observed temporal associations between the implementation of the SMESY program and improvements in MetS risk factors. However, such improvements differed by risk-stratified group, being most robust for the high-risk group, modest for the moderate-risk group, and aggravated for the low-risk group. Thus, more intensive interventions targeting different risk-stratified groups are needed, given a better understanding of the increase in risk factors observed in the low-risk group.

Factors associated with health-related quality of life among overweight and obese Korean women

Health-related quality of life (HRQOL) tends to be lower among individuals who are overweight and obese than those of normal weight, and women may be more vulnerable to lower HRQOL associated with obesity than men. Identifying factors associated with HRQOL may be crucial for improving HRQOL for overweight/obese women. We aimed to determine the factors associated with obesity-specific HRQOL among overweight/obese Korean women. A cross-sectional study was conducted with 125 women aged 20-64 years, who comprised a baseline sample in the Community-based Heart and Weight Management Trial. The data were collected from September 2010 to November 2011. The Weight Efficacy Lifestyle, Beck Depression Inventory-II, Interpersonal Social Evaluation List, and Impact of Weight on Quality of Life (IWQOL)-Lite scales were used to measure self-efficacy for weight control, depressive symptoms, social support, and HRQOL, respectively. Increased body mass index, lower self-efficacy for weight control, and higher levels of depressive symptoms were significantly associated with greater impairment in total IWQOL in the regression models. However, social support was not significantly associated with IWQOL. Along with weight loss strategies, other strategies for improving self-efficacy and alleviating depressive symptoms may be essential for improving HRQOL among overweight and obese women.