Background. Nonpharmacologic management of hypertension is an important strategy in treating people with hypertension, but little is known about patter

Churilla, JR, Summerlin, M, Richardson, MR, and Boltz, AJ. Mean combined relative grip strength and metabolic syndrome: 2011–2014 National Health and Nutrition Examination Survey. J Strength Cond Res 34(4): 995–1000, 2020—The purpose of this study was to examine the relationships among mean combined relative grip strength (MCRGS), the metabolic syndrome (MetS), and the individual MetS criterion using a nationally representative sample of U.S. adults (≥20 years of age). The study sample included subjects from the 2011–2014 National Health and Nutrition Examination Study (NHANES). Subject MCRGS, using an average of 3 attempts per hand, was measured by a trained examiner using a handgrip dynamometer. All anthropometric, blood pressure, and serum blood measures used to diagnose the MetS were obtained in a Mobile Examination Center using a subsample of NHANES subjects (N = 4,664). Results suggest a favorable inverse dose–response relationship exists across quartiles of increased MCRGS and likelihood of MetS in both men and women (p < 0.0001 for trend). In analyses adjusted for age, race, education, and meeting aerobic physical activity recommendations, when compared with a referent group in the lowest quartile of MCRGS (MCRGS <2.66 kg/body mass index [BMI] in men; MCRGS 3.20–3.77 kg/BMI in men; MCRGS >1.99–2.38 kg/BMI in women) and fourth quartile (MCRGS >3.77 kg/BMI in men; MCRGS >2.38 kg/BMI in women), were significantly less likely to have the MetS, independent of gender (p ≤ 0.05 for all). Similar findings varied according to individual MetS criterion. These findings provide the first data suggesting that increased MCRGS may be inversely related to the MetS or the individual MetS criterion in a nationally representative sample of U.S. adults.

Purpose: To examine the relationship between leisure-time physical activity (LTPA) and the metabolic syndrome in the U.S. adult population. Methods: The sample (N=5,620) in this cross-sectional study included adults aged 20 years and older. Physical activity was measured in two ways: a six-level measure based upon those reporting no LTPA and quintiles of LTPA, and a three-level categorical measure, according to participants who were found to be inactive, insufficiently active, and those meeting the current public health PA recommendation. SAS and SUDAAN were used for the statistical analysis. Results: When utilising the AHA/NHLBI criteria, adults acquiring between 736 and 1,360 MET·minutes per week (MET·min·wk^-1) of LTPA were found to be 35% (OR 0.65; 95% CI 0.48, 0.88) less likely to meet the metabolic syndrome diagnosis criteria compared with those reporting no LTPA. However, protection (OR 0.70; 95% CI 0.51, 0.96) started earlier when utilising the WHO criteria (393—737 MET·min·wk^-1). Significant inverse associations (OR 0.54; 95% CI 0.44, 0.66) and (OR 0.61; 95% CI 0.48, 0.77) for WHO and AHA/NHLBI criteria respectively, were also found for the metabolic syndrome when examining LTPA by the current public heath PA recommendation. In addition, the overall age-adjusted prevalence of the metabolic syndrome among U.S. adults was estimated to be 21.9% and 36.3% for the WHO and AHA/ NLHBI definitions respectively. Conclusion: Our findings estimate that adults engaging in a level of LTPA similar to the current public health recommendation may have a decreased risk of developing the metabolic syndrome. Also, depending on the definition used, between one in three and one in five U.S. adults are estimated to have the metabolic syndrome.

Background: This study examined the association of total physical activity volume (TPAV) and physical activity (PA) from three domains [leisure-time physical activity (LTPA), domestic, transportation] with metabolic syndrome. We also investigated the relationship between LTPA intensity and metabolic syndrome risk. Methods: Sample included adults who participated in the 1999–2004 National Health and Nutrition Examination Survey. Physical activity measures were created for TPAV, LTPA, domestic PA, and transportational PA. For each, a six-level measure based upon no PA (level 1) and quintiles (levels 2–6) of metabolic equivalents (MET)·min·wk⁻¹ was created. A three-level variable associated with the current Department of Health and Human Services (DHHS) PA recommendation was also created. SAS and SUDAAN were used for the statistical analysis. Results: Adults reporting the greatest volume of TPAV and LTPA were found to be 36% [odds ratio (OR) 0.64; 95% confidence interval (CI) 0.49–0.83] and 42% (OR 0.58; 95% CI 0.43–0.77), respectively, less likely to have metabolic syndrome. Domestic and transportational PA provided no specific level of protection from metabolic syndrome. Those reporting a TPAV that met the DHHS PA recommendation were found to be 33% (OR 0.67; 95%; CI 0.55–0.83) less likely to have metabolic syndrome compared to their sedentary counterparts. Adults reporting engaging in only vigorous-intensity LTPA were found to be 37% (OR 0.63; 95 CI 0.42–0.96) to 56% (OR 0.44; 95% CI 0.29–0.67) less likely to have metabolic syndrome. Conclusions: Volume, intensity, and domain of PA may all play important roles in reducing the prevalence and risk of metabolic syndrome.

Despite the accepted health consequences of obesity, emerging research suggests that a significant segment of adults with obesity are metabolically healthy (MHO). To date, MHO individuals have been shown to have higher levels of physical activity (PA), but little is known about the importance of PA domains or the influence of weight history compared to their metabolically abnormal (MAO) counterpart. To evaluate the relationship between PA domains, PA guideline adherence, and weight history on MHO. Pooled cycles of the National Health and Nutritional Examination Survey (NHANES) 1999–2006 (≥20 y; BMI ≥ 30 kg/m2; N = 2,753) and harmonized criteria for metabolic syndrome (MetS) were used. Participants were categorized as “inactive” (no reported PA), “somewhat active” (>0 to < 500 metabolic equivalent (MET) min/week), and “active” (PA guideline adherence, ≥ 500 MET min/week) according to each domain of PA (total, recreational, transportation and household). Logistic and multinomial regressions were modelled for MHO and analyses were adjusted for age, sex, education, ethnicity, income, smoking and alcohol intake. Compared to MAO, MHO participants were younger, had lower BMI, and were more likely to be classified as active according to their total and recreational PA level. Based on total PA levels, individuals who were active had a 70 % greater likelihood of having the MHO phenotype (OR = 1.70, 95 % CI: 1.19–2.43); however, once stratified by age (20–44 y; 45–59 y; and; ≥60 y), the association remained significant only amongst those aged 45–59 y. Although moderate and vigorous PA were inconsistently related to MHO following adjustment for covariates, losing ≥30 kg in the last 10 y and not gaining ≥10 kg since age 25 y were significant predictors of MHO phenotype for all PA domains, even if adherence to the PA guidelines were not met. Although PA is associated with MHO, the beneficial effects of PA may be moderated by longer-term changes in weight. Longitudinal analysis of physical activity and weight change trajectories are necessary to isolate the contribution of duration of obesity, PA behaviours, and longer-term outcomes amongst MHO individuals.