Research article
Accelerometer-Determined Steps/Day and Metabolic Syndrome

https://doi.org/10.1016/j.amepre.2010.02.015Get rights and content

Background

There is a lack of knowledge about the relationship between objectively measured physical activity and the odds of having metabolic syndrome (MetS) and cardiovascular (CVD) risk factors.

Purpose

This study aims to investigate associations between accelerometer-determined steps/day and the odds of having MetS and its individual CVD risk factors in the U.S. population.

Methods

Adults in 2005–2006 NHANES with accelerometer-determined steps/day and measurements necessary to determine MetS by AHA/NHLBI were included (n=1446, 48.2% men, 33.5% with MetS, mean age=47.5 years, mean BMI=28.7 kg/m2). Logistic regression was used to estimate the odds of having MetS or abnormal CVD risk factors from incrementally higher levels of steps/day.

Results

MetS prevalence decreased as steps/day increased (p<0.0001), with 55.7% of participants in the lowest categoric level of steps/day and 13.3% in the highest level having MetS. The odds of having MetS were 10% lower for each additional 1000 steps/day (OR=0.90, 95% CI=0.86, 0.93). The likelihood of having MetS was OR=0.28 (95% CI=0.18, 0.44) for active to highly active and 0.60 (0.43, 0.82) for low to somewhat-active compared to sedentary adults (p<0.0001). Adults who took more steps/day tended to have lower waist circumference, higher high-density lipoprotein (HDL) cholesterol level, and lower levels of triglycerides.

Conclusions

Adults who maintain an active lifestyle by accumulating more steps are likely to have a lower prevalence of MetS and its individual CVD risk factors. Although other concomitant lifestyle behaviors may influence this lower prevalence, the evidence presented here on steps/day and metabolic syndrome, and elsewhere on physical activity and other health and disease states, suggest that it is a fundamental component of daily living.

Section snippets

Background

Metabolic syndrome (MetS) is made up of unhealthy cardiovascular disease (CVD) risk factors including abdominal obesity, high levels of triglycerides, low level of high-density lipoprotein (HDL) cholesterol, elevated blood pressure, and elevated fasting glucose level as defined by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI).1 According to the National Health and Nutrition Examination Survey (NHANES) 1999–2004,2 approximately 36% of the U.S. adult

Methods

Analyses were conducted in 2009 using data from the U.S. NHANES 2005–2006. NHANES uses a complex, multistage, probability sampling design to select participants who are representative of the U.S. population. The National Center for Health Statistics ethics review board approved the original survey protocols, and informed consent was obtained for all NHANES participants. The Pennington Biomedical Research Center's IRB approved this data analysis. Eligibility criteria included being aged ≥20

Results

The analytic sample included 1446 adults (n=758 men and n=688 women). The weighted prevalence estimate of MetS among U.S. adults was approximately 34% (n=272 men and n=251 women). Descriptive characteristics of the total sample and those with and without MetS are presented in Table 1. The estimated prevalence of MetS for each of the step-defined physical activity categories was as follows: basal active, 55.7%; limited active, 43.2%; low active, 29.5%; somewhat active, 28.3%; active, 18.8%;

Conclusion

Higher levels of steps/day were associated with significantly lower odds of MetS and several CVD risk factors, in agreement with previous studies.19, 20, 21, 22 A recent Australian study utilized Tudor-Locke and Bassett's31 step-defined classifications and found that the prevalence of cardiometabolic risk clustering was significantly lower in categories with higher levels of physical activity.22 Specifically, estimated prevalence of MetS ranged from 55.7% in the lowest to 13.3% in the groups

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