Leisure-time physical activity and the risk of metabolic syndrome: meta-analysis

Age-Dependent Health Status and Cardiorespiratory Fitness in Austrian Military Mountain Guides

Puehringer, Reinhard, Martin Berger, Michael Said, and Martin Burtscher. Age-dependent health status and cardiorespiratory fitness in Austrian military mountain guides. High Alt Med Biol. 21:346-351, 2020. Background: Mountaineering activities (at moderate and high altitudes) require a relatively high level of physical fitness, which may be closely associated with healthy aging. This cross-sectional study was aimed at evaluating the age-dependent health status and fitness level in Austrian military mountain guides. Methods: A total of 166 professional mountain guides were recruited for a comprehensive health check and exercise testing. Comparisons were made between 3 different age groups, that is, ≤40 years (n = 74), 41-50 years (n = 70), and >50 years (n = 22). Besides exercise capacity, anthropometric, biomedical, and cardiorespiratory parameters have been assessed. Results: None of the assessed parameters differed between age group 1 and 2. A slight increase was observed in the age group 3 concerning body weight, body mass index, blood lipids, blood glucose, and urea levels, and resting systemic blood pressure values. Peak aerobic capacity and maximal heart rates were slightly lower in this age group than the younger groups. When compared with the general population, mountain guides of similar age showed lower prevalence of being overweight, and suffering from systemic hypertension and diabetes. Conclusions: Our findings indicate favorable aging of mountain guides occupationally performing mountaineering activities (at moderate and high altitudes), characterized by maintaining a high fitness level and developing reduced cardiovascular risk factors until older than 50 years.

Metabolic Syndrome and Its Associated Factors in Older Adults: A Secondary Analysis of SABE Colombia in 2015

Background: Understanding the metabolic syndrome (MetS) prevalence at the national level is important to develop effective programs and strategies to prevent and control MetS. This study aimed to analyze the prevalence of MetS according to gender and aging stage, and its association with potential factors in older individuals ≥60 years of age in Colombia. Methods: The data for this study came from a secondary cross-sectional, nationally representative SABE study Survey on Health, Well-Being, and Aging in Colombia, 2015. A total of 1637 participants (60.7% women, 70.5 ± 7.9 years) from 86 Colombian municipalities participated. A structured questionnaire was used to collect data on socio-demography, lifestyle, and self-report medical conditions. Measurements included anthropometric (weight, waist circumference, body mass index), sarcopenia "proxy" status (calf circumference) handgrip strength levels, high-density lipoprotein cholesterol, triglycerides, fasting glucose, and blood pressure. Univariate and multiple regression models were established as part of the main analysis. Results: Using the harmonized Joint Scientific Statement criteria, MetS was present in 54.9% of the study population, with a higher prevalence among females than males (59.8% vs. 47.3%). Individuals who were cigarette smokers (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.0-2.4; P = 0.034), female gender (OR = 1.3; 95% CI = 1.0-1.8; P = 0.020), and sarcopenia "proxy" (OR = 1.6; 95% CI = 1.0-2.5; P = 0.026) were more likely to have a higher prevalence estimate of MetS, after controlling for relevant covariates. Conclusions: Overall prevalence of MetS among older adults in Colombia is high. Smoking, female gender, and sarcopenia "proxy" status are associated with MetS. These results suggested that MetS is still a serious public burden in Colombia, and screening for promotion of healthy lifestyle and nutrition counseling should be offered routinely in old age.

Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies

OBJECTIVE

Metabolic syndrome is an important metabolic disorder which impose noticeable burden on health system. We aimed to review and imply the prevalence of it in Middle-East countries.

METHODS

present study was a systematic review to present overview about metabolic disorder in Middle East. Electronic literature search of Medline database and Google scholar were done for English-language articles without time filtering, as well as for population-based or national studies of the prevalence of metabolic syndrome. The fallowing search terms were used simultaneously: prevalence of ^"metabolic syndrome" and "national study", "prevalence of metabolic syndrome in Middle East", "prevalence of metabolic syndrome" and "name of country", "metabolic syndrome &name of country". Additionally, relevant articles in bibliography were searched. Analysis of data was carried out in STATA version 11.0.

