Elsevier

Preventive Medicine

Volume 44, Issue 4, April 2007, Pages 328-334
Preventive Medicine

Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome

https://doi.org/10.1016/j.ypmed.2006.11.016Get rights and content

Abstract

Objective

To evaluate the association between physical activity, sleeping hours, alcohol intake and smoking and metabolic syndrome.

Methods

Social, demographic, personal and family medical histories and behavioral characteristics were collected as self-reported for 2164 participants (1332 women; 832 men), aged 18–92 years old, randomly selected during 1999–2003, among residents in Porto, Portugal, evaluated in the Department of Epidemiology of Porto Medical School. Metabolic syndrome was defined according to the NCEP-ATPIII. Associations between metabolic syndrome and lifestyles factors were computed as odds ratios (OR) and 95% confidence intervals (95% CI).

Results

After adjustment, higher total physical activity (OR = 0.63 95% CI%: 0.43, 0.94—females; OR = 0.55 95% CI: 0.33, 0.91—males) and work activity levels in females (OR = 0.55; 95% CI: 0.33, 0.91) were significantly associated with lower prevalence of the metabolic syndrome. More sleeping hours were positively associated with metabolic syndrome (OR = 1.25; 95% CI: 1.13, 1.38–females; OR = 1.19; 95% CI: 1.04, 1.36—males).

Regarding smoking, the only statistically significant association was found in women that smoked less than 10 cigarettes per day (OR = 0.32 95% CI: 0.11, 0.92).

No statistically significant association was found between ethanol intake and metabolic syndrome.

Conclusions

An association between decreased physical activity, increased sleeping hours and metabolic syndrome was found. No association was found between cigarette smoking, alcohol intake 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.

References (47)

  • M. Vernay et al.

    Alcohol consumption and insulin resistance syndrome parameters: associations and evolutions in a longitudinal analysis of the French DESIR cohort

    Ann. Epidemiol.

    (2004)
  • N.J. Wareham et al.

    Cigarette smoking is not associated with hyperinsulinemia: evidence against a causal relationship between smoking and insulin resistance

    Metabolism

    (1996)
  • R. Wolk et al.

    Sleep and cardiovascular disease

    Curr. Probl. Cardiol.

    (2005)
  • S. Zhu et al.

    Lifestyle behaviors associated with lower risk of having the metabolic syndrome

    Metabolism

    (2004)
  • K. Andersson et al.

    Systemic nicotine stimulates human adipose tissue lipolysis through local cholinergic and catecholaminergic receptors

    Int. J. Obes. Relat. Metab Disord.

    (2001)
  • N.T. Ayas et al.

    A prospective study of self-reported sleep duration and incident diabetes in women

    Diabetes Care

    (2003)
  • S. Bertrais et al.

    Sedentary behaviors, physical activity, and metabolic syndrome in middle-aged french subjects

    Obes. Res.

    (2005)
  • N.G. Boule et al.

    Effects of exercise training on glucose homeostasis: the HERITAGE Family Study

    Diabetes Care

    (2005)
  • G. Burazeri et al.

    Over 8 hours of sleep-marker of increased mortality in Mediterranean population: follow-up Population Study

    Croat. Med. J.

    (2003)
  • S.R. Coughlin et al.

    Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome

    Eur. Heart J.

    (2004)
  • Diabetes Prevention Program Research Group

    Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin

    N. Engl. J. Med.

    (2002)
  • L. Djousse et al.

    Alcohol consumption and metabolic syndrome: does the type of beverage matter?

    Obes. Res.

    (2004)
  • Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults

    Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

    JAMA

    (2001)
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