Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome
Introduction
The association between disturbed lipid and glucose metabolism, unhealthy lifestyles and cardiovascular risk factors has been extensively studied in different populations and across generations (Stampfer et al., 2000, Diabetes Prevention Program Research Group, 2002). The clustering of these two metabolic abnormalities along with high blood pressure and central obesity, usually termed as the metabolic syndrome, is expected to be associated with the same specific set of behavioral choices and lifestyle determinants, as the one observed for each of its individual features (Freeman et al., 1998, Rimm et al., 1999, Corella et al., 2002).
The intervention on modifiable lifestyles had a clear influence on individual and population distribution of cardiovascular risk (Diabetes Prevention Program Research Group, 2002). Similar preventive strategies targeting behavioral modifications are expected to play an important contribute on metabolic syndrome occurrence, mainly through weight reduction. However, it is well known that several additional pathways operate beyond that effect, explaining the influence of physical activity, smoking and alcohol on insulin sensitivity (Mayer-Davis et al., 1998, Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults, 2001, Tuomilehto et al., 2001, Rennie et al., 2003).
In a stable setting of genetic predisposition, the key determinants of metabolic syndrome are the exposure to sedentary lifestyles and obesity (Ford et al., 2002, Laaksonen et al., 2002). The syndrome is an increasingly common condition in Western societies (Ford et al., 2002, Balkau et al., 2003), and observational knowledge on its association with behavioral exposures in different geographic and social settings is an important first step to understand its basis and design effective preventive approaches. Thus, we aimed to evaluate the association between physical activity, sleeping hours, alcohol consumption and smoking and metabolic syndrome in a representative sample of the urban Portuguese adult population.
Section snippets
Methods
Non-institutionalized inhabitants of Porto, Portugal, were selected using random digit dialing. After the identification of a household, permanent residents were characterized according to age and sex, and one adult was selected by simple random sampling and invited to visit our department for interview and examination. If there was a refusal, replacement was not allowed. The participation rate was 70% (Ramos et al., 2004). The local institutional ethics committee approved the study and all
Results
Table 2 presents crude metabolic syndrome prevalence according to the sociodemographic and the behavioral characteristics considered. The syndrome peaked at 60 to 69 years (42.3% in females and 24.6% in males), it was more frequent in less educated females (34.5% in those with ≤ 4 years of education vs. 7.6% in those with > 12 years of education) and in professionally inactive participants (31.2% vs. 13.4% in females and 20.7% vs. 14.2% in males).
Both in males and females, metabolic syndrome
Discussion
We found an independent protective effect of total physical activity and a risk effect of longer sleeping hours on the occurrence of metabolic syndrome. No association was found between smoking and alcohol intake and the metabolic syndrome.
It is known that lifestyles changed over the preceding decades. There was a trend towards an increase in sedentary lifestyles, excessive nutrition and obesity that contributed to an increased incidence of diabetes and metabolic syndrome. Increasing physical
Acknowledgments
This study was funded by Fundação para a Ciência e Tecnologia, POCTI/ESP/35767/99, POCTI/ESP/42361/2001, POCI/SAU-ESP/61160/2004.
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