Impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study

doi:10.1016/S0002-8703(03)00442-3

American Heart Journal

Volume 147, Issue 1, January 2004, Pages 106-112

https://doi.org/10.1016/S0002-8703(03)00442-3 Get rights and content

Abstract

Background

Individuals with the metabolic syndrome (MS) are at high risk for coronary heart disease and may benefit from aggressive lifestyle modification. In this study, we evaluated the effect of leisure time physical activity (PA) and the Mediterranean diet (MD) on the prevalence of the MS.

Methods

The ATTICA study is a health and nutritional survey. On the basis of a multistage, random sampling, 1128 men and 1154 women (>18 years old) without any evidence of cardiovascular disease or diabetes mellitus were enrolled from the greater Athens area during 2001 to 2002. The MS was defined according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria. PA was determined from a detailed questionnaire and graded according to the kcal/min expanded. MD was assessed through a validated nutrient questionnaire.

Results

The overall prevalence of the MS was 453 of 2282 subjects (19.8%). Of these subjects, 284 (25.2%) were men and 169 (14.6%) were women (P <.001). The prevalence of the MS increased accordingly to age (P for trend <.001). With multiple logistic regression analysis, the odds ratio of having the MS when the participant consumed the MD was 0.81 (95% CI, 0.68–0.976), and when even a little to moderate PA (<7 kcal/min)was reported, the odds ratio was 0.75 (95% CI, 0.65–0.86). The higher levels of inflammation and coagulation markers among participants with MS did not explain much of the aforementioned effect of lifestyle modification.

Conclusion

MS is common in Greece and is becoming even more common in the middle-aged population. The suggested therapeutic lifestyle approach may contribute to the reduction of the prevalence of the MS, beyond the levels of several lipid, inflammation, and coagulation markers.

Section snippets

Study design

The ATTICA project is a health and nutrition survey that is being carried out in the province of Attica, Greece (including 78% urban and 22% rural areas), of which Athens is a major metropolis, during 2001 to 2002. The multistage sampling was performed on the basis of the city sex- and age-distribution, according to data provided by the National Statistical Service Census of 2000. The sampling was random, anticipated enrolling only 1 participant per household, and excluded all people living in

Epidemiology of the metabolic syndrome in the study population

The overall prevalence of the metabolic syndrome in our sample was 453 of 2282 participants (19.8%). Therefore, the odds of having the metabolic syndrome was, roughly, 1 in 4 or 24.6%. Of the 453 participants who met the ATP III criteria, 284 were men (25.2% of men) and 169 were women (14.6% of women; P for sex differences <.001). Most participants (78% of men and 74% of women) were unaware of their condition. An increasing trend of the prevalence of the metabolic syndrome was observed by age,

Discussion

We found that approximately 1 of 5 people met the ATP III criteria for the metabolic syndrome, whereas most of them (78% of men and 74% of women) were unaware of their condition. Furthermore, our findings suggest that even light-to-moderate physical activity and the adoption of the Mediterranean diet was associated with significantly lower odds of having the metabolic syndrome, after controlling for several potential confounders. Additionally, the prevalence of the syndrome seems to increase

Acknowledgements

We thank the filed investigators of ATTICA study.

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^☆: The ATTICA study was supported by research grants from the Hellenic Cardiological Society (HCS2002) and the Hellenic Heart Foundation (HHF2001-HHF2002).

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Clinical investigationImpact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study☆

Abstract

Background

Methods

Results

Conclusion

Section snippets

Study design

Epidemiology of the metabolic syndrome in the study population

Discussion

Acknowledgements

Am J Cardiol

Int J Cardiol

Nutrition

Am J Cardiol

Prev Med

Am J Clin Nutr

Lancet

Prevalence of the metabolic syndrome among US adultsfindings from the third National Health and Nutrition Examination Survey

JAMA

Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome

Am J Cardiol

Hypertriglyceridemia, insulin resistance, and the metabolic syndrome

Am J Cardiol

Clinical investigation
Impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study☆