Physical Activity and Healthy Eating Prevent Metabolic Syndrome, Study Finds

Past studies have shown that either physical activity or a healthy diet can help lower the risk of developing metabolic syndrome (MetS). But a new study published in Journal of the American Heart Association wanted to see if the combination of physical activity and a healthy diet pattern could have a synergistic effect on lowering the risk for MetS. 

Metabolic syndrome (MetS) is a grouping of five conditions that can lead to heart disease, type 2 diabetes, stroke and other chronic conditions.

MetS is diagnosed if someone has three or more of these five risk factors:

• High blood sugar levels
• Low HDL (good) cholesterol levels
• High triglyceride levels
• Large waist circumference
• High blood pressure

Studies show that healthy lifestyles can help manage these conditions and slow the progression towards MetS. Getting enough physical activity and eating and healthy, balanced diet are recommended for the prevention of MetS at all ages.

In this new study, researchers looked at how Americans who adhere to the Physical Activity Guidelines (PAG) for Americans and the Dietary Guidelines for Americans (DGA) fare with MetS both now and in later life.

They were also curious whether adhering to both the PAG and DGA in midlife would have a synergistic effect on heart health in later life.

The Study Explained

This study utilized the comprehensive Framingham Heart Study database and looked at 2,379 participants with a mean age of 47 years.

Researchers gathered data on how closely the participants adhere to the following guidelines:

• The 2018 PAG: For heart disease prevention, the PAG recommends a weekly minimum of 150 minutes of moderate‐to‐vigorous physical activity for adults age 18+. In the study, adherence to the PAG was measured as ≥150 min/week of physical activity. 
• 2015 DGA: To prevent chronic disease, the DGA suggest adhering to a high‐quality healthy dietary pattern. Participants were given a DGA Adherence score between 0-100, with higher scores showing higher diet quality. 

Data on physical activity was obtained by having participants wear an omni-directional accelerometer, which measures acceleration.

Dietary intake was measured using a food frequency questionnaire, which included questions about the intake of 150 food items over a one year time frame.

What Did the Study Find?

The researchers found that about half of participants got ≥150 minutes of physical activity per week, and the average DGA score was 61 (out of 100).

In total, 28 percent of participants met both the physical activity recommendation of the DAG and adhered to the dietary guidelines.

In follow-up over eight years, about 18 percent of participants developed MetS. The researchers noted that those who met the PAG and had higher adherence to the DGA had lower odds of developing MetS, both at the time of the study and in the eight years of follow up.

Using statistical analysis, the researchers noted that every 10 minutes of exercise per day or every 10‐point increase in DGA adherence was associated with 18-19% lower odds of prevalent MetS.

The researchers say that they observed a 52 percent lower risk of MetS in individuals who adhered to both guidelines compared with those who don’t follow the guidelines.

The study concluded that adhering to either the DAG and DGA was individually associated with lower odds of prevalent MetS, but adhering to both guidelines was associated with the lowest odds of MetS.

“Regarding the results of the study, it is exactly what I would expect to see,” says dietitian and personal trainer Emma Backes, of Saint Cloud, Minnesota.

 “Too often, people focus on exercise OR a healthy diet, but real changes are happening when people focus on exercise AND nutrition,” explains Backes.

The study supports the idea that maintaining both regular physical activity and a healthy diet in midlife can help protect heart health now and in later life.

One caveat: the study participants were all white individuals of European ancestry, which limits the ability to generalize the findings to other racial groups. Further studies are needed with a multi-ethnic sample.

Dietary Advice

The updated 2020-2025 DGA outlines a diet plan that includes an emphasis on nutrient-rich foods including vegetables, fruits, legumes, grains, calcium-rich options, protein foods and healthy oils.

Anthony DiMarino RD, a dietitian and certified personal trainer from Cleveland, OH says he helps his clients focus on moderation and making wise choices.

“I recommend that my clients follow a sensible, common sense meal plan,” says DiMarino.

In line with the DGAs, DiMarino focuses on vegetables, nuts/seeds, oils, whole grains, whole fruits, low-fat dairy products and lean meats.

“Individuals who are concerned with their heart health should limit food items high in sugars, salts, and saturated fats,” says DiMarino.

He cites examples including potato chips, candies, cookies, fried foods, and processed meats.

Stay Active

The PAG encourages adults to move more and sit less throughout the day.

Specifically, it recommends at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity aerobic physical activity, preferably spread throughout the week. Additional health benefits are gained by getting even more physical activity.

In addition to aerobic activity, such as walking, dancing or swimming, adults should also do muscle-strengthening activities at least twice a week.

“With my clients, I like to focus on the two-fold benefits of physical activity,” says Backes. “Physical activity can improve mental and physical well-being. I like to promote it as a form of self-care that can yield some awesome benefits.”

Backes tells clients that exercise is not an “all or nothing” idea, and even 20 minutes of movement is great on days when they cannot get in a full workout.

“I recommend clients complete 2-3 days of strength-based training along with cardio 2-3 as well,” says Backes. “I also promote stretching/yoga at least 1 day per week.” 

Di Marino recommends his clients find exercise that they enjoy and can do consistently. “We discuss their favorite movements and how they can implement them into their busy lives,” says DiMarino.