The Relationships Between Lifestyle Behaviors, Health Perceptions, and Psychosocial Outcomes of Metabolic Syndrome Severity.

Purpose: The prevalence of metabolic syndrome (MetS) continues to increase. The severity of MetS can be defined by the number of components or, more recently, a continuous MetS severity score (MetSSS). However, studies that examine lifestyle factors predictive of MetS severity, in general, are lacking. This study aims to compare lifestyle behaviors (eg, physical activity and diet), health perceptions (eg, overall and mental health perceptions), and psychosocial outcomes (eg, perceived stress and social support) among people with a varied number of MetS components and to evaluate associations with MetSSS.

Patients and methods: This cross-sectional study utilized baseline data from a randomized controlled trial of 618 participants with MetS recruited from 5 different sites across the US We collected data using accelerometers, standard questionnaires, bloodwork, and doing physical measurements. We used a series of separate linear regression models (unadjusted and adjusted) to evaluate differences in lifestyle behaviors, health perceptions, and psychosocial factors between people with 3, 4, and 5 MetS components. We conducted additional linear regression models (unadjusted and adjusted) to assess the association between these same variables and a continuous MetSSS.

Results: Lifestyle behaviors, health perceptions, and psychosocial factors were not different among people with 3, 4, and 5 MetS components. However, in the adjusted models, a lower MetSSS was associated with more average daily steps (β = -631.69, p < 0.001), healthier overall health perception (β = -0.14, p = 0.014), more social support for physical activity from friends (β = -0.89, p = 0.011) and more social support for healthy eating from friends (β = -0.42, p = 0.015).

Conclusion: The MetSSS was shown to be more sensitive to modifiable lifestyle factors compared to the number of MetS components, indicating the importance of using the MetSSS in lifestyle interventions targeting MetS to achieve MetS remission.