Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study
Laura Gallardo-Alfaro, María del Mar Bibiloni, Catalina M. Mascaró, Sofía Montemayor, Miguel Ruiz‐Canela, Jordi Salas‐Salvadó, Dolores Corella, Montserrat Fitó, Dora Romaguera, Jesús Vioqué, Ángel M. Alonso‐Gómez, Julia Wärnberǵ, J. Alfredo Martínéz, Lluís Serra‐Majem, Ramón Estruch, José Carlos Fernández‐García, José Lapetra, Xavier Pintó, Antonio García, Aurora Bueno‐Cavanillas, José J. Gaforio, Pilar Matía‐Martín, Lidia Daimiel, R.M. Micó-Pérez, Josép Vidal, Clotilde Vázquez, Emilio Ros, César I. Fernández-Lázaro, Nerea Becerra‐Tomás, Ignacio Manuel Gimenez-Alba, María Dolores Zomeño, Jadwiga Konieczna, Laura Compañ‐Gabucio, Lucas Tojal‐Sierra, Jessica Pérez‐López, M. Ángeles Zulet, Tamara Casañas-Quintana, Sara Castro‐Barquero, Ana María Gómez‐Pérez, José Manuel Santos‐Lozano, A. Galera, Francisco Javier Basterra-Gortari, Josep Basora, Carmen Sáiz, Karla Alejandra Pérez‐Vega, Aina M. Galmés‐Panades, Cristina Tercero-Maciá, Carolina Sorto-Sánchez, Carmen Sayón-Orea, Jesús García‐Gavilán, Júlia Muñoz-Martínez, Josep A. Tur
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 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.