RESULTS

out of 456 studies in first-step searching (selecting by title) 59 studies were recruited and reviewed. Prevalence of metabolic syndrome fluctuated by country and time of study. This amount was 2.2-44% in Turkish, 16-41% in Saudi-Arabia, 14-63 in Pakistan, 26-33 in Qatar, 9-36 in Kuwait, 22-50 in Emirate, 6-42 in Iran, and up to 23 in Yemen. Pooled estimate was 25%. Attributable risk for cardiovascular disease, coronary heart disease, and stroke was 15.87, 11.7, and 16.23, respectively.

CONCLUSION

The prevalence rate of metabolic syndrome is high and it is noticeable cause for stroke, coronary heart disease, and cardiovascular disease.

Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort

Background

There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer.

Methods

We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline.

Results

High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively.

Conclusions

Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.

Association between physical activity and the prevalence of metabolic syndrome: from the Korean National Health and Nutrition Examination Survey, 1999-2012

The purpose of this study was to determine favorable physical activities, by intensity, type, and frequency that would serve to minimize the prevalence of metabolic syndrome. A total of 24,178 individuals participated in the Korean National Health and Nutrition Examination Survey that investigated the risk factors for metabolic syndrome and physical activity including the physical activity type (vigorous and moderate activity, walking, strength, and flexibility) and the frequency (numbers of days per weeks where physical activity lasted at least 10 min per session). Complex-samples analysis, descriptive statistics, Pearson’s Chi-square test, and multivariate logistic regression analyses were conducted to analyze the data. The results confirmed that physical activity had a favorable effect on reducing the occurrence of metabolic syndrome. The lowest prevalence of metabolic syndrome was observed when vigorous physical activity was conducted six times per week (OR 0.65, 95% CI 0.45–0.94). The associated beneficial effects included improvements in the risk factors of metabolic syndrome, depending on the specific physical activity type and frequency. Patients diagnosed, as having metabolic syndrome should be aware of the associated underling risk factors in order to determine a targeted physical activity intervention.

Energy expenditure and nutritional complications of metabolic syndrome and rheumatoid cachexia in rheumatoid arthritis: an observational study using calorimetry and actimetry

OBJECTIVE

Altered energy expenditure may contribute to the nutritional complications of RA, metabolic syndrome (MS) and rheumatoid cachexia (RC). The main aim of this study was to evaluate whether the altered resting energy expenditure (REE) and physical activity (PA)-related energy expenditure (EE) are related to the duration of RA and inflammatory activity and nutritional complications in RA.

METHODS

Among patients with well-characterized RA (duration, activity: DAS28 ESR), we measured REE by indirect calorimetry, and PA-EE by actimetry (SenseWear Armband). MS was defined according to the International Diabetes Federation criteria and RC from DXA body composition analysis. The relations between the characteristics and nutritional complications, and EE were analysed by linear regression.

RESULTS

Fifty-seven patients were included [73% women, age 57 (10) years] with a wide range of disease duration: 3.8 (3.0) years, and DAS28 ESR: 3.9 (1.4). The mean REE was 1486 (256) kcal/day, associated with the DAS28 ESR (β = +0.21, P = 0.02 after adjusting for gender and fat free mass). The prevalence of MS and RC was, respectively, 24 and 18%, and they were unrelated to each other. The patients with MS and/or RC had double the longstanding RA score (P < 0.05), twice the homeostasis model assessment of insulin resistance values (P = 0.052) and halved levels of PA (P < 0.05 for metabolic equivalent tasks (METs) and number of steps/day). Two modifiable factors were associated with the presence of MS and/or RC: a low level of PA as METs [exp(B) = 0.03, P = 0.009] and the use of glucocorticoids [exp(B) = 4.08, P = 0.046].

CONCLUSION

Low levels of PA and treatment by glucocorticoids are associated with the nutritional complications of RA, suggesting the potential for therapeutic interventions.

Metabolic syndrome in first-time hospitalized patients with depression: a 1-year follow-up study

OBJECTIVE

Studies on metabolic syndrome (MetS) in younger patients with depression are few. We examined the prevalence and progression of MetS in first-time hospitalized patients with depression during 1 year of follow-up. Furthermore, we explored putative risk factors of MetS.

