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

Abstract

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 Nutrients 2020, 12, 1013 3 of 20 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.

Spousal Concordance in Dietary Behaviors and Metabolic Components, and Their Association: A Cross-Sectional Study

“…These factors may be other unmeasured confounding factors or poorly measured confounding factors. For example, physical activity is a potential confounder for metabolic syndrome [15,34], but we did not adjust for this variable due to a lack of sufficient information. Finally, we do not have information about the duration of cohabitation or the timing of the diagnoses of the metabolic components in this study.…”

“…Previous studies have reported that spouses are concordant in several dietary behaviors, such as drinking [10][11][12], alcohol consumption [12,13], fruit and vegetable consumption [14], and the intake of salty food [11]. Furthermore, spousal concordance is also found in MS and its related conditions [15], including being overweight/obesity [16,17], dysglycemia [17], diabetes [18][19][20], hypertension [12,16,21,22], hyperlipidemia [22], coronary heart disease [12,23], and stroke [12]. However, the association between dietary behaviors and metabolic components among spouses is still unclear.…”

Association between Non-Alcoholic Fatty Liver Disease and Mediterranean Lifestyle: A Systematic Review

“…It decreases lipid disorders, such as a high plasma level of triglycerides and low HDL-cholesterol, as well as a decrease in weight and blood pressure [ 13 ]. High levels of physical activity decrease type 2 diabetes mellitus, MetS, and NAFLD [ 14 , 15 ], while it is very usual that people with metabolic disorders also engage in low regular physical activity [ 16 , 17 ]. Exercise intensity is also important in reducing MetS risk factors [ 12 ]; 3–5 sessions per week of moderate or vigorous physical activity, an equivalent of 150–200 min per week, has been shown to have decreased the development of NAFLD [ 18 ].…”

“…A Mediterranean lifestyle based on regular physical activity and following a Mediterranean diet is essential to decrease MetS [ 7 , 17 , 19 ].…”

The Role of Lifestyle, Eating Habits and Social Environment in the Prevention and Treatment of Type 2 Diabetes and Hypertension

“…Regarding hypertension, three observational studies were published in the special issue. Starting with the baseline data of the PREDIMED study, Gallardo-Alfaro et al [ 14 ], revealed that metabolic syndrome severity was associated with lower levels of physical activity, higher sedentary time and lower adherence to the Mediterranean dietary pattern. Another observational study by Xue et al [ 15 ], in apparently healthy adults, showed that excess visceral body fat is associated with elevated blood pressure, as well as with increased risk of hypertension.…”