METHOD

We evaluated MetS and its components in first-time hospitalized patients with depression (N = 52) and healthy controls (N = 50) (18-45 years). Physical activity, aerobic fitness, sleeping disturbances, smoking and dietary habits, and psychopharmacological treatment were recorded at baseline for all participants and after 1 year for the patients.

RESULTS

Patients had significantly higher waist circumference (WC) and lower high-density lipoproteins compared with healthy controls (P < 0.05). Patients had higher prevalence of MetS, but this was not significant when adjusted for age. Patients had significant increase in WC and triglycerides and a non-significant increase in the prevalence of MetS. Antipsychotic medication (OR 10.5, 95% CI 1.18-94.14) and low aerobic fitness (OR 0.79, 95% CI 0.68-0.93) were significantly correlated with MetS (P < 0.05).

CONCLUSION

Metabolic syndrome is highly prevalent in younger, severely depressed patients and the incidence increases during 1 year of follow-up. Low aerobic fitness and use of atypical antipsychotics are strongly correlated with MetS.

Metabolic syndrome and aerobic fitness in patients with first-episode schizophrenia, including a 1-year follow-up

OBJECTIVE

To compare the prevalence of metabolic syndrome (MetS) and metabolic abnormalities in patients with first-episode schizophrenia (FES) with sex- and age-matched healthy controls; to investigate changes in MetS during 1year of treatment; and to investigate predictors of MetS.

METHODS

Patients with FES (N=99) and healthy controls (N=50) were included in the study. MetS was defined according to IDF based on waist circumference (WC), blood pressure (BP), triglycerides (TG), high-density lipoprotein (HDL), and fasting-glucose. Data on physical activity, aerobic fitness, smoking, and dietary habits, sleeping disturbances, psychopathology and psychotropic medication were also obtained. Patients were assessed at baseline and at 1year follow-up.

RESULTS

Compared with healthy controls patients with FES had a higher baseline prevalence of MetS (p=.07), and metabolic abnormalities: WC (p<.01), TG (p<.01), HDL (p=.017), and fasting glucose (p=.04). Patients with FES had significantly increased prevalence of MetS (p=.03), WC (p=.04), and TG (p=.01) during the study period. Antipsychotics and low physical activity were significantly correlated with the increase in metabolic abnormalities. In multivariate analyses low aerobic fitness was the most consistent and significant predictor of metabolic abnormalities and MetS.

CONCLUSION

MetS and metabolic abnormalities are highly prevalent in patients with FES, and both increase significantly during 1year of treatment. Apart from confirming the metabolic adverse effects of antipsychotics, our study highlights that low aerobic fitness is a significant risk factor for MetS. Promoting a healthier lifestyle should be part of psychiatric treatment and rehabilitation.

Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings--data from SCAPIS pilot study

BACKGROUND

As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions.

METHODS

A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders.

RESULTS

Concurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration.

DISCUSSION

In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations.

CONCLUSION

Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.

The impact of long-term changes in metabolic status on cardiovascular biomarkers and microvascular endothelial function in middle-aged men: a 25-year prospective study

BACKGROUND

The aim of this analysis was to examine long-term effects of changes in metabolic status on microvascular endothelial function and cardiovascular diseases (CVD) biomarkers among physically active middle-aged men.

METHODS

Metabolically healthy men (n = 101, mean age 59.7 years), free of symptoms and treatment, have been prospectively observed for their lifestyle and CVD risk factors (observation period 24.7 years). At the latest follow-up (2011/2012) a set of CVD biomarkers was measured using enzyme-linked immunosorbent assay. Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. At follow-up the participants were divided into metabolically healthy (0-1 metabolic parameters) and metabolically unhealthy (≥2 metabolic parameters) groups. Metabolic syndrome was defined according to the NCEP ATP III definition.

RESULTS

Traditional metabolic risk factors were significantly associated with hsCRP, ox-LDL, Il-6, leptin and adiponectin/leptin ratio. Reactive hyperemia index was negatively related to body mass (p < 0.01), waist circumference (p < 0.05), triglycerides (p < 0.01), TG/HDL ratio (p < 0.01), uric acid (p < 0.05), sICAM-1 (p < 0.05) and Il-6 (p < 0.05), and positively to HDL-C (p < 0.01) and leisure-time physical activity (p < 0.01). Men who maintained metabolically healthy status (n = 47) through the observation had significantly lower hsCRP and uric acid (p < 0.05), higher adiponectin/leptin ratio (p < 0.05), higher mean RHI and lower prevalence of endothelial dysfunction (p < 0.05) as compared to the metabolically unhealthy group (n = 54). Regular physical activity level was significantly higher among metabolically healthy individuals during the whole observation.

CONCLUSIONS

Even subtle changes in metabolic profile influence inflammatory biomarkers and microvascular endothelial function. Leptin, adiponectin/leptin ratio and hsCRP are significant predictors of metabolic profile. Interleukine-6 and sICAM-1 may be used as indicators of early endothelial dysfunction in asymptomatic men. High leisure-time physical activity level is an important contributor of metabolically healthy profile through middle adulthood.

A possible role of serum uric acid as a marker of metabolic syndrome

BACKGROUND/AIMS

The association between serum uric acid (SUA) levels and metabolic syndrome (MetS) has recently been reported in several cross-sectional and longitudinal studies. We investigated SUA as a biomarker to predict future development of MetS in healthy Korean men without diabetes or hypertension and determined the optimal cut-off levels of SUA.

METHODS

A retrospective cohort study was conducted using data from healthy men who received a general health check-up in 2003. A total of 1809 participants free of MetS, diabetes and hypertension was enrolled. Participants were classified into three groups based on SUA levels: group 1 (<5.5 mg/dL), group 2 (5.5-6.9 mg/dL) and group 3 (≥7.0 mg/dL).

RESULTS

During 13,802 person-years of follow up, 127 participants developed MetS. After adjusting for multiple associated parameters, SUA was significantly associated with incident MetS (hazard ratios comparing groups 2 and 3 vs group 1, 2.45 and 3.47 respectively; P < 0.001). In receiver operating characteristic curve analysis, the optimal cut-off level for SUA to predict the development of MetS was 6.5 mg/dL.

CONCLUSION

Our results indicate that an increased level of SUA, even within the normal range, is associated with future development of MetS in healthy middle-aged men.

Personality Correlates of Midlife Cardiometabolic Risk: The Explanatory Role of Higher-Order Factors of the Five-Factor Model

Varying associations are reported between Five-Factor Model (FFM) personality traits and cardiovascular disease risk. Here, we further examine dispositional correlates of cardiometabolic risk within a hierarchical model of personality that proposes higher-order traits of Stability (shared variance of Agreeableness, Conscientiousness, inverse Neuroticism) and Plasticity (Extraversion, Openness), and we test hypothesized mediation via biological and behavioral factors. In an observational study of 856 community volunteers aged 30-54 years (46% male, 86% Caucasian), latent variable FFM traits (using multiple-informant reports) and aggregated cardiometabolic risk (indicators: insulin resistance, dyslipidemia, blood pressure, adiposity) were estimated using confirmatory factor analysis (CFA). The cardiometabolic factor was regressed on each personality factor or higher-order trait. Cross-sectional indirect effects via systemic inflammation, cardiac autonomic control, and physical activity were tested. CFA models confirmed the Stability "meta-trait," but not Plasticity. Lower Stability was associated with heightened cardiometabolic risk. This association was accounted for by inflammation, autonomic function, and physical activity. Among FFM traits, only Openness was associated with risk over and above Stability, and, unlike Stability, this relationship was unexplained by the intervening variables. A Stability meta-trait covaries with midlife cardiometabolic risk, and this association is accounted for by three candidate biological and behavioral factors.

Cardiorespiratory Fitness, Sedentary Behaviour and Physical Activity Are Independently Associated with the Metabolic Syndrome, Results from the SCAPIS Pilot Study

Background

Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared.

Objectives

The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively.

Methods

Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition.

Results

Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI:0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs.

Conclusion

The